The Sussex County Office of Public Health Nursing will offer the regular flu vaccine and the high-dose flu vaccine, which is recommended for people age 65 and older, at clinics this fall.
The cost of the flu vaccine is $25 per dose; the high-dose one costs $65 per dose. Only cash or checks are accepted.
Flu vaccines are free for people with Medicare Part B and any Blue Cross Blue Shield plan. Participants must bring their Medicare Part B and/or Blue Cross Blue Shield insurance card.
The Office of Public Health Nursing also offers flu vaccinations for residents who are homebound.
Clinics will be held during October. Call the Office of Public Health Nursing to schedule an appointment at 973-579-0570 ext. 1275.
Flu clinic schedule
Thursday, Oct. 26 at Sussex County Library Dorothy Henry Branch, 66 Route 94, Vernon, from 10 a.m. to noon.
Saturday, Oct. 28 at Sandyston Municipal Building, 133 Route 645, from 10 a.m. to noon.
SciCheck Digest
Small amounts of DNAfrom the manufacturing process may remain in the mRNA COVID-19 vaccines. Purification andquality control steps ensure any leftover DNA is present within regulatory limits. There isnt reason to think that this residual DNA would alter a persons DNA or cause cancer, contrary to claims made online.
How do we know vaccines are safe?
No vaccine or medical product is 100% safe, but the safety of vaccines is ensured via rigorous testing in clinical trials prior to authorization or approval, followed by continued safety monitoring once the vaccine is rolled out to the public to detect potential rare side effects. In addition, the Food and Drug Administration inspects vaccine production facilities and reviews manufacturing protocols to make sure vaccine doses are of high-quality and free of contaminants.
One key vaccine safety surveillance program is the Vaccine Adverse Event Reporting System, or VAERS, which is an early warning system run by the Centers for Disease Control and Prevention and FDA. As its website explains, VAERS is not designed to detect if a vaccine caused an adverse event, but it can identify unusual or unexpected patterns of reporting that might indicate possible safety problems requiring a closer look.
Anyone can submit a report to VAERS for any health problem that occurs after an immunization. There is no screening or vetting of the report and no attempt to determine if the vaccine was responsible for the problem. The information is still valuable because its a way of being quickly alerted to a potential safety issue with a vaccine, which can then be followed-up by government scientists.
Another monitoring system is the CDCs Vaccine Safety Datalink, which uses electronic health data from nine health care organizations in the U.S. to identify adverse events related to vaccination in near real time.
In the case of the COVID-19 vaccines, randomized controlled trials involving tens of thousands of people, which were reviewed by multiple groups of experts, revealed no serious safety issues and showed that the benefits outweigh the risks.
The CDC and FDA vaccine safety monitoring systems, which were expanded for the COVID-19 vaccines and also include a new smartphone-based reporting tool called v-safe, have subsequently identified only a few, very rare adverse events.
For more, see How safe are the vaccines?
Link to this
The COVID-19 vaccines made by Pfizer/BioNTech and Moderna areproducedwith help from DNA templates, which include instructions for making the mRNA that encodes the spike protein. Manufacturers take steps topurifythe final vaccine components, cutting up and removing the DNA, although there could be a very small amount of DNA left.
Past research and mechanistic logic indicate that any DNA remaining after these purification and quality control steps is likely inconsequential. However, in recent months unsubstantiated theories have spreadonlinethatDNA remaining inmRNAvaccines couldintegrate into a persons ownDNA and cause cancer, or even that the vaccines are already causing cancer.
A spokesperson from the U.S. Food and Drug Administration told us in an email that no safety concerns related to residual DNA have been identified. The spokesperson added that with regard to the mRNA vaccines, while concerns have been raised previously as theoretical issues, available scientific evidence supports the conclusion that the minute amounts of residual DNA do not cause cancer or changes to a persons genetic code.
A spokesperson for the European Medicines Agency which helps regulate medical products in the European Union told us via email that the agency can confirm that we have not seen any reliable evidence of residual DNA exceeding approved/safe levels for the Pfizer/BioNTech or Moderna COVID-19 vaccines. Nor is the EMA aware of scientific evidence showing that the very small amounts of residual DNA that may be present in vaccine batches could integrate into the DNA of vaccinated individuals, the spokesperson continued.
Various experts also told us that it is unlikely that residual DNA in the vaccines could integrate into DNA or cause cancer, even in theory. And as we have previouslywritten, there isntevidenceto date that the vaccines cause cancer or have led to an increase in cancer.
Marc Veldhoen, an immunologist at the Instituto de Medicina Molecular Joo Lobo Antunes in Portugal, told us via email that residual DNA would be expected, but he refuted the idea that it could cause cancer. Yes, there would be some fragments, but within the limit this is allowed and without any clinical consequence, he said.
This family of claims was originally inspired by a preprint posted in April, which said there was DNA contamination that exceeds the EMA and FDA regulatory limits in Moderna and Pfizer/BioNTech vaccine vials sent anonymously to the authors in the mail without cold packs. This led to other reports of DNA in mRNA vaccine vials, including a second preprint that analyzed largely expired vaccine vials obtained at pharmacies in Canada.None of this work has been published in peer-reviewed journals, and many elements of it have been criticized.
We reached out to Kevin McKernan, an author on both preprints, to better understand his views. Rather than replying to our email, he posted a screenshot of it on X, formerly known as Twitter, and included responses there. McKernan, who has an undergraduate degree in biology, is the founder of Medicinal Genomics, a company that markets test kits and genomics-related services to the cannabis, hemp and mushroom industries.
Some of the alleged concern has focused on the possibility, raised in the original preprint, that some of the residual DNA in the Pfizer/BioNTech vaccine is from a monkey virus called SV40. The EMA confirmed to us that the plasmid, or DNA template, used to make the Pfizer/BioNTech vaccine contains some short sections of DNA from this virus. A Pfizer spokesperson also told us via email that specific, non-infectious parts of the SV40 sequence, which are commonly used in the pharmaceutical industry are present in starting material used by Pfizer and BioNTech.
But none of the sequences identified in the preprint are known to cause cancer, contrary to recent social mediapoststhatsay SV40, a cancer causing sequence was put in the Covid Vaccine.
Experts say there isnt reason to think that any small pieces of leftover DNA, including SV40 DNA, in the vaccines would be harmful.
It is very unlikely that any residual DNA would integrate into a persons genome and if it did it would be even much less likely to cause cancer, Barry Milavetz, a molecular biologist who studies SV40 at the University of North Dakota, told us in an email.
Reports of residual DNA in the mRNA COVID-19 vaccines and its purported dangers spread further after a Sept. 12 South Carolina Senate committeelistening session. One speaker, molecular biologist and cancer geneticistPhillip Buckhaultsfrom the University of South Carolina, sharedhis ownfindings that DNA pieces were present in leftover vaccine in the bottom of used Pfizer/BioNTech vials.
In hispresentation, which was shared widely online, he said that DNA can and likely will integrate into the genomes of peoples cells, and he shared concerns about various potential health impacts, including cancer. As weve said, other experts and regulatory agencies disagree that residual DNA is likely to integrate into a persons own DNA.
It was surprising to me to see any DNA in this product, and I am a bit concerned about the theoretical possibility of genome modification, Buckhaults told us in an email. I want the scientific community to help find out if this is a real hazard or not a problem.
He also said that he did not intend for his comments to be widely circulated in the public and compromising peoples confidence in vaccines.
Another widely posted clip from the listening session was of Janci Lindsay, who runs a toxicology consulting firm and has a history ofsharingincorrectinformationabout vaccines and COVID-19. She also spoke about unsubstantiated cancer risks andtoldthe lawmakers that she believes the SV40 DNA sequences were included in the vaccines with nefarious intent. The idea that the presence of these sequences is nefarious is a conspiracy theory with no basis in reality.
Lindsay goes on to reference hydroxychloroquine and ivermectin, falsely concluding, We never needed these vaccines. We had treatments that worked. This is incorrect. The COVID-19 vaccines saved many lives, and randomized controlled trials have shown that hydroxychloroquine and ivermectin do not help people recover from COVID-19.
FactCheck.org obtained a copy of an Oct. 16 letter sent to the Senate committee by Pfizer. In the letter, Pfizer disagrees with comments made during the session, saying that statements are incorrect that the vaccine contains plasmid DNA that could potentially impact a persons DNA and be a theoretical cancer risk. The letter continues, There is no evidence to support these claims and they provide the risk of being misconstrued by either Committee members and/or the public at large.
The letter also states that no signs of DNA mutation or COVID-19 vaccine-induced cancer have been reported to date related to the Pfizer/BioNTech COVID-19 vaccine.
Research into residual DNA in vaccinesdates back decades. Anti-vaccine fear-mongering aboutresidual DNAor other substances invaccinesis also not a new phenomenon.
Many currently available vaccines are made using cells. Some vaccines, such as the one againstchickenpox, rely on weakened virus that is grown in cells. For other vaccines, such as forhepatitis A, viruses are grown in cell culture and then inactivated. Cells also can be used to produce protein-based vaccines. One example is the COVID-19 vaccine fromNovavax, which is grown in moth cells.
In all of these cases, the active ingredients for the vaccines are purified, but thevaccinescan stillcontainsmallamountsofresidual DNAfrom thecellsused to make them. The FDA and other regulatory agencies have offeredguidanceon limiting the quantity and size of residual DNA left over from cells used to make vaccines.
The limits are based on thetheoretical concernthat residual DNA specifically from mammalian cell lines could cause cancer or a viral infection, particularly if there were a cancer-causing gene or certain viral DNA present in the cell line. But Dr. Paul Offit, director of the Vaccine Education Center at Childrens Hospital of Philadelphia, told us that regulatory limits on residual DNA in vaccines are set conservatively.
Pfizers letter to the South Carolina Senate committee refers to a quality control process that ensures that residual DNA levels in its mRNA vaccine for COVID-19 are within regulatory limits.
The validated method for assessment of residual DNA has shown that the Pfizer-BioNTech COVID-19 vaccine meets the requirements of the World Health Organization (WHO) and the FDA for biological products, the letter states. Vaccine batches are only certified and released if the criteria, during quality control testing, are met using the validated and approved method.
The EMA spokesperson added that in the European Union, these results must be checked by an independent laboratory. As a result, we are confident that the DNA levels in the vaccine are consistently below the approved/safe level, the spokesperson said.
A spokesperson from the Therapeutic Goods Administration, which regulates medical products in Australia, told us that the agency has been monitoring batches of Moderna and Pfizer/BioNTech mRNA COVID-19 vaccines. This includes independent testing performed by the TGA laboratories to confirm that residual DNA impurity levels arebelow the acceptable limit, the spokesperson told us in an email. To date all batches of COVID-19 vaccines supplied in Australia have met all quality specifications.
Research on experimental DNA vaccines, which contain DNA as their active ingredient, also supports the idea that DNA in vaccines is unlikely to integrate into a persons DNA. Stephen M. Kaminsky, a professor of research in genetic medicine at Weill Cornell Medical College, told us via email that there is little concern of integration from DNA vaccines that are delivered in much greater quantities than any residual DNA that might be found in one of the mRNA vaccines for COVID-19.
Since amounts of DNA vaccines in the milligram range have been approved for clinical evaluation, it is difficult to imagine that the smaller quantities of residual cell-substrate DNA present in viral vaccines would pose a significant risk due to integration, FDA scientists also concluded in onepaper.
The FDA scientists went on to state that they consider the primary cancer-related concern with DNA in vaccines to be the introduction of an activated version of a cancer-causing gene to a cell not just any DNA integrating into the genome at the wrong place.
Offit added that we are constantly exposed to DNA, including in the food we eat and from viruses that dont cause cancer.
Experts told us that theories for how residual DNA would cause cancer rely on an entire series of events, many of them unlikely.
As weve discussed above, changing a persons DNA is not easy. The residual DNA would first need to get into a cell. This could happen if the DNA was inside one of the fatty bubbles called lipid nanoparticles used to package the mRNA in the vaccines, Veldhoen, the immunologist in Portugal, said. But even if this happened, the DNA would only end up in the cytoplasm, the region of a cell outside the nucleus.
Next, any residual DNA that made it into a cell would need to get access to a persons DNA in the nucleus and insert itself. In general, a cell needs to be in the process of dividing for foreign DNA to integrate into the cells own DNA.
The mRNA vaccines are injected into the muscles, where the bulk of the vaccine remains. Muscle cells do not divide rapidly and have lots of cytoplasm compared to the size of their nuclei, Milavetz, the molecular biologist at the University of North Dakota, said. This means that it is very unlikely that any residual DNA from a vaccine introduced to the cytoplasm of a cell will make it into the nucleus and insert itself into the DNA there in the first place, he added.
Even if it enters the nucleus, which it probably cant, it would still have to be integrated into DNA, which requires an integrase, which it also doesnt have, Offit said. An integrase is an enzyme some viruses use to insert themselves into cellular DNA.
In the event that some residual DNA did manage to insert into a persons DNA, it would need to be exactly the wrong kind of DNA, land in exactly the wrong place or a combination of the two.
And then, if this entire sequence of events occurred in one of a persons trillions of cells, the cell would need to avoid destruction by the immune system, divide and give rise to other cells, which would need to continue along the path toward becoming cancerous.
In reality, the immune system can detect when cells take up foreign DNA or mRNA, Veldhoen said. In the end, cells that had taken up residual DNA would not survive, he said, and the DNA bits would be broken down, its individual parts recycled.
As weve said, social media posts misleadingly refer to the presence of SV40, a cancer causing sequence. This brings to mind past concerns, which were not borne out, that contamination of polio vaccines with the entire SV40 virus could cause cancer. Researchers discovered in 1960 that monkey kidney cells that had been used to produce some polio vaccines were contaminated with SV40, which was found to cause cancer in rodents. But the virus has not been shown to cause cancer in humans, and the contamination did not ultimately lead to more cancer in children who received the contaminated vaccines compared with those who didnt.
The small amount of SV40 DNA in the DNA template for the Pfizer/BioNTech vaccine does not encode the entire virus. SV40 is a naturally occurring virus and the virus itself is not included in either starting materials, plasmid DNA, or in the final product of the Pfizer-BioNTech COVID-19 vaccine, the Pfizer spokesperson said.
McKernans original preprint did not indicate the presence of the whole virus or any DNA encoding viral proteins, but rather highlighted regulatory DNA. Regulatory DNA, including a type of sequence called a promoter, helps control which genes in a cell are turned on.
Milavetz said that the portion of SV40 shown to have the potential for causing cancer in the lab encoding a protein called T-antigen is not among the sequences McKernan identified in the vaccine.
It is unclear why the Pfizer/BioNTech DNA template would include SV40 regulatory DNA. The EMA told us that the sequence is not directly relevant for producing copies of the DNA template or for producing mRNA for the vaccine, so it is considered to be a non-functional part of the structure of the source plasmid.
McKernan has suggested that a piece of SV40 regulatory DNA could cause cancer by integrating into a persons DNA and turning on a cancer-causing gene. In response to criticisms that its difficult for DNA to get into the nucleus, McKernan points toresearchshowing a role for part of that sequence in helping to bring DNA into the cell nucleus.
But its hardly clear that any nuclear entry mechanism would be at play in human cells exposed to residual DNA fragments. And as we have previously explained, there are multiple reasons why residual DNA is unlikely to integrate into a persons DNA.
Fragments of the SV40 sequence may only be present as residual impurities at very low levels that are routinely controlled, the EMA spokesperson said. There is no scientific evidence that any of these SV40 fragments can act as insertional mutagens, the spokesperson said, meaning there is no evidence the fragments would integrate into a persons DNA.
Buckhaults, who also found SV40 regulatory DNA in Pfizer/BioNTech vaccine vials, told us thebits of SV40 DNA arent any more dangerous than all the other bits of DNA he found in the vaccine vials.
Milavetz pointed out the improbability of the SV40 regulatory sequence causing cancer, even if it did somehow integrate into a persons DNA.
He said that any residual DNA present would be unlikely to contain only the SV40 sequence needed to turn on a gene. There would likely be extra chunks of DNA that would prevent it from functioning.
For this to be a viable problem only critical portions of the promoter would have to be introduced into the regulatory region of only a very small subset of genes in a human in a very specific way, he said. In my opinion there are too many things that would have to occur perfectly for the promoter to be integrated into one of these critical human genes.
Various posts also reference a change in the DNA template used to produce the Pfizer/BioNTech vaccine between the clinical trials and the rollout of the vaccine to the general public. To make the vaccine supply that was primarily used in the clinical trials, manufacturers produced copies of the DNA template using a process called PCR, in which DNA is amplified in a lab without the help of biological organisms. To help scale up production, manufacturers enlisted bacteria to make many copies of a plasmid, a circular piece of DNA. The bacteria divide rapidly and can make large quantities of DNA.
Based on this process change, social media posts have said that the Pfizer covid vaccine approved the for emergency use was not the same one used on the public! or posted the BREAKING news that Pfizers COVID vaccine that was approved for emergency use was not the same one they injected into billions of arms.
To be clear, the fact there was a process change has long been publicly available information. It is mentioned in the Pfizer clinical trial protocol, the emergency use authorization from the FDA and an EMA public assessment report first published in December 2020. The EMA spokesperson confirmed thatvaccine batchesproduced by both processes were tested in clinical studies, adding that the manufacturer provided test results and other information to show the comparability of the product resulting from both processes.This assessmentof comparability confirmed there was no meaningful difference in the quality of material from process 1 and process 2 that could impact the safety and/or efficacy of the vaccine, the EMA spokesperson said.
Editors note: SciChecks articles providing accurate health information and correcting health misinformation are made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.orgs editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation.
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Vesterberg, Jonas. Former MIT Lead Scientist Finds Monkey Virus DNA in COVID Vaccines. The Florida Standard. 1 Jun 2023.
Dr. Simon Goddek (@goddeketal). This new discovery of the presence of green monkey DNA, including tumor-linked viral promoters, in the jabs has this microbiologist and immunologist calling for an immediate halt in the use of mRNA vaccines. All perpetrators must be arrested immediately! X. 12 Jun 2023.
Mercola, Joseph. Monkey Virus DNA Found in COVID-19 Shots. The Epoch Times. Updated 20 Jun 2023.
momma exposing corruption (@free_spirit_momma). #educate #inform. Instagram. 30 Sep 2023.
Think Truth (@think_truth_). They always knew #Repost @ifyindulgeglobal. Instagram. 7 Oct 2023.
Barnett, Rebekah. Scientists Shocked and Alarmed at Whats in the mRNA Shots. The Spectator Australia. 25 Sep 2023.
Johnson, Mandi. IF THERES ONE THING YOU NEED TO WATCH TODAY ITS THIS.. #CanWeTalkAboutIt #RealNotRare . Facebook. 18 Sep 2023.
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DiedSuddenly (@DiedSuddenly_). Why was SV40, a cancer causing sequence, put in the Covid Vaccine? Because Cancer is the Medical Industrial Complexs #1 money maker. Now, 20 year olds are getting turbo cancer, and those who were once in remission have had their cancer come back 10x worse. It was all intentional. X. 20 Sep 2023.
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Experts urged results were preliminary and may be explained by other factors.
October 26, 2023, 5:18 AM ET
5 min read
Older adults who received last years COVID booster and a high-dose version of the flu vaccine in the same visit may have a potential increased risk of stroke, according to a new FDA-funded study.
Experts urged that the results were preliminary and may be explained by other factors such as the fact that older adults are already at a higher risk for stroke due to their age.
"There is no need for panic, and emphatically no need to stop giving COVID and flu shots at the same time to older adults," said Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, while he reiterated that more research is needed.
The results were also not yet peer-reviewed, meaning it hasn't been vetted in the normal scientific process.
"These data should be considered by patients and their physicians, but there is no reason for alarm. The increased risk of stroke appears to be small and must be balanced against the known benefit of these vaccines in elderly individuals," said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center.
Last year, health authorities noted a safety signal for ischemic stroke in adults over the age of 65 after receiving the bivalent COVID vaccine, prompting further research.
"Additional data are needed before we can consider these findings definitive. It is good that the FDA has made these safety data available to inform the public," Barouch said.
There was about a 20-35% increased stroke risk in older adults that received both shots in the same visits, according to the study.
"I dont know that the risk is very meaningful on an individual patient basis," said Dr. Amesh Adalja, an infectious disease specialist at the Johns Hopkins University Center for Health Security.
Infection from COVID and flu also have been shown to increase risk of stroke as well as a host of other life-threatening outcomes linked to respiratory illnesses like pneumonia, according to Chin-Hong.
The Food and Drug Administration told ABC News in part of a statement that they remain, "confident in the safety, effectiveness and quality of the COVID-19 vaccines that the agency has authorized and approved."
"The review conducted in this preprint paper is part of our ongoing safety surveillance efforts, which utilize a variety of data sources," the statement continued.
The Centers for Disease Control and Prevention reiterated that current vaccine guidance remains the same. "The COVID-19 vaccines meet the FDAs and CDCs very high safety standards. Hundreds of millions of people in the United States have safely received COVID vaccines under the most intense safety monitoring in U.S. history," the agency said in part of a statement.
Experts reiterated patients should turn to their health care provider to learn about the benefits and potential risks of vaccination. Older adults choosing to get both the flu and COVID shot at the same time for convenience or in two separate visits are both reasonable decisions, Adalja explained.
"For now, I will not dissuade my mom from getting both the high dose flu shot or the COVID shot, even at the same time," Chin-Hong said.
"Ultimately we need ongoing data in other countries and in future years to inform best practice," he added.
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After several attempts by Republicans to rein in COVID-19 vaccine mandates by Texas employers, lawmakers are edging closer to a statewide ban on the practice after legislation won House approval early Thursday.
Violators would be subject to a whopping $50,000 fine under an amendment adopted by the Texas House. The bills sponsor called it the strongest such ban in the country.
This bill is not about infringing on employers ability to protect their employees in the workplace. And this bill is not about what vaccines are good or bad, or what vaccines someone should or should not take, said state Rep. Jeff Leach, R-Plano, the bills House sponsor. This bill is instead about who should decide.
After debating the bill on Wednesday, the Texas House gave final approval to Senate Bill 7 on a 91-54 vote in the early hours of Thursday morning, with all Republicans in favor and most Democrats opposed, after a passionate debate on the merits and safety of the vaccine, the impact of employer mandates on Texas workers, the rights of private business owners vs. private individuals, whether to allow stronger exceptions for hospitals and doctors, and the bills impact on medically vulnerable populations.
The Texas Senate passed the legislation, authored by state Rep. Mayes Middleton, R-Galveston, last week, and the bill will go to a conference committee to work out changes made by the House. Abbott included the ban in his agenda for the special legislative session, which could last up to two more weeks.
SB 7 would ban private businesses from requiring employees and contractors to get the COVID vaccine.
Health care facilities would be allowed to require unvaccinated employees and contractors to wear protective gear, such as masks, or enact other reasonable measures to protect medically vulnerable patients.
The same allowances could also be true for other private employers under the bill, lawmakers on both sides of the debate said, although its not as clearly laid out for that group. The legislation only prohibits actions taken against an unvaccinated employee that the Texas Workforce Commission considers to be punishing or otherwise adversely affects the employee.
Enforcement would be handled through employee complaints to the commission, with violators subject to a fine of $50,000 in the House version or anywhere from $1 to $10,000 in the Senate bill and potential lawsuits by the Texas attorney general to prevent further violations.
The commission also has the power to refer cases to district courts for criminal action, and could also do so under this legislation, although the bill does not create any new crimes or grounds for lawsuits.
House supporters said the bill was needed to protect the rights of individuals to make their own health care decisions without negative consequences to their livelihoods. They also extended the bills protections to nursing and medical students, volunteers and unpaid interns who work in those facilities but may not be considered employees.
I believe very strongly that that decision as to whether to get an immunization should be a very personal decision in conjunction with someones doctor and informed by medical expertise, informed by deeply held personal values, Leach said. This bill protects employees' rights to not be vaccinated and maintain their ability to work and apply for jobs.
Opponents argued that the ban would handcuff the ability of health care professionals to impose vaccine policies that lower the risk of viral spread for their patients. Supporters batted away attempts by Democrats to exclude health care and child care facilities from the ban.
This is about protecting your most vulnerable constituents, your most vulnerable family and friends, said state Rep. Chris Turner, D-Arlington, a public relations consultant.
Some critics said the bill also would infringe on the rights of business owners to make their own policy decisions.
Some lawmakers also said they were concerned that business owners could be subject to expensive legal and administrative costs for trying to enact other measures to protect their employees. The bill is vague on what those parameters might be.
Rep. Rafael Anchia, a Dallas Democrat who runs a real estate investment firm, sought to amend the bill to include a list of what private employers would be allowed to do in lieu of a vaccine mandate, such as requiring unvaccinated employees to work from home, change offices or wear personal protective gear.
Employers are going to have to react to it and come up with interventions for their employees to keep them safe while at the same time following the tenets of this bill, Anchia said. Its important that we give them clear guidelines.
Leach said employers would likely be able to require unvaccinated employees to wear protective gear much like health-care institutions are allowed to do under the bill but he declined to list specific measures that ultimately would be allowed.
Leach said it wasnt up to lawmakers to draw those lines, adding that the workforce commission would judge each case separately.
Employers can still protect their employees, he said. Someone should not be fired for deciding not to take the vaccine.
Anchias amendment failed.
Texans lived for three years under a statewide COVID-19 emergency declaration, which Abbott maintained in spite of pushback from his party. He promised to lift it only after lawmakers had codified his executive orders that prohibited local COVID restrictions.
During the regular session, lawmakers obliged by prohibiting local governments from requiring masks, vaccines or business shutdowns in response to COVID-19. That law went into effect Sept. 1. Efforts to extend the ban to private businesses, however, fell short.
Abbott ended the emergency declaration over the summer, which the bills supporters say triggered a critical need to protect workers who did not want to be vaccinated against the virus.
The issue triggered a highly personal and extremely bitter battle among House Republicans on social media in late August.
Midlothian Republican state Rep. Brian Harrison publicly slammed House Calendars Committee Chair Dustin Burrows, R-Lubbock, and House Speaker Dade Phelan, a Beaumont Republican, for allowing his bill banning all vaccine mandates to die without a floor vote during the regular session in May.
Harrison continued his drumbeat the day before floor debate on the bill, which he did not co-sponsor.
While #Txlege House leadership has PROTECTED #covid vaccine mandates for over two years... the Texas Senate has repeatedly passed bills to ban them, he wrote on social media.
Harrison was chief of staff for the U.S. Health and Human Services Commission under then-President Donald Trump during Operation Warp Speed to accelerate the development and distribution of a COVID vaccine amid lockdowns at the start of the pandemic.
Burrows hit back hard with a series of posts calling Harrison a showpony who now pretends to care and a bureaucrat who spent his time in DC overseeing the shutting down of small businesses and ruining familys lives.
[Dr. Anthony] Fauci and Harrison lied, and people died, Burrows wrote. He didnt care enough to get out of his desk and try and get his bills passed. ... He just sounds like he cares on Twitter.
Leach, the sponsor of vaccine legislation that passed the House on Wednesday, joined the fray.
Brian you were the self-described Chief Architect of the unconstitutional COVID regime that robbed millions of Americans of their rights, freedoms and livelihoods, Leach wrote on X. You can do all the TV interviews you want but until you come clean and own the damage and destruction many of your policies caused to hard-working Americans, you cannot, will not and should not expect those hard-working Americans to trust you.
The battle drew in several Republicans at a time when the House GOP was already split over the impeachment of Attorney General Ken Paxton, with Harrisons allies calling Burrows and others Republicans in Name Only for attempting to remove Paxton over corruption allegations.
Paxton was eventually acquitted in the Senate and returned to office, escalating the tensions between the factions.
Harrison tried several times Wednesday to change the bill, and Leach at one point accused Harrison of trying to kill the bill with one of his amendments. The two traded indirect barbs during the debate. But the warring Republicans eventually voted together to pass the legislation.
Texans value freedom and liberty, and I truly believe you cannot have freedom without this, said Harrison, who voted for the bill.
A study of three hospitals in Chicago found that increased use of antibiotics at the outset of the COVID-19 pandemic was limited to COVID-19 patients, researchers reported yesterday in Infection Control & Epidemiology.
To determine differences in antibiotic use between COVID-19 and nonCOVID-19 patients, a team led by researchers from Rush University Medical Center analyzed electronic health record data from three tertiary acute-care hospitals covering the preCOVID-19 period (March to December 2019) and the COVID-19 period (March to December 2020). They stratified patients by COVID-19 status, calculated relative percentage differences in antibiotic use in COVID-19 versus nonCOVID-19 patients during the two periods, and also compared antibiotic use in nonCOVID-19 patients during the two periods.
Facility-wide antibiotic use for all antibiotics was significantly greater in COVID-19 patients compared with nonCOVID-19 patients in two of three hospitals during the COVID-19 period, and use of broad-spectrum agents for hospital-onset infections was significantly greater in COVID-19 patients versus nonCOVID-19 patients in all three hospitals during both the COVID-19 period (with relative increases of 73%, 66%, and 91% for hospitals A, B, and C, respectively) and the preCOVID-19 period (with relative increases of 52%, 64%, and 66% for hospitals A, B, and C, respectively).
In contrast, facility-wide antibiotic use for all antibacterial agents was significantly lower in nonCOVID-19 patients during the COVID-19 period versus the preCOVID-19 period (with relative decreases of 8%, 7%, and 8% in hospitals A, B, and C, respectively).
The study authors say the increased use of broad-spectrum antibiotics at the beginning of the pandemic "likely resulted from the diagnostic and therapeutic uncertainty in the context of high mortality rates," while reduced antibiotic use in nonCOVID-19 patients during that period could reflect both the durability of antimicrobial stewardship efforts and changes in inpatient populations.
"Elective procedures were deferred, admissions for less critical illnesses were reduced, and the most chronically ill patients who ordinarily would have been admitted for nonCOVID-19 indications may instead have been admitted with COVID-19," they wrote.
A cruise operator that failed to cancel a voyage from Sydney that led to a major COVID-19 outbreak was ruled negligent in its duty of care to passengers in an Australian class-action case Wednesday.Related video above: Cancer patient fights for cruise refundThe Ruby Princess ocean liner left Sydney on March 8, 2020, with 2,671 passengers aboard for a 13-day cruise to New Zealand but returned in 11 days as Australias borders were closing. COVID-19 spread to 663 passengers and claimed 28 lives.Passenger Susan Karpik was the lead plaintiff in the case against British-American cruise operator Carnival and its subsidiary Princess Cruises, the ship's owner.Federal Court Justice Angus Stewart ruled that Carnival had been negligent as defined by Australian consumer law by allowing the cruise to depart in the early months of the pandemic. He said Carnival had a duty to take reasonable care of her health and safety in regard to COVID-19.I have found that before the embarkation of passengers on the Ruby Princess for the cruise in question, the respondents knew or ought to have known about the heightened risk of coronavirus infection on the vessel and its potentially lethal consequences and that their procedures for screening passengers and crew members for the virus were unlikely to screen out all infectious individuals, Stewart said.Carnival had already experienced outbreaks on its cruises in the previous month aboard the Grand Princess off California and the Diamond Princess off Japan, the judge said.Carnival had failed to explain why it offered free cancellation for all cruises worldwide leaving from March 9 the day after the Ruby Princess departed and suspended all cruises on March 13, he said.To the respondents knowledge, to proceed with the cruise carried significant risk of a coronavirus outbreak with possible disastrous consequences, yet they proceeded regardless, Stewart said.Susan Karpik had sued Carnival for more than 360,000 Australian dollars ($230,000).However, she was only awarded her out-of-pocket medical expenses of AU$4,423.48 ($2,823.28) for reasons including that the judge did not accept she suffered from long COVID and that Carnival had refunded all the passengers fares.But she said she was happy with the outcome.I was very pleased with that finding. And I hope the other passengers are pleased with that finding too, she told reporters outside court.I hope the finding brings some comfort to them because theyve all been through the mill and back, she added.Her lawyer Vicky Antzoulatos said other passengers who suffered worse consequences from their sickness could expect larger payouts.While Susan Karpik's symptoms were relatively mild, her husband Henry Karpik spent two months in hospital and almost died from his infection.Susans husband was very catastrophically injured, so we expect that he will have a substantial claim, and that will be the same for a number of the passengers on the ship, Antzoulatos said.Each passenger will have to prove their claims unless Carnival agrees to settle, she said.Its been a long time coming and a very comprehensive victory for the passengers on the Ruby Princess, Antzoulatos said.Carnival Australia said in a statement it was considering the judgment in detail.The pandemic was a difficult time in Australias history, and we understand how heartbreaking it was for those affected, Carnival said.
A cruise operator that failed to cancel a voyage from Sydney that led to a major COVID-19 outbreak was ruled negligent in its duty of care to passengers in an Australian class-action case Wednesday.
Related video above: Cancer patient fights for cruise refund
The Ruby Princess ocean liner left Sydney on March 8, 2020, with 2,671 passengers aboard for a 13-day cruise to New Zealand but returned in 11 days as Australias borders were closing. COVID-19 spread to 663 passengers and claimed 28 lives.
Passenger Susan Karpik was the lead plaintiff in the case against British-American cruise operator Carnival and its subsidiary Princess Cruises, the ship's owner.
Federal Court Justice Angus Stewart ruled that Carnival had been negligent as defined by Australian consumer law by allowing the cruise to depart in the early months of the pandemic. He said Carnival had a duty to take reasonable care of her health and safety in regard to COVID-19.
I have found that before the embarkation of passengers on the Ruby Princess for the cruise in question, the respondents knew or ought to have known about the heightened risk of coronavirus infection on the vessel and its potentially lethal consequences and that their procedures for screening passengers and crew members for the virus were unlikely to screen out all infectious individuals, Stewart said.
Carnival had already experienced outbreaks on its cruises in the previous month aboard the Grand Princess off California and the Diamond Princess off Japan, the judge said.
Carnival had failed to explain why it offered free cancellation for all cruises worldwide leaving from March 9 the day after the Ruby Princess departed and suspended all cruises on March 13, he said.
To the respondents knowledge, to proceed with the cruise carried significant risk of a coronavirus outbreak with possible disastrous consequences, yet they proceeded regardless, Stewart said.
Susan Karpik had sued Carnival for more than 360,000 Australian dollars ($230,000).
However, she was only awarded her out-of-pocket medical expenses of AU$4,423.48 ($2,823.28) for reasons including that the judge did not accept she suffered from long COVID and that Carnival had refunded all the passengers fares.
But she said she was happy with the outcome.
I was very pleased with that finding. And I hope the other passengers are pleased with that finding too, she told reporters outside court.
I hope the finding brings some comfort to them because theyve all been through the mill and back, she added.
Her lawyer Vicky Antzoulatos said other passengers who suffered worse consequences from their sickness could expect larger payouts.
While Susan Karpik's symptoms were relatively mild, her husband Henry Karpik spent two months in hospital and almost died from his infection.
Susans husband was very catastrophically injured, so we expect that he will have a substantial claim, and that will be the same for a number of the passengers on the ship, Antzoulatos said.
Each passenger will have to prove their claims unless Carnival agrees to settle, she said.
Its been a long time coming and a very comprehensive victory for the passengers on the Ruby Princess, Antzoulatos said.
Carnival Australia said in a statement it was considering the judgment in detail.
The pandemic was a difficult time in Australias history, and we understand how heartbreaking it was for those affected, Carnival said.
Overview
This report and action plan summarize the proceedings and outcome of a 2-day Joint convening on COVID-19 vaccination in humanitarian settings and the contribution to broader pandemic preparedness held on 1415 February 2023 in Nairobi, Kenya.
The goal of the joint convening was to address the challenges encountered in implementing coronavirus disease (COVID-19) vaccination for populations of concern (PoCs) and to prepare for future pandemics. The convening was organized by the COVID-19 Vaccine Delivery Partnership (CoVDP) and key partners from the Africa Centres for Disease Control and Prevention, Gavi, the Vaccine Alliance, the Global Health Cluster (GHC), International Committee of the Red Cross (ICRC), International Council of Voluntary Agencies (ICVA), International Federation of Red Cross and Red Crescent Societies (IFRC), INTERSOS, Mdecins Sans Frontires (MSF), bilateral partners, and UN agencies.
It connected health and humanitarian agencies and other actors, and stakeholders discussed lessons learnt as well as concrete steps to enable equitable responses during pandemics in which those affected by humanitarian emergencies and in need of humanitarian assistance have access to public health and medical countermeasures (MCMs), such as vaccines, therapeutics and diagnostics that can be used to diagnose, prevent or treat diseases in pandemic
Certain gut-dwelling fungi flourish in severe cases of COVID-19, amplifying the excessive inflammation that drives this disease while also causing long-lasting changes in the immune system, according to a new study led by investigators at Weill Cornell Medicine and NewYork-Presbyterian. This discovery identifies a group of patients who may benefit from specialized but yet-to-be-determined treatments.
Utilizing patient samples and preclinical models, the research team determined that the growth of fungi in the intestinal tract, particularly strains of Candida albicans yeast, trigger an upsurge in immune cells whose actions can exacerbate lung damage. Their findings, published Oct. 23 in Nature Immunology, also elucidate that patients retain a heightened immune response and immune memory against these fungi for up to a year after the resolution of SARS-CoV-2 infection.
The research reveals a new dimension of the complex pathology unleashed by severe COVID-19, according to senior author Iliyan Iliev, associate professor of immunology in medicine in the Department of Medicine, co-director of the Microbiome Core Lab and a member of the Jill Roberts Institute for Research in Inflammatory Bowel Disease at Weill Cornell Medicine.
Severe and long COVID-19 were not thought to involve fungal blooms in the intestines that, in addition to the virus, can impact patients immunity, he said.
Iliev, an immunologist who studies the microbiome and the chronic inflammatory conditions targeting the gastrointestinal tract, pivoted to COVID-19 during the pandemic. As researchers gained a better handle on the new viral infections, it became clear that, in COVID-19 as in inflammatory bowel disease, the bodys own inflammatory immune response causes harm.
To investigate this errant immune response, Iliev and Takato Kusakabe, a postdoctoral fellow and a first author in the study, worked with numerous colleagues to acquire three large clinical cohorts of COVID-19 patients and develop a mouse model to study the disease. They collaborated with members of the Weill Department of Medicine and the Department of Pathology and Laboratory Medicine at Weill Cornell Medicine including Stephen Josefowitz, Dr. Mirella Salvatore, Dr. Melissa Cushing, Lars Westblade and Adolfo Garca-Sastre, a professor of microbiology and director of the Global Health and Emerging Pathogens Institute of the Icahn School of Medicine at Mount Sinai.
The team first made the connection when analysis of blood samples from patients at New York-Presbyterian/Weill Cornell Medical Center diagnosed with severe COVID-19 unveiled the presence of antibodies, tuned to attack fungi common to the gut. The researchers then found that populations of yeast, and one species in particular, Candida albicans, increased in the intestines of the patients during the course of severe COVID-19.
When they looked at the patients immune systems, the researchers found a parallel increase in immune cells called neutrophils. In severe COVID-19, excessive numbers of neutrophils appear in the lungs, where their activity worsens the inflammatory response already damaging these organs.
Turning to preclinical models, the investigators found that mice bearing fungi from patients with severe COVID-19 produced more neutrophils in their blood and lungs, and had signs of heightened inflammation when infected with SARS-CoV-2. However, giving them an antifungal drug reduced these effects.
From within patients blood samples, researchers also uncovered evidence of persistent changes to the immune system they believe are related to a condition known as long COVID-19, in which symptoms linger, or new ones develop, after an infection has cleared.
When the team examined patients blood up to a year afterward, they found it still contained anti-fungal antibodies. In addition, when they looked at the stem cells that give rise to neutrophils, the researchers found that these progenitors are primed to respond to fungi. They found that an immune protein called IL-6, which these fungi induce, appears to bolster both the neutrophils and the antibodies.
Further experiments showed that blocking IL-6 in the patients or in mice dampened this immunological memory, causing the presence of neutrophils and antibodies to wane.
While these results do not have immediate implications for treating severe or long COVID-19, they suggest new opportunities to tailor therapy, according to Iliev.For example, anti-fungal antibodies could potentially serve as a marker to identify patients who might benefit from a therapy that targets the fungi or the immunological changes they instigate.
Or, assuming further research supports it, the antibodies presence could indicate someone might be at risk for long COVID-19. The teams discoveries may also have relevance beyond COVID-19, said Iliev, who notes this research could open new avenues of exploration for the treatment of other infectious and inflammatory diseases.
This research was supported by grants from the National Institutes of Health, the Jill Roberts Institute for Research in Inflammatory Bowel Disease, the Leona M. and Harry B. Helmsley Charitable Trust, the Irma T. Hirschl Career Scientist Award, Crohns and Colitis Foundation, and the Burrough Welcome Trust PATH Award.
Many Weill Cornell Medicine physicians and scientists maintain relationships and collaborate with external organizations to foster scientific innovation and provide expert guidance. The institution makes these disclosures public to ensure transparency. For this information, see the profile for Dr. Melissa Cushing.
Wynne Parry is a freelance writer for Weill Cornell Medicine.
Urgent Need for Vaccination With the Newest COVID-19 Vaccine
The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices recently recommended vaccination with the COVID-19 vaccines that had been granted Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration (FDA) on Sept. 11. These EUAs were issued to Moderna and Pfizer for their new and updated mRNA COVID-19 vaccines to combat the increasingly prevalent new variant for which prior natural or acquired immunity does not confer protection.
In a commentary published in the American Journal of Medicine , researchers from Florida Atlantic Universitys Schmidt College of Medicine and collaborators provide the most updated guidance to health care providers.
The war on COVID-19 continues to be fought valiantly and selflessly by health care professionals in communities and hospitals across the nation., said Allison H. Ferris, M.D., senior author, chair of the Department of Medicine, and program director of the internal medicine residency program, FAU Schmidt College of Medicine. As competent and compassionate physicians, we must redouble our efforts to promote evidence-based clinical and public health practices, including vaccination of all eligible U.S. adults and children with the new vaccine."
A large body of reliable randomized evidence indicates that the benefits of COVID-19 vaccination on mortality and hospitalizations vastly outweigh the risk for all individuals aged 6 years and older. Moreover, vaccination of children eligible to receive the new COVID-19 vaccine will have major clinical and public health impacts by reducing their hospitalizations and deaths as well as those of their parents, grandparents, childcare providers and schoolteachers. While the absolute risks of severe COVID-19 are low in youths, the benefit to risk ratio is favorable toward vaccination.
In addition, COVID-19 vaccines are readily available and accessible with minimal out-of-pocket expenses. These favorable circumstances result from the collaborations between the pharmaceutical industry, the FDA, the CDC, as well as federal and private insurers. The updated COVID-19 vaccines are now readily available at most pharmacies, and sources can be accessed at Vaccines.gov. Health providers can reassure their patients that the Affordable Care Act mandates that insurance companies reimburse the cost for the updated vaccine for COVID-19 as well as all vaccines that are endorsed by the Advisory Committee on Immunization Practices. Further, the CDCs Bridge Access Program for both underinsured and uninsured patients from participating providers, health centers and pharmacies. In addition, uninsured children are covered by the Vaccines for Children Program.
In the face of continuing opposition to masking, social distancing and crowd avoidance in the U.S., vaccination is the best defense against a new emerging strain, said Charles H. Hennekens, M.D., Dr.P.H., co-author, and the first Richard Doll Professor and senior academic advisor to the dean in the Charles E. Schmidt College of Medicine at FAU. This approach coupled with a prescription of Paxlovid as needed during the first five days following infection will also further reduce hospitalizations and deaths.
Study co-authors are Sarah K. Wood, MD, FAAP, M.D., senior author, director of the Harvard Macy Institute at Harvard Medical School and former professor of pediatrics and vice dean for medical education, FAU Schmidt College of Medicine. Dennis G. Maki , M.D., Ovid O. Meyer professor of medicine, director of the COVID-19 Intensive Care Unit and an internationally renowned infectious disease clinician and epidemiologist from the University of Wisconsin School of Medicine and Public Health and Mia Glickman, second year medical student, FAU Schmidt College of Medicine.
Maki and Hennekens served together for two years as lieutenant commanders in the U.S. Public Health Service as Epidemic Intelligence Service (EIS) officers with the CDC. They served under Alexander D. Langmuir, M.D., who created the EIS and epidemiology program at the CDC, and Donald A. Henderson, M.D., chief of the virus disease surveillance program at the CDC. Langmuir and Henderson made significant contributions to the eradication of polio and smallpox using widespread vaccinations and public health strategies.
-FAU-
In a recent study published in the journalHypertension Research, researchers review the role of nuclear factor kappa B (NF-B) activation in the replication of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)and the impact of coronavirus disease 2019 (COVID-19)medications on NF-B activation.
Study:The role of SARS-CoV-2-mediated NF-B activation in COVID-19 patients. Image Credit: Avocado_studio / Shutterstock.com
SARS-CoV-2 infections exhibit substantial heterogeneity, with some infected individuals completely asymptomatic and others progressing to acute pneumonia that requires hospitalization and respiratory assistance. Severe SARS-CoV-2 infections have also resulted in various sequelae involving multiple organ systems.
However, the rapid development of various COVID-19 vaccines and subsequent global vaccination campaigns have been largely successful in reducing the spread and virulence of SARS-CoV-2. Currently, public health officials have transitioned from preventing SARS-CoV-2 infection to treating COVID-19 cases that arise following infection with new SARS-CoV-2 variants.
Various comorbidities, including hypertension, are known to increase the risk of severe COVID-19. Common hypertension medications include inhibitors of angiotensin-converting enzymes or angiotensin receptors; however, the role of the NF-B activation, particularly the angiotensin-converting enzyme 2 (ACE2)-mediated type, in the progression of COVID-19 has not been well-studied.
In the present review, researchers examine the changes associated with NF-B activation that occur during SARS-CoV-2 infections in the renin-angiotensin-aldosterone system (RAAS). Moreover, they discuss whether angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) used to treat hypertension can affect the severity of COVID-19.
The impact of COVID-19 medications on NF-B activation was also assessed to elucidate how these drugs regulate the uncontrolled inflammatory responses that are characteristic of SARS-CoV-2 infections.
NF-B is a major transcription factor that gets activated during inflammatory responses. NF-B is typically present in its inactivated form in the cytoplasm of cells, where it is bound to the inhibitor of nuclear factor kappa B (IB) suppressor protein.
The degradation of IB activates NF-B through different signaling pathways. The canonical pathway of NF-B activation leads to further activation of other factors, such as interleukin 1 receptor, tumor necrosis factor (TNF) receptors, and toll-like receptors, resulting in inflammatory and immune responses.
The non-canonical pathway does not require the degradation of IB. However, the phosphorylation of NF-B inducing kinase and the receptor activator of NF-B of B lymphocytes is essential for this process.
The abnormal activation of NF-B has been documented in various diseases, including diabetes, immune deficiency, atherosclerosis, and inflammatory diseases.
The ACE-2 receptor mediates the entry of SARS-CoV-2 into the host cell. In fact, the high affinity of the SARS-CoV-2 spike protein subunit 1 to the ACE-2 receptor is largely responsible for the high transmissibility of this virus.
However, ACE-2 also plays a pivotal role in the RAAS in regulating electrolyte balance and blood pressure. The binding of SARS-CoV-2 to ACE-2 could result in competitive inhibition of the catalytic activity of ACE-2, which could enhance the activation of NF-B.
The inflammatory imbalance that results from SARS-CoV-2 infection could lead to an increased susceptibility to inflammatory cytokine storm and inflammatory imbalance in hypertension patients with COVID-19. However, previous studies have reported that treatment with ARBs and ACEIs can inhibit the activation of NF-B and lower the secretion of pro-inflammatory cytokines in the alveolar cells in the lungs.
Treatment with ARBs and ACEIs may also reduce the number of critical cases and deaths among hypertensive COVID-19 patients. The therapeutic effects of tocilizumab, which is a monoclonal antibody treatment for COVID-19, have been enhanced when used in combination with ARBs and ACEIs in COVID-19 patients with hypertension.
Growing evidence suggests that the uncontrolled inflammatory response and cytokine storm that occurs during severe SARS-CoV-2 infection play a significant role in the development of severe post-COVID-19 sequelae. Thus, these hyper-inflammatory responses must be controlled to prevent the multi-organ dysfunction and respiratory distress that often occurs after COVID-19.
However, the administration of certain drugs used to suppress hyper-inflammatory responses, such as dexamethasone and metformin, is associated with some limitations. For example, dexamethasone has been primarily effective in patients receiving respiratory support, whereas metformin is unsuitable for patients with heart failure, renal impairments, or severe respiratory distress.
Treatment with ARBs and ACEIs has been shown to be beneficial in reducing the severity and mortality rates among COVID-19 patients with hypertension. Likewise, the effects of monoclonal antibody therapies have improved when combined with ARBs and ACEIs.
Further research is needed to determine the dosage, administration timings, potential contraindications, and side effects of using COVID-19 drugs that inhibit the activation of NF-B.
