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The Impact of the COVID-19 Vaccine on Spread of Disease - Contemporary Pediatrics
Period of engagement: Consultant will work on average 20 hours per/week for 12 to 20 weeks.
Project Description/Background:
The INGO COVID-19 Vaccine Collaborative is a group of six organizations (CARE, Catholic Relief Services, International Rescue Committee, Mercy Corps, Save the Children, and World Vision) working together to advocate for and implement programming related to equitable COVID-19 Vaccine uptake. One major undertaking by the collaborative has been to develop a COVID-19 Vaccine Information and Response Dashboard which presents the work done by both local and international NGOs, while providing greater insight into what is happening in countries utilizing a unique viewpoint that only these organizations can provide. This mapping exercise will help large international donors better direct resources to address the issues which are most impacting communities.
Description of Services:
The consultant will be responsible for collecting and organizing data utilizing pre-written surveys and informal interviews to input into the dashboard. This individual will work closely with all members of the Collaborative and other international and national NGOs to gather information, focusing primarily on the 18 countries that have been prioritized by GAVI and other countries where the Collaborative is working. The consultant will contact and interview an initial set of contacts from collaborative members and may also collect input from other local NGOs as necessary. The countries are list in the full SOW here. Note that the country list may expand or contract.
The consultant will display strong interview and data collection skills to gather information about the work done in these priority countries by as many NGOs in each country as possible. They will also document observations by the Country Offices and work with the Dashboard team to craft succinct and effective narratives detailing the barriers to vaccination, and how these INGOs are well placed to address the barriers.
Deliverables and Timeline:
By October 31, the consultant will have completed the following:
Qualifications:
The successful consultant will have the following qualifications:
Management of Consultancy:
The consultants technical work will be managed by Jeanne Koepsell, Senior Advisor, Digital Health and Community Case Management. All operational aspects will be managed by Daniel Sweeney, Sr. Administrator, Program Operations.
Submit your resume detailing your relevant qualifications and proposed daily rate to Daniel Sweeney (dsweeney@savechildren.org) by Friday, August 5.
Visit link:
INGO Collaborative COVID-19 Vaccine Information and Response Data Collection - ReliefWeb
As the United States clamors with anti-vax protests, researchers seek to understand what social and behavioral values are keeping patients from electing to vaccinate themselves against the coronavirus disease 2019 (COVID-19) virus. Over the past year, the race to vaccinate has become less about developing working vaccines and more about finding ways to encourage vaccine uptake.This paper examines the question of vaccine hesitancy in rural Chemung County, NY. In identifying various psychosocial barriers to patient vaccination, which we hypothesize will be mostly political, we seek to understand the local mindset in the hopethat our data guidethe way to change it.
The SARS-CoV-2 virus that resulted in the coronavirus disease 2019 (COVID-19) pandemic was first detected in Wuhan, China, in December 2019.This novel coronavirus spread rapidly around the world, and in March 2020, the World Health Organization (WHO) declared COVID-19 a worldwide pandemic [1]. Current statistics show over 520 million cases worldwide, with more than six million deaths as of May2022 [2].
Since the first case of COVID-19 emerged over a year ago, the extent of its consequences has been devastating in many ways. The global health, social, and economic effects of this pandemic will be felt for years to come. Before the production of efficacious vaccines, efforts to prevent the spread of COVID-19 relied heavily on social distancing, self-isolation, hand hygiene, mask mandates, travel restrictions, and widespread testing.
As vaccines became available between December 2020 and March 2021, the next step in preventing the spread of COVID-19 became mass vaccination to reach herd immunity, which is defined as a high enough vaccination percentage within the community to prevent the massive spread ofdisease [3,4]. Vaccines available and deemed effective by the Centers for Disease Control and Prevention (CDC) are Johnson & Johnson, Moderna, and Pfizer [5]. Over 11 billion vaccine doses have been given worldwide; however, in Chemung County, NY, where this study was conducted, the vaccination rate is only 58.99% [6].
Vaccine hesitancy is defined as a motivational state of being conflicted about the effects or safety of a certain vaccine or being opposed to vaccination in general [7]. Vaccine hesitancy is not a single entity; it lies between complete acceptance and refusal of all vaccines. Within the context of this pandemic, the term anti-vaxer may apply only to the COVID-19 vaccine rather than as a blanket term for those who refuse all vaccines. In researching the reasoning of the unvaccinated, our terminology must expand with our understanding of their personal barriers [1,8].
The dilemma of COVID-19 vaccine hesitancy is multifactorial and comprises many barriers. Of primary concern is the politicization of vaccine uptake and a growing sense of distrust in the government and mainstream medias representation of health facts on the news [9]. Additional factors include whether to trust the vaccine or the provider of the vaccine. Dror et al. found that geopolitical concerns over the vaccine's country of origin were likely to impact the uptake of the vaccine globally [10].Moreover, the concerns of Americans include factors such as the speed of the vaccines development, its components, efficacy, the rigor of testing, and its potential for causing long-term adverse effects [9]. Many patients also struggle to understand the value of the vaccineand they lack convenient access to it [11].
Many employers under the guidance of New York State, especially within health care, have introduced vaccination mandates for employees to reduce the burden of COVID-19 among healthcare workers. These mandates were an ultimatum: be vaccinated or be unemployed. In many places, mandates were met with hostility and a mass exodus of healthcare workers who stated similar reasons for vaccine distrust as listed above. In rural New York, where our study was conducted, the medical center lost 80 employees to vaccine mandates. Some employees resigned voluntarily before the deadline due to disagreement with the mandate, and those who refused to be vaccinated by the deadline were terminated. These individuals were willing to risk their financial security rather than receive the vaccine, believing that the act of a mandate inherently violates the principle of their autonomy [12]. New York State was dumbfounded by the negative response to these mandates, namely, severe staffing shortages, and in February 2022, decided that despite the original intent of its mandate, the state would not be enforcing the mandate regarding booster shots [13]. This decision was not based on health data but rather a response to social behaviors that dictated the necessity of removing a mandate to staff hospitals amidst the crisis of a pandemic, further illustrating the complexity of questions and problems regarding the vaccination of American citizens. More data on the consequences of vaccination mandates on the attitudes of employees will be required to understand the impact of the concept on global health and the economy in other democratic states.
Anti-vaccine attitudes and beliefs that pre-date the COVID-19 pandemic pose another significant barrier to vaccine uptake along with a pervasive lack of trust in pharmaceutical companies and government agencies such as the CDC. People with conservative political beliefs, residence in non-metropolitan areas, and recent refusal of the seasonal influenza vaccine are other major factors and obstacles to COVID-19 vaccine uptake [7].
Public health awareness about the risks of COVID-19 and the benefits of vaccination needs to be communicated in ways that are easily accessible and understandable within the community [14]. This study is valuable as a means to decipher which types and routes of communication may be useful in targeting the vaccination rate in rural America.
This study received IRB exemption and was approved by Arnot Healths System Review Board and Privacy Committee.
Conducted in November 2021, this study is cross-sectional in nature. A self-administered electronic SurveyMonkey questionnaire, included in the Appendix, was sent via e-mail three times over the course of a two-week period.Each group of emails was sent to the same 1243 patient body to increase the response rate. All patients utilized for this survey had verified emails in the clinics electronic medical record. No patient identifying information other than age, gender, and race/ethnicity was recorded. The study targeted patients aged 18 years and above who visited the Eastside Primary Care Clinic in Elmira, NY, between 06/01/2021 and 10/01/2021.
The questionnaire was designed and developed specifically for this study, utilizing only questions deemed necessary for establishing the demographics of the patient base and their opinions regarding vaccination. Participants were briefly informed about the objective of the study and the handling of their personal information. Two research experts independently reviewed and validated the questionnaire, and the final version consisted of three domains: socio-demographic variables, beliefs toward COVID-19 vaccination, and potential barriers that may prevent participants from choosing vaccination. Respondents who refused to get the vaccine underwent further analysis within the questionnaire. These questions consisted of both answer choices about their possible reasons for refusal and a free-form response box. Free-form responses were analyzed individually.
Analysis of all responses was conducted with SurveyMonkey (Momentive Inc., San Mateo, CA) and Microsoft Excel (Microsoft Corporation, Redmond, WA).
A total of 118 responses were collected from 1243 patients surveyed, yielding a 10% response rate. Of patients,79% indicated previous acceptance of the vaccine, and 21% indicated that they were not willing to take a COVID-19 vaccine. Of the cohort of 25 individuals indicating they were unwilling to accept a vaccine, 80% were women and 20% were men. Of patients, 60% belonged to the age group of 31-50 years, and 88% were White Americans. A total of 72% had been offered COVID-19 vaccination but refused it, and 28% reported not having been offered vaccination. See Table 1for the breakdown of respondents by demographics.
When asked to explain their reservations about the vaccine, 23% of respondents said that they feared the vaccine was not safe, 18% were concerned about a lack of long-term safety data, 9% feared potential side effects, 32% disagreed with mandating the vaccine, and 18% believed that the vaccine is not effective. This question, shown in Figure 1, was conducted via choosing the most important reason for vaccine refusal, but patients also had the option to leave comments to elaborate on their choices.
Figure 2 outlines a question about additional information that could be offered to help patients make the decision to get vaccinated, and within the question, they could select any and all options that they felt applied to their opinion. The box labeled, "no amount of information will change my mind" was selected 16 times. "Long-term safety data" was selected 10 times. "More educational materials" was selected three times, and "further discussion from a health professional" was selected twice.
The free-form responses indicated other lesser reasons for refusing vaccination including pushback against the existence of mandates, concerns that mRNA-based vaccines confront religious beliefs, and personal experiences that they believed to outweigh any clinical data on the subject. One patient responded that she had been hospitalized for COVID-19 and recovered without lasting effects and would like to see a vaccine that lasts longer than a year. Another respondent stated, whether you receive the vaccine or not, you can still catch COVID!
Additionally, five patients refused to fill out the survey but emailed us back instead with their negative responses toward the COVID-19 vaccine.
The most cited reason for not getting vaccinated regarded distrust toward the government andgovernmental policy on COVID-19. In addition, fear about adverse reactions and the rapid vaccination approval process were related to hesitancy regarding vaccination, which is consistent with previous studies. In a report released by the World Health Organization (WHO), congruous, transparent, compassionate, and proactive communication about vaccines was cited to help build trust in COVID-19 vaccines [14]. Avenues such as those discussed in the report may be of benefit to this population of patients with specific fears about the components of the vaccines and their long-term safety.
The key reasons for vaccine refusal in this population were as expected: patients were concerned about the lack of long-term safety data, indignant atmandates, and bothered by the apparent influence of the political sphere on the vaccines creation and distribution, a consistent finding within the literature search [8].
The most striking finding of this study was that 66% of unvaccinated respondents said that no amount of information would change their minds about receiving a vaccine, while the remaining participants suggested that more data about long-term safety and provider recommendations could convince them to get vaccinated. A closer examination of these responses indicated pervasive mistrust of the system, which ultimately thwarts the desired outcome of this study: education and increased vaccination rates. It is much easier to collect data and educate a population about the benefits of vaccination than it is to sway the conviction of an individual firm in the belief that taking a vaccine violates his basic rights to autonomy and beneficence. In community settings where these convicted individuals abound, herd immunity becomes less an attainable reality than it is a "pipe dream" of improbability.
This project contains important limitations. With responses from only 118 individuals, of which just 25 were unvaccinated, the small sample size prevents the extrapolation of the data to a larger population. Additionally, several non-vaccinated patients were offended at the mere mention of COVID-19 and chose not to participate in the survey, further limiting responses within the target demographic. While the questionnaire used was validated by an internal team, it was novel and designed solely for the purpose of this study, which limits theability to compare itto other studies of this type. The questionnaire was also self-administered, and some patients chose to skip questions, which narrows the response rate for portions of the survey and provokes questions about the reliability of self-administered patient surveys.
The data clearly showed that for one-third of patients, education and personal recommendations from physicians may be enough to convince them to vaccinate, but for the remaining two-thirds of patients vehemently committed against vaccination for personal and political reasons, simple education measures may not be enough to change minds. The questions then become, how do we remove the politicalized stigma of the COVID-19 vaccine, and is non-partisan marketing enough? Where appeals to ethos and pathos have failed, what ultimately motivates the individual to set aside his convictions? Given the rates of unemployment and severe understaffing in health institutions, mandates were not the answer to this question; thus, more studies on a sociological-economic level will need to be completed to answer these questions.
Meanwhile, providers should broach the subject of vaccination with their patients armed with the most current research and a willingness to appeal to what motivates patients on an individual basis. This recommendation requires more of a grassroots effort than can be accomplished with wide-reaching advertisements ontelevision or social media marketing, but it may prove to be a local solution to a local problem.
You are invited to participate in a research study about COVID-19 VACCINE barriers. If you have a moment to spare, please fill out this short survey. It will take less than a minute. The goal of this research study is to identify the barriers and the ways to encourage people to get vaccinated. Wed greatly appreciate your feedback.
This study is being conducted by Dr. Richard Terry, Dr. Aeman Asrar, and Samantha Lavertue (medical student).
Patients who had been to Eastside Primary Care Clinic between 06/01/2021 and 10/01/2021 and 18 years or older qualify to participate in the study.
Participation in this study is voluntary. If you agree to participate in this study, you would be asked to answer some simple questions via an online survey (attached below) about your vaccination status. If you chose not to be vaccinated, we would ask you some questions about why you decided not to receive the vaccine.
Participating in this study will help us learn about attitudes toward COVID vaccination in our community. The questions we would ask you about the decisionto not be vaccinated are the sorts of things you might discuss with family or friends.
The information you will share with us if you participate in this study will be kept completely confidential to the full extent of the law. The answers you give to any questions are completely anonymous and will not affect in any way the care you receive.
We will be using SurveyMonkey to administer the surveys. SurveyMonkey will not record your computers IP numbers and no patient identifying information other than age and gender will be recorded. Again, your answers will be kept completely anonymous.
If you have any questions about this study, please contact Dr. Aeman Asrar at [emailprotected]
By completing this survey, you are consenting to participate in this study.
We thank you for devoting one minute of your time.
Gender:
* Male
* Female
Age:
* 18-30 years
* 31-50 years
* 51-64 years
* 65+ years
Ethnicity:
* White American
* African American
* Asian
* Hispanic
* Other
* Prefer not to answer
1. Were you offered COVID-19 vaccination?
a. Yes
b. No
If you answered NO to this question, you have completed the survey and do not need to answer any further questions.
2. Did you receive COVID-19 vaccine?
a. Yes
b. No
If you answered YES to this question, you have completed the survey and do not need to answer any further questions.
3. If you were offered vaccination but decided not to get it, please tell us the reason for this decision.
a. Fear that vaccine is not safe because of its rapid development
b. Lack of long-term safety data
c. Fear of potential side effects
d. Personal reasons (disagree with any mandate)
e. I believe the vaccine is not effective
f. Other (please describe) ___________________________
4. What information would you want to receive to help you make the decision to get vaccinated?
a. Long-term safety data
b. More educational material
c. Further discussion from a health professional
d. No amount of information will change my mind
5. Where have you received information about the COVID vaccine? (Check as many as applicable)
a. Print media
b. Broadcast media (television and radio)
c. Internet
d. Word of mouth
6. Do you believe that approved/authorized vaccines are effective at preventing COVID-19?
a. Yes, in most cases
b. No, I don't believe so
c. Yes, but may dependon general health status
7. What strategies do you follow to protect yourself from COVID-19?
a. Wash your hands often with plain soap and water
b. Cover your mouth and nose with a mask when around others
c. Avoid large gatherings and practice social distancing (stay at least six feet apart from others)
d. Nothing
Read this article:
COVID-19 Vaccine Hesitancy in a Rural Primary Care Setting - Cureus
Few serious side effects have been reported from the administration of the various new vaccines that were developed during the coronavirus pandemic [1]. However, vaccine-induced thrombotic thrombocytopenia (VITT) is a very rare prothrombotic syndrome that has been reported in some patients after receiving coronavirus vaccination with the adenovirus vector-based vaccines: AstraZeneca (ChAdOx1 nCoV-19) and Johnson and Johnson (Ad26.COV2.S) [2].
VITT is a thrombotic syndrome that involves the development of immunoglobulin G (IgG) antibodies that bind to the Fc portion of the IgG receptor on platelet factor-4 (PF4). Platelet activation occurs upon binding, a phenomenon similar to heparin-induced thrombocytopenia (HIT). The immunopathology of VITT differs from HIT since the antibodies bind to a different epitope on PF4, and VITT is not dependent on exposure to heparin products. The mechanism in which VITT causes antibody formation is still unclear. Some theories suggest vaccine components may generate a neoantigen when bound to PF4 [2]. VITT is a very rare complication of the adenoviral-vector-based COVID-19 vaccines, with the CDC estimating an incidence of 1 in 533,333 [3].
In this report, we present a case of VITT in an adult female with no previous medical issues.
A 37-year-old female with no previous health conditions presented to the ED with an 11-day history of headachez following vaccination with the Johnson and Johnson COVID-19 adenovirus-based vaccine. The headache was localized to the bi-temporal region, was constant in nature, and had been progressively worsening since the time of vaccination. The patient had a past surgical history of cholecystectomy and Cesarean section. She had no known medical conditions and was a current cigarette smoker with a 10-pack-year history. The patient reported a positive history of blood clots in her sister and mother, with no known diagnoses of hereditary coagulopathies. Vital signs on arrival were within the normal limits: temperature of 98.1, heart rate of 72 beats per minute, blood pressure of 114/78 mmHg, and oxygen saturation of 96% on room air. Labs in the ED were significant for thrombocytopenia, with a platelet count of 22,000. Other pertinent lab values include an elevated C-reactive protein (CRP) of 3.19 mg/dL. -HCG was negative, and urinalysis showed no evidence of urinary tract infection. At the time of presentation, the patient had no signs of active internal bleeding, petechiae, purpura, or ecchymosis. Physical examination was unremarkable, although the patient appeared to be in significant distress because of the headache. A non-contrast CT scan of the head was ordered and showed no acute abnormalities. A chest X-ray was also performed and demonstrated no acute cardiopulmonary disease. The COVID-19 rapid antigen test was positive, and a polymerase chain reaction (PCR) test was ordered. A full respiratory serology panel was performed and was negative. The patient received a 500 mL bolus of sodium chloride, 30 mg of IV ketorolac, and 10 mg of IV dexamethasoneand was admitted to the general medical floor for observation and management of thrombocytopenia.
On day 1 of hospitalization, the patient woke up with sudden excruciating right lower extremity pain. At this time, she was diaphoretic, tachycardic, and flushed. The pain was associated with numbness, tingling, and decreased sensation around the right ankle with preserved motor function. The dorsal pedal, posterior tibial, and popliteal pulses were non-palpable and non-Dopplerable. Labs showed a high d-dimer level of 6.01 (normal 0.19-0.5), a low platelet count of 20,000, and an elevated immature platelet fraction of 14.3%. Fibrinogen was normal at 217, and coagulation studies, including prothrombin time (PT), partial thromboplastin time (PTT), and International Normalized Ratio (INR), were within the normal limits. CRP was elevated at 2.67, and procalcitonin was normal at 0.06 ng/mL. Venous duplex ultrasound of the right lower extremity showed no evidence of deep vein thrombosis. A computed tomography angiography (CTA) scan of the abdominal aorta with runoff was ordered and showed a right common femoral artery embolus extending into the origin of the superficial femoral and profunda artery, a left distal popliteal trifurcation embolism with segmental occlusion, a small pulmonary embolism in the right lower lobe, and a mural thrombus of soft plaque in the anterior wall of the infrarenal abdominal aorta (Figures 1-3). The patient was not a candidate for thrombolysis due to thrombocytopenia, so an open thrombectomy of the right common and superficial femoral arteries was done with an embolectomy catheter. Post-operatively, the patient received anticoagulation with argatroban.
Following the procedure, the patients platelet count had decreased to 12,000, the WBC was elevated at 12,400, hemoglobin (Hb) was low at 11.6, and PTT was increased to 39.9. She was admitted to the ICU and was started on 10 mg IV dexamethasone Q6H for four days. The COVID-19 PCR test came back negative, confirming a false-positive rapid antigen test. Pathology was consulted to examine a peripheral blood smear, which showed normal platelet morphology with a decrease in the number of platelets. The pathologist suggested that this may be secondary to peripheral consumption and SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia. The patients serum was tested for heparin-platelet factor 4 (heparin-PF4) antibodies. Heparin-PF4 antibody enzyme-linked immunosorbent assay (ELISA) was positive with 100% heparin-PF4 antibody inhibition and an optical density of 2.265. Hematology was consulted and suggested that thrombosis is related to a HIT-like mechanism, even without known exposure to heparin products. This was concluded by cases in the literature that showed immune-induced thrombocytopenia with vascular thrombotic events after COVID-19 vaccination, mostly after receiving the AstraZeneca vaccine. It was recommended that low-weight molecular heparin and platelet transfusions should be avoided to prevent worsening thrombosis. Hematology requested that the patient be started on IV immunoglobulin (IVIG) for two days if there was worsening thrombocytopenia or any signs of bleeding.
On hospital day two, morning labs showed that the platelet count dropped to 8000. The patient received her first day of IVIG. WBC count at this time increased to 14,300. Immature platelet fraction had increased to 19.6%, and PTT increased to 41.4. At this time, hematology suggested that platelet transfusions should be withheld unless active bleeding is present. Venous duplex ultrasound of the unaffected left leg was taken and showed no evidence ofdeep vein thrombosis (DVT). Venous duplex ultrasounds of the bilateral upper extremities showed acute DVT in the left brachial vein. MRI of the brain showed no evidence of acute infarct, parenchymal hemorrhage, cerebral edema, or cerebellar tonsillar ectopia. Magnetic resonance angiogram (MRA) showed no significant stenosis of the major intracranial arteries and did not identify any medium or large-sized aneurysms. Magnetic resonance venography (MRV) showed no evidence of dural venous thrombosis. CT scan of the brain and head with contrast showed no evidence of dural venous sinus or cavernous sinus thrombosis and no acute intracranial hemorrhage or mass effect. Repeat afternoon labs showed some improvement in platelet count, rising to 14,000. WBC count at this time continued to trend upward to 16,200. Immature platelet fraction increased to 21.6%. Coagulation studies showed prolonged PT of 16.3 and PTT of 45. Other lab abnormalities include low fibrinogen of 135 and an elevated aspartate aminotransferase (AST) of 123.
On hospital day three, the platelet count continued to trend upwards to 20,000, WBC count remained stable at 14,500, Hb was low at 10.3, immature platelet fraction remained stable at 22.3%, PTT remained stable at 44.5, and AST was high but trending downwards to 105. The head CT scan showed no evidence of dural venous sinus or cavernous sinus thrombosis and no acute intracranial hemorrhage. The patient received day two of IVIG.
On hospital day four, the platelet count increased to 47,000. The WBC count trended downwards to 13,100. Hb remained low but stable at 10, PT remained elevated but stable at 24.3, PTT was high but stable at 50, and AST continued to trend down to 69.
On hospital day five, the platelet count improved to 101,000. WBCs trended down to 12,200, Hb was 10.4, PTT was 48.4, and AST was 42, trending towards normal. The patient was discontinued on argatroban and started on oral apixaban 10 mg two times a day (BID) every 12 hours (Q12H) for seven days. The dexamethasone changed from IV to 10 mg per os (PO) today, and she was transferred from the ICU to the medical floor. Pathology confirmed that the content analyzed from the femoral arteries was consistent with a thrombus.
On hospital day six, the platelet count improved to 143,000. WBC count was elevated at 17,500, Hb increased to 11.7, and AST trended down to 52. Dexamethasone was tapered to 10 mg BID, then discontinued upon discharge. The patient was told to decrease the apixaban dose to 5 mg BID after seven days.
Lab values recorded during the hospital stay are summarized in Table 1.
VITT is an uncommon but potentially life-threatening complication that has developed after vaccination with AstraZeneca and Johnson and Johnson COVID-19 adenoviral-based vaccines. This led to safety concerns as several individuals received these vaccinations during the COVID-19 pandemic. However, studies reveal that there is no association between the development of VITT and the BioNTech Pfizer vaccine [4]. One case report has also been published on fatal thrombotic events following vaccination with Moderna. However, it is unknown if this was a direct result of VITT or was related to a prior illness [5].
We reported a case of VITT following the Janssen (Johnson and Johnson) COVID-19 vaccination. A case report in the UK that included 220 cases of definite or probable VITT stated that the median time of diagnosis post-vaccination is 14 days, ranging from 5 to 48 days [6]. This study showed a female predominance among cases, with 55% of patients being female, making this a significant risk factor for VITT [6]. Over half of the patients studied had multiple thrombi present in different locations. The patient in our case report had similar demographics to this study as she presented to the hospital with symptoms 11 days post-vaccination, is female in gender, and had four different thrombotic sites. In systematic reviews, the headache was shown to be the most common presenting symptom in patients with VITT and cerebral venous sinus thrombosis (CVST) [7]. Despite our patients presentation of an unremitting headache, no signs of CVST or neurological abnormalities were found on imaging.
Sites of venous thrombosis in VITT can vary but are more commonly seen as deep vein thrombosis of the lower extremities and thromboembolism to the lungs [1,8]. Some rare but observed sites of thrombosis in VITT include the splenic, portal, mesenteric, adrenal, cerebral, and ophthalmic veins [1,8]. CVST is an uncommon but serious complication of VITT, where thrombosis of the cerebral sinuses occurs, leading to intracranial hypertension [9]. Thrombosis in the presence of VITT can be diagnosed through MRI with venography or CT venography. This was done after our patient developed thrombosis in the setting of thrombocytopenia, thus ruling out dural sinus thrombosis as a cause of the headache [1,9].
Arterial thrombosis caused by VITT has been displayed through reports of middle cerebral artery stroke and occlusion of peripheral arteries [10]. Our patients sites of thrombosis are consistent with these locations as they include the femoral arteries, popliteal artery, pulmonary vasculature, and abdominal aorta. The median platelet count for patients with VITT is 20,000-25,000 [2]. In this report, the patients platelet count dropped as low as 8000 but mostly remained within the 10,000-20,000 range.
VITT is diagnosed by using PF4 antibody tests [11]. A diagnosis is based on a positive PF4 antibody assay and the presence of thrombocytopenia or thrombosis. The test used on our patient was the ELISA, which is the recommended screening test [11]. Other screening tests include serotonin release assay, which can be used in patients with suspected VITT with a negative or equivocal ELISA [12]. Patients diagnosed with VITT from case reports in the UK had high optical densities on ELISA, ranging between a density of 2 and 3 [2]. The patient in our report had an optical density of 2.265.
Our patient was treated for two days with IVIG infusions, one of the mainstays of treatment in VITT, as it substantially improves the patients platelet count while stabilizing coagulative events [13]. IVIG interferes with the ability of PF4 to activate platelets by blocking FcRyIIA receptors, as seen in HIT [14]. Plasma exchange is another potential treatment that temporarily reduces the PF4 antibodies, thus decreasing coagulability [7]. It is important to note that platelet infusions should be avoided in the case of VITT to prevent further antibody formation and thrombosis [14]. The long-term complications of PF4 antibodies have not yet been established [13]. An observational study showed that VITT patients had a negative platelet functional assay within a median time of 15.5 weeks [15]. However, 7.5% of subjects showed persistently high levels of antibodies and optical densities, and two out of these five patients had a recurrent episode of thrombocytopenia [15]. Due to the new emergence of this condition, the prolonged implications of VITT and PF4 antibodies will be an essential topic for research in the coming years.
Our patient presented with a case of vaccine-induced thrombotic thrombocytopenia, a recent illness that arose with the development of vaccines produced in light of the COVID-19 pandemic. VITT can be life-threatening if not recognized quickly and treated adequately.
In this case, the patient was treated surgically and medically for multiple thrombotic events in the presence of thrombocytopenia, leading to a full recovery prior to discharge. VITT is a very rare complication of the adenoviral-vector-based COVID-19 vaccines, and although it can result in serious medical issues, the benefits of protection against COVID-19 heavily outweigh any associated risks.
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A Case of COVID-19 Vaccine-Induced Thrombotic Thrombocytopenia - Cureus
Deputy head of the National Health Commission (NHC) Zeng Yixin said on Saturday that "all China's incumbent state and party leaders" have been vaccinated against Covid-19 with domestically made shots, referring to top officials at the national and deputy national level -- a category that includes Xi, Premier Li Keqiang, and other senior leaders.
It is exceptionally rare for health-related information about Chinese leaders to be made public, but the statement was made amid a recent wave of Covid-19 infections and public concerns about the safety of vaccines.
Zeng didn't specify when the officials had been vaccinated or if they received booster shots. The vaccination status of Xi had not previously been disclosed to the public.
China has repeatedly sought to address questions around the safety of its vaccines and to boost its vaccination rates, especially among the elderly. While nearly 90% of China's vaccine eligible population has been fully vaccinated, only 61% of people over the age of 80 have been fully vaccinated and only 38.4% have received booster shots, according to the NHC.
On Saturday, the NHC addressed online speculation on the safety of the vaccines, including accusations they cause leukemia and diabetes in children, saying statistics show no evidence of these diseases linked to vaccines.
Of the nearly 3.4 billion doses of Covid-19 administered in China, only around 70 people per million have reported side effects -- a percentage far lower than other vaccines like polio, measles, hepatitis B, rabies and Influenza, the NHC said.
China has so far only approved domestically made vaccines to be used in mainland, including those by Sinopharm and Sinovac which use inactivated virus instead of the genetically engineered mRNA vaccines. In trials, these vaccines have shown lower efficacy than their mRNA counterparts -- a criticism dismissed by Beijing as a "bias-motivated ... smear." Beijing has instead pointed to the vaccines' effect in reducing severe cases and deaths as a metric of their success.
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One of the former U.S. officials who led the COVID-19 response during the Trump administration said July 22 that COVID-19 vaccines were not expected to protect against infection.
I knew these vaccines were not going to protect against infection. And I think we overplayed the vaccines. And it made people then worry that its not going to protect against severe disease and hospitalization,Deborah Birx, the White House COVID-19 response coordinator under former President Donald Trump, said during an appearance on Fox News.
The Moderna and Pfizer COVID-19 vaccines were granted emergency use authorization in late 2020 to prevent symptomatic COVID-19, and were promoted by many health officials, including Birx.
This is one of the most highly-effective vaccines we have in our infectious disease arsenal. And so thats why Im very enthusiastic about the vaccine, Birx said on an ABC podcast at the time.
She made no mention of concerns the vaccines might not protect against infection.
Data shows the vaccines did prevent infection from early strains oftheCCP (Chinese Communist Party) virus, which causes COVID-19, but that the protection waned over time. The vaccines have proven increasingly unable to shield even shortly after administration, and provide little protection against the Omicron virus variant and its subvariants.
The vaccines continue to protect against severe disease and hospitalization, Birx said on Friday. But lets be very clear50 percent of the people who died from the Omicron surge were older, vaccinated, she said.
So, thats why Im saying, even if youre vaccinated and boosted if youre unvaccinated, right now, the key is testing and Paxlovid, she added.
Paxlovid is a COVID-19 pill produced by Pfizer that has had uneven results in clinical trials and studies, but is recommended by U.S. health authorities for both unvaccinated and vaccinated COVID-19 patients to prevent progression to severe disease.
President Joe Biden, who tested positive this week, was prescribed Paxlovid by his doctor.
There are signs the protection from vaccines against severe illness is also dropping quickly as new strains emerge.
That protection was just 51 percent against emergency department or urgent care visits, and dropped to just 12 percent after five months, according to a recent study. Against hospitalization, protection went from 57 percent to 24 percent. A booster increased protection but the shielding quickly dropped to substandard levels.
Dr. Anthony Fauci also helped lead the U.S. pandemic response along with Birx and once said that vaccinated people would not get infected.
What was true two years ago, a year and a half ago, changes because the original ancestral strain did not at all have the transmission capability that were dealing with with the omicron sublineages, particularly BA. 5. So the vaccine does protect some people, not 95 percent, from getting infected, from getting symptoms, and getting severe disease. It does a much better job at protecting a high percentage of people from progressing from severe disease, Fauci said on Fox.
He said that vaccines with updated compilations, which are expected to debut in the fall, are necessary.
We need vaccines that are better. That are better because of the breadth and the durability, because we know that immunity wanes over several months. And thats the reason why we have boosters, he said. But also, we need vaccines that protect against infection.
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Zachary Stieber covers U.S. and world news. He is based in Maryland.
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Birx Says COVID-19 Vaccines Were Never 'Going to Protect Against Infection' - The Epoch Times
Throughout the pandemic, scientists have discovered that being biologically male or female might impact you when it comes to COVID-19 outcomes, long COVID, and vaccine responses but the reasons for these differences have yet to be fully understood.
While experts investigate this topic (many are calling for more studies that look at outcomes based on sex), its important to know how your sex may affect your risk, particularly if youre immunocompromised. This should be part of the ongoing conversation you have with your doctor to determine your risk level and your strategy for protecting yourself against COVID-19.
Heres what we know about the differences in COVID-19 between males and females so far and what it may mean for you.
While researchers agree that males die of COVID-19 at a higher rate than females, its not entirely clear why. A series of social factors may play a bigger role than biological differences, per a February 2022 Harvard GenderSci Lab study of more than 30 million confirmed coronavirus cases in the United States.
The team found that males were infected and died at higher rates than females in some states, but these rates were about even in other states. And at certain points during the pandemic, females outpaced males in cases and fatalities. Because of this, looking at the aggregate data for the nation could be misleading.
Whats more, the gap between males and females was smaller than what experts originally thought: Early on, it was reported that males were dying of COVID-19 at twice the rate of females. However, the data from the teams tracker showed that males in the United States had a mortality rate that was just 10 to 20 percent higher than that of females between April 2020 and May 2021.
After statistical modeling, the researchers found that 30 percent of this variation was due to state-level factors, such as differences in public health policies, timing and length of mask mandates, and other social factors like gendered health behaviors, occupational exposures, pre-existing health conditions, and demographics including race, age, and education.
The model also showed that 10 percent of the difference was based on when a measurement was taken during the pandemic.
The remaining 60 percent of the variation was not explained by either time or state. Still, researchers dont believe that interventions centered on sex-related biological factors like the use of testosteron blockers or estrogen would have a significant impact on outcomes.
Without considering [social and contextural] factors, youre missing part of the picture of why people might be getting exposed or getting a more severe case, Tamara Rushovich, a graduate student at the T.H. Chan School of Public Health and part of the GenderSci Lab research team, told The Harvard Gazette. For example, when you see numbers that show different rates of cases or deaths, its not just biology, but what was your exposure risk? And thats influenced by things like your occupation or your income.
Gendered behaviors can also play a role in the different outcomes between males and females.
Thereve been studies that look at things like adherence to mask policies or social-distancing guidelines, added Rushovich. They saw differences in gender adherence to those, so men being less likely to wear masks properly or to adhere to social distancing guidelines.
For instance, an October 2020 study in the Proceedings of the National Academy of Sciences of the United States of America looked at the gender differences in COVID-19 attitudes and behavior from eight countries. Researchers found that 59 percent of females considered COVID-19 to be a very serious problem during the first wave of the pandemic (March 16-30, 2020) across all eight countries studied (Australia, Austria, France, Germany, Italy, New Zealand, United Kingdom, and the United States), compared to just 48.7 percent of the males.
In both periods studied (including the second period from April 15-20, 2020), individuals were asked to evaluate how strictly they were following seven recommended rules, including keeping physical distance from others or staying at home. Compliance was markedly higher in females (by 5 to 6 percent), but smaller than the differences in beliefs about the pandemic.
And even after adjusting for sociodemographic characteristics and employment status, females were much more likely than males to believe that the health consequences of the pandemic were very serious and were also more supportive of restraining measures and more compliant with public health and social distancing measures, per the researchers.
The risk of severe COVID-19 outcomes may be further heightened in certain immunocompromised populations. In an April 2021 review in the Journal for ImmunoTherapy of Cancer, researchers found that individuals who were hematopoietic stem cell transplant (HCT) recipients had a 68 percent rate of 28-day survival after COVID-19 with risk factors for mortality including being male, being older than 50 years, and getting infected within 12 months after HCT.
Likewise, the COVID-19 Global Rheumatology Alliance (GRA) has looked at factors associated with COVID-19 mortality in 3,729 patients with rheumatic diseases. Being male, having an older age, and living with certain comorbidities (hypertension, heart disease, and chronic lung disease) were risk factors for COVID-19-related death. More rheumatic disease activity and certain medications (like rituximab) also raised risk.
On the other hand, some research shows that females might be more likely to encounter long COVID than males but additional studies are needed to confirm this.
A June 2022 review in Current Medical Research and Opinion found that the likelihood of having long-COVID syndrome was 22 percent greater among females. In particular, female patients were significantly more likely to have long-COVID symptoms in the categories of psychiatric and mood (i.e. depression); ear, nose, or throat; musculoskeletal (i.e. myalgia); and respiratory.
That said, male patients were significantly more likely to have long COVID in the category of renal disorders (i.e. acute kidney injury).
Differences in immune system function between females and males could be an important driver of sex differences in long COVID-19 syndrome, note the researchers. Females mount more rapid and robust innate and adaptive immune responses, which can protect them from initial infection and severity. However, this same difference can render females more vulnerable to prolonged autoimmune-related diseases.
As with Lyme disease, the COVID-19 pathogen might remain hidden and generate greater levels of inflammatory cytokines in females than males, per a February 2022 review in the European Respiratory Journal. Some experts believe that fragments of SARS-CoV-2 could hang around areas of the body like the kidneys or brain, sparking a chronic inflammation-associated cascade. This may result in symptoms like pain or brain fog.
In general, 80 percent of all individuals affected by autoimmune disorders are females, due to variation within the sex chromosomes and hormonal changes, per a May 2020 review in Cureus. (An increasing body of research has pointed toward the possibility that COVID-19 causes the development of autoantibodies linked to other autoimmune diseases and may be tied to long-COVID symptoms.)
All of this said, most studies on long COVID do not evaluate or report granular data by sex, so more research in this area will be key for better understanding the risk of long COVID.
The lack of studies reporting sex-disaggregated outcomes for COVID-19 speaks to the need for further, large-scale research that includes sex as an analytical variable and that reports data by sex, note the researchers of the Current Medical Research and Opinion review.
Its important to talk to your doctor about your risk of long COVID as an immunocompromised patient and how your sex might play a role in that risk.
I have not seen data to suggest confirming that immunocompromised patients are more likely to develop long COVID than patients who are not immunocompromised, Samoon Ahmad, MD, clinical professor of psychiatry at NYU Grossman School of Medicine, told us previously. That said, its clear that immunocompromised patients are more likely to develop severe COVID if they get it and research suggests that people who have severe COVID are more likely to develop long COVID.
Read more about what you should know about long COVID.
Individuals who are biologically male or female also have differences when it comes to the COVID-19 vaccine, whether its in regards to vaccine hesitancy or risk of adverse effects.
Initially, females were more hesitant than males to get the COVID-19 vaccine. In a review of 60 studies published in the Journal of Public Health, researchers found that 58 percent of papers reported males having higher intentions to get vaccinated against COVID-19. Significantly fewer females stated that they would get vaccinated than males during the time period studied (November 2020 to January 2021).
Overall, males were on average 41 percent more likely to report that they intended to receive a vaccine rather than being unwilling or undecided compared with females. The gender effects were even higher among health care workers compared with unspecified population samples. (That said, this result requires cautious interpretation, given that gender proportions in the health care worker samples were highly unbalanced and the number of studies with health care worker samples was comparatively small.)
However, many of the studies included in this review asked individuals about their intentions to get vaccinated before a vaccine was available.
By April 2021, more females than males had gotten vaccinated in many states, per the Kaiser Family Foundation. The vaccine breakdown between males and females was generally close to 60 percent and 40 percent for instance, 58 percent of those vaccinated in Alabama were females and 57 percent were females in Florida.
There may be many reasons for this difference: For instance, females make up three-quarters of the workforce in health care and education, which were sectors prioritized for initial vaccines. Females also tend to have longer life spans, so older individuals initially eligible for vaccines were more likely to be female. However, the gender gap continued even as eligibility expanded to all adults.
When it comes to rare adverse reactions to the vaccines, males and females also appear to be affected differently. In a February 2022 review in the journal Vaccines, researchers found that the risk of adverse events after the Pfizer-BioNTeach COVID-19 vaccine were consistently higher in females of all ages. This included local responses such as pain at the injection site, systemic events such as fever, and sensory events such as paresthesia (a burning, prickling sensation) in the hands and face.
Females may have increased reactogenicity of vaccines and are at higher risk of anaphylaxis, per the review.
The remarkably consistent excess in the rates of adverse events in females following immunization with the Pfizer-BioNTech COVID-19 vaccine, in all age groups, suggests that gender-specific factors influence the response to the vaccine, note the researchers. These findings indicate that different doses of the vaccine for men and women should be explored.
Females also report more vaccine side effects in general. More than 79 percent of nearly 7,000 reports processed through the Centers for Disease Control and Prevention (CDC) Vaccine Adverse Event Reporting System from December 14, 2020 to January 13, 2021 came from females, per the CDCs Morbidity and Mortality Weekly Report. The most frequently reported symptoms were headache, dizziness, and fatigue.
This could be due to females greater immune response. From a biological perspective, women and girls produce sometimes twice as many infection-fighting antibodies from vaccines, said Rosemary Morgan, a research scientist at Johns Hopkins Bloomberg School of Public Health, told USA TODAY.
Whats more, male sex hormones like testosterone and dihydrotestosterone (DHT) have immunosuppressive qualities because of the way they modulate the breakdown of fat, per St. Lukes Health. Some research has shown that males have lesser antibody responses and lesser inflammatory cytokine expression when given the flu shot than females.
However, this doesnt appear to affect COVID-19 vaccine efficacy rates which were actually slightly higher for males than females in clinical trials. For instance, clinical trials showed that the Moderna vaccine was 95.4 percent effective at preventing COVID-19 in males, compared to 93.1 percent for females. For the Pfizer vaccine, efficacy was 96.4 percent in males and 93.7 percent in females.
One study in the journal Molecular Pharmacology looked at whether fat-based nanoparticles could be the cause behind the difference in vaccine efficacy. Researchers found that there were significant differences in the uptake of these nanoparticles between male and female natural killer cells (a type of immune cell that has small particles with enzymes that can kill cells infected with a virus).
The results of this proof-of-concept study show the importance of recipient sex as a critical factor which enables researchers to better consider sex in the development and administration of vaccines for safer and more-efficient sex-specific outcomes, note the researchers.
If youre immunocompromised, youre likely already mindful of mitigation efforts to protect yourself against COVID-19. While being biologically male or female isnt likely to make a major impact on your risk of severe disease (unless you partake in behavior that increases your risk), it might affect your chances of long COVID.
And while its possible you may have a slightly higher risk of an adverse reaction to the vaccine if youre female, such reactions are rare. In most cases, the benefits of the COVID-19 vaccine outweigh the risks.
Of course, as an immunocompromised patient, its important to be aware of every tool you have to protect yourself and to stay aware of your risks. For instance, you should have a conversation with your doctor about your risk level for long COVID should you get infected (and how your sex may play a role in that risk).
Although we still have much to learn about the differences between females and males when it comes to COVID-19, you can use the clues available to create the best-informed strategy to protect yourself in partnership with your doctor.
Join the Global Healthy Living Foundations free COVID-19 Support Program for chronic illness patients and their families. We will be providing updated information, community support, and other resources tailored specifically to your health and safety.Join now.
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How COVID-19, Long COVID, and COVID Vaccines Differ Between Males and Females - CreakyJoints
Children between the ages of 6 months and 5 years of age finally became eligible for COVID-19 vaccination in the U.S. on June 18, after the Director of the Centers for Disease Control and Prevention (CDC) recommended their use for this population, following emergency use authorization granted by the Food and Drug Administration. We recently wrote about some of the issues to consider in vaccinating young children, ranging from fewer access points and more reticence among their parents, compared to their 5-11 year-old counterparts. Here, we examine the status of vaccine uptake in this group, one month into their eligibility. Our analysis is based on data obtained from CDCs Data Tracker on the number of first COVID-19 doses administered by age as of July 20, 2022 nationally and by jurisdiction (see methods below for more information). Overall, we find that vaccination has already peaked in the youngest age group, and is far below where 5-11 year-olds (who became eligible in November of last year) were at this point in their eligibility:
These data suggest that achieving vaccination coverage of the youngest age group will likely take some time, may require more intensive and ongoing efforts, and may lag behind even their slightly older peers (even among 5-11 year-olds, just 30% have been fully vaccinated, eight months since they became eligible; vaccine coverage jumps to 60% of 12-17 years-olds and 77% of those 18 and older). This slow uptake likely reflects a range of factors. In addition to there being fewer access points for those under the age of 5, our prior COVID-19 Vaccine Monitor Surveys, fielded before children under 5 became eligible for vaccination, found that most parents were cautious about getting their young children vaccinated; soon-to-be released survey data will show that this caution has continued even after the CDC recommended vaccination for those 6 months and older. As a result, many parents may not encounter an offer of a vaccine until they go in for a routine visit to a pediatrician at some point in the year. More broadly, the sense of COVID-19 as an emergency has diminished among the public. Still, the country is in the midst of another COVID wave, due to the latest Omicron variant, and while children generally fare much better than adults if they do get COVID-19, some do get quite sick, suffer longer-term health issues, and even die from the disease. Vaccination against COVID-19 is safe and effective, can protect them from illness, and minimize disruptions to childcare, camp, school, and other needed services.
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WASHINGTON The U.S. Army announced COVID-19 vaccination rates and exemption requests for the Total Army as of July 21, 2022.
Maintaining readiness continues to be among the Armys highest priorities, and the COVID 19 vaccine helps ensure Soldiers are ready. Beginning July 1, 2022, as directed by the Secretary of Defense, members of the Army National Guard and U.S. Army Reserve who have refused the lawful DOD COVID-19 vaccination requirements without a temporary or permanent exemption (to include a religious accommodation) may not participate in federally funded drills, training, and other duty nor receive payment or retirement credit.
However, unit commanders may place unvaccinated reserve component Soldiers in an appropriate duty status for limited administrative purposes, such as receiving the vaccine, processing their exemption requests, or conducting separation procedures. Soldiers could receive compensation and retirement credit for these service days.
Army policy allows Soldiers to submit requests for temporary (up to 365 days) or permanent medical exemptions through medical channels. Soldiers may also request an administrative exemption from the vaccine requirement. Administrative exemptions include requests for religious accommodations.
Army officials review each request on an individual basis to determine whether an exemption is appropriate. Medical requests are reviewed primarily by healthcare providers, while religious accommodation requests include interviews with the Soldiers chaplain, recommendations from the chain of command, as well as a public health and a legal review.
All Soldiers who refuse the order to be vaccinated without an approved or pending exemption request are subject to certain adverse administrative actions, including flags, bars to continued service, and official reprimands.Soldiers who continue to refuse the vaccination order without an approved or pending exemption may also be subject to additional adverse administrative action, including separation.
As the Army accesses and discharges Soldiers and continues to refine data tracking processes, the vaccination percentages will vary slightly.
The Army will publish additional details as they become available.
For additional information on Army vaccination rates, contact the U.S. Army Media Relations Division at usarmy.pentagon.hqda-ocpa.mbx.mrd-press-desk@army.mil.
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Department of the Army announces Total Army COVID-19 vaccination statistics - United States Army
Biden tests positive for COVID-19
President Biden is experiencing "very mild" symptoms after testing positive for COVID-19.
Claire Hardwick, USA TODAY
An increasing number of people, including President Joe Biden, are getting infected with COVID-19 in spite of being vaccinated and boosted.
But that doesn't mean the COVID-19 vaccine isn't working.
Subvariants of the omicron variant of the COVID-19 virus, including the dominant BA.5 subvariant,are both contagious and particularly good at evading immunity, whether it's from the vaccine or a prior infection.
Yet the vaccine is still the best protection against serious illness, even if it doesn't protect against infection, federal,state and countypublic health officials say.
"The (COVID-19) vaccine is remarkable at keeping people out of the hospital even though the variants going around right now are very different than the original strain the vaccine was created for," said Dr. Bob England, interim director of the Arizona Partnership for Immunizationandformer longtime Maricopa County Health Department director.
"Joe Biden is old. I don't know what other chronic conditions he may have, but he's old, and he's at high risk of having serious COVID disease. But he is at way less at that risk because of the vaccines he got. ... Your odds are way better with the vaccine than not."
Biden, following recommendations for people ages 50 and older, is fully vaccinated and has received two boosters. Still, the White House announced Thursday that he had tested positive for COVID-19. So far, he is experiencing mild illness and is getting treated with the antiviral Paxlovid.
"Because the president is fully vaccinated, double-boosted, his risk of serious illness is dramatically lower," White House COVID-19 coordinator Dr. Ashish Jha said during a news briefing Thursday.
Here are five things to know about COVID-19 infection and the effectiveness of vaccines and boosters:
Vaccines and booster doses "have been doing a very good job of preventing a substantial rise in hospitalizations and deaths," Don Herrington, interim director of the Arizona Department of Health Services, wrote Thursday in a blog post.
"In May, adults who were vaccinated and boosted were eight times less likely to be hospitalized and 21 times less likely to die than unvaccinated individuals."
Everyone 5 and older is recommended to get a vaccinebooster dose. Individuals ages 50 and older andthose 12 and older with weakened immune systems are recommended to get a second booster dose.
The Centers for Disease Control and Prevention published research on July 15 that showedthird and fourth COVID-19 vaccine doses offered substantial protection among adults with healthy immune systems who were eligible to receive them early in 2022, when the omicron variant of the COVID-19 virus first emerged.
The findings suggest that currently available vaccines may provide protection against serious illness caused by the currently circulating BA.5 variant, CDC officials said.
COVID-19 vaccines and booster doses can be located at azhealth.gov/FindVaccine.
It's not known whether Bidenwas infected withthe BA.5 subvariant, but BA.5 is dominant both in the U.S. and Arizona.
Clinicians said many BA.5 symptoms are similar to those seen in previous variants, including congestion, headaches, cough and fever, and children tend to have more gastrointestinal symptoms, USA TODAYreported this week.
On Wednesday, state health officials added 18,135 new COVID-19 cases in Arizona and 66new known deaths over the weeklong period ending July 16. June and July have seen relatively similar weekly case additions, with this past week's slightly higher.
Case counts are still far below the winter,state data shows, but case numbers in recent months likely are not showing the full picture of infections as many more people have usedat-home test kits and may not reportpositive resultsto county health departments.
TheCDC's "community level" recommendations, updated on Thursday, for a second consecutive week sayresidents of 10 Arizona counties should be wearingwell-fitting masks indoors in public, regardless of vaccination status or individual risk, including in K-12 schools and other community settings.
The guidance is updated weekly and ranks counties as low, medium and high, or green, yellow and orange. The Arizona counties designated as high, where masks are recommended, are Maricopa, Pinal, Apache, Coconino, Gila, La Paz, Mohave, Navajo, Yavapai and Yuma. Greenlee, Santa Cruz,Pima, Graham and Cochise are medium.
The metrics are based on a countys COVID-19 hospital bed use, COVID-19 hospital admissions and case rates for the virus over the past week. Nearly 42% of counties in the U.S. as of Thursday were designated as "high."
Masks are not explicitlyrecommended forcommunities in the medium level except for certain people, including those who are immunocompromised, at high risk for severe disease, orhave a household or social contactathigh riskfor severe disease.
The CDC also recommends"enhanced prevention measures in high-risk congregate settings" in communities designated at the medium level.
As of July 13, there had been 2,057breakthrough deaths in fully vaccinated individuals (two doses of a two-dose vaccine), according to state health officials preliminary data, which works out to a breakthrough death rate of about 0.04% among fully vaccinated people.
Data from Mayshow that 25.6% of cases, 24.9% of hospitalizations and 19.2% of COVID-19 deaths wereamong fully vaccinated people without a booster, with much of the rest among unvaccinated people. Fully vaccinated people with a booster made up 36.4% of reported cases, 31.5% of hospitalizations and 26% of deaths in May.
The COVID-19 virus' disproportionate impact on older adults, who are also more likely to have a booster dose, could help explain why a higher percentage of people who were fully vaccinated and boosted died of COVID-19 in April than those who were fully vaccinated and not boosted. Theeffectiveness of boosters also appears to waneafter severalmonths.But the precise explanation for those percentages of deaths is unclear.
Looking at the proportions of deaths by vaccination status does not tell the risk, though.State health officials recommend considering therates of deathamong boosted individuals versus unvaccinated individuals, which show significantly lower death rates in vaccinated and boosted individuals compared with unvaccinated individuals.
Unvaccinated people 12 and older in Arizona had a 1.8times greater risk of testing positive for COVID-19, 8times greater risk of hospitalization from COVID-19 and 21 times greater risk of dying from COVID-19 in May compared withfully vaccinated people with a booster,according to a state analysis.
Arizona's rate of fully vaccinated people out of the total population was 62.5%, which was behindthe national rate of 67.1%,according to the CDCas of July 13.
A higher level of vaccinated people in acommunity will provide more protection for the community as a whole, particularly those who are more vulnerable. The point where a large portion of a communitybecomes immune to a disease is often referred to as "herd immunity."
"If more people are vaxxed and boosted, fewer people will get infected," said England, of the Arizona Partnership for Immunization. "The whole impact will be less. It's that simple."
Out ofpeople ages5 and older, 66.5% of those in Arizona were fully vaccinated, compared with 71.3% at the national level, CDC data shows.
Health experts stronglyrecommend booster shotsfor those eligible, especially with the omicron variant spreading. About 47.3% of fully vaccinated Arizonans over the age of 18 had received a first booster shot as of July 6, below the national rate of 51.3% for that same age group.
"COVID-19 has been especially dangerous for older people throughout the pandemic, but data on the current increase in cases provides even more reason for those in this age group to make sure their vaccines are up to date," Herrington wrote in his blog post.
"Compared to the winter surge driven by the Omicron variant, Arizona has since February seen a greater share of cases, hospitalizations, and deaths among those 65 and older."
"COVID-19 vaccines remain our single most important tool to protect people against serious illness, hospitalization, and death," the CDC said July 15.
"Getting vaccinated now will not prevent you from getting an authorized variant-specific vaccine in the fall or winter when they are recommended for you."
Given recent increases in deaths and hospitalizations associated with the BA.5 variant, everyone should stay up to date with recommended COVID-19 vaccinations, including additional booster doses for those who are moderately to severely immunocompromised and adults over 50, officials with the federal agency say.
'It is spreading everywhere':What to know about latest COVID-19 wave in Arizona
Generally, public health experts and health providers say stayingup to date on vaccines and boosters will provide the best protection right now, when the virus that causes COVID-19 is still spreading.
"If you haven't already had COVID, you don't want to have COVID. ... In my view, first is worst," Dr. Joe Gerald,an associate professor of public health policyat the University of Arizona's Mel and Enid Zuckerman College of Public Health, told The Arizona Republic earlier this month.
"The greatest risk from COVID occurs in that first infection, whether it's severe illness, death, long COVID. It's avoiding that first one that provides the greatest benefit to you individually."
Republic reporter Alison Steinbach contributed to this article
Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.
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Vaccinated people are getting COVID-19. But the vaccine still works - The Arizona Republic
