The Case for Vaccine Access in the Bay Area: When Children and Young Blacks Live in a Bay Area with a Covid-19 Shot

Marin County has embraced vaccine at a higher rate than the majority of the country due to the fact that the Covid-19 shot is an important litmus test for vaccine acceptability in the modern age. It comes after public health efforts to change parents’ opinions, as well as a strict state mandate that students get vaccinated for childhood diseases.

The corner of the Bay Area had become a great example of a community with high education and low childhood vaccine rates, thanks to a group of parents skeptical of traditional medicine. Marin was something of a paradox to mainstream Democrats, and often a punching bag. In 2015, during a measles outbreak in California, the comedian Jon Stewart blamed Marin parents for being guilty of a “mindful stupidity.”

Birmingham may have been an extreme case, but it was also part of a pattern. Around the U.S., many Black and Latino communities had limited early access to the Covid vaccines. That lack of access — combined with greater vaccine hesitancy among some people of color — contributed to racial gaps in vaccination and, by extension, large racial gaps in Covid death rates.

The Trump administration had seemed uninterested in combating those inequities, leaving it up to states. President Biden made closing the gaps a priority. The White House chief of staff told me the response was built with equity in mind.

Covid-19 fever in Europe has spiked in the past two weeks, with the latest vaccines launching in the European Union and the implications for public health

As cooler weather arrives in Europe, the public health experts warn that a new Covid-19 wave is imminent, with vaccine fatigue being one of the factors that could limit booster uptake.

The majority of infections are still behind Omicron subvariants, but newer ones are gaining ground. Hundreds of new forms of Omicron are being tracked by scientists, World Health Organization (WHO) officials said this week.

According to WHO, the European Union had 1.5 million cases last week, an 8% increase from the prior week. Case numbers have been declining globally.

In the week ending October 4, Covid-19 hospital admissions with symptoms jumped nearly 32% in Italy, while intensive care admissions rose about 21%, compared to the week before, according to data compiled by independent scientific foundation Gimbe.

Two types of vaccines addressed the BA.1 as well as the BA.5 subvariants were launched in Europe as of September, all of which are Omicron-adapted. Only the BA.1-tailored shots have been approved for use in Britain.

European and British officials have endorsed the latest booster only for people with compromised immune systems, and the elderly. Public health experts said the choice of vaccine as a booster will likely add to confusion.

“If someone is less concerned about their risk, the lack of publicity is likely to reduce the number of people who seek it out,” says a professor of European public health. “So on balance I fear that uptake will be quite a bit lower.”

A high percentage of the population may have had a Covid episode in the last few months, according to a professor at a college in London.

According to the European Centre for Disease Prevention and Control, Pfizer-BioNTech and Moderna have supplied 40 million vaccine doses to member states in the European Union since September 5.

Schaffner said that he almost had to remind people about influenza. “We’ve had two quite curtailed, very low influenza years. And of course, everyone’s been preoccupied with Covid, and they want to put Covid behind them and get on with their lives.”

The government was ill prepared for the fall-winter season, and that a publication on management of the epidemic had been blocked, according to Italy’s Gimbe science foundation.

British officials last week warned of the effects of renewed circulation of flu and a resurgence in Covid-19, which could lead to pressure on the National Health Service.

Covid-19: Where do we stand, what are we really doing? Why we shouldn’t see the deaths of older adults, especially in the U.S.

First, a programming note: This is my last newsletter before starting a book leave. I’ll be back in late January. Until then, other Times journalists will be writing The Morning, and I look forward to reading their work along with all of you.

The messages about the threat of a triple threat of viruses isn’t the same as it was before. The urgency is real, as hospitals across the country stretch their capacity to record levels, but it’s not driving people to action.

“It strikes me that people have gotten used to bad flu seasons for the elderly. There are a few different Viruses around, and it’s the same. There’s a sense that this is what we’re going to expect and this is what we have to live with,” said Dr. Jesse Hackell, a pediatrician who co-authored a clinical report about countering vaccine hesitancy in 2016.

One answer is that as a country, we prefer just to not see those deaths at all, regarding a baseline of several hundred deaths a day as a sort of background noise or morbid but faded wallpaper. Since it is the country’s thirdleading cause of death, we don’t need to understand why so many Americans are dying from Covid-19 every day. This is normalization at work, but it is also a familiar pattern: We don’t exactly track the ups and downs of cancer or heart disease either.

Many of us were also turned off by dismissive rhetoric from the beginning of the pandemic, when those minimizing the threat pointed to the disproportionate risks to the very old as a reason to not worry all that much about limiting spread. The country as a whole is ageist, without enough respect for the well-being of old people. But hearing the conservative commentator Ben Shapiro or the Texas lieutenant governor Dan Patrick so blithely dismissing the deaths of older adults in 2020 probably made the whole subject seem considerably more taboo to the rest of us than it might’ve been otherwise.

How Much Flu Flu and Covid-19 Vaccinations Have Helped Health Care? The Yale Center for Infectious Disease Modeling and Analysis (CIDMA) explains how many vaccines were needed

Numerous studies have found that flu and Covid-19 vaccines significantly reduce the risk of severe outcomes for those who become infected, including hospitalization and death – thus reducing the burden on the health care work force.

To determine exactly how much the shots have helped, researchers from the Commonwealth Fund and Yale School of Public Health created a computer model of disease transmission that incorporated demographic information, people’s risk factors, the dynamics of infection and general information about vaccination.

One of the study authors stated that the savings could go up if long Covid cases were taken into account.

“Given the emergency of highly transmissible variants and immune-evading variants like Omicron, it is a remarkable success and an extraordinary achievement,” said Galvani, founding director of the Yale Center for Infectious Disease Modeling and Analysis.

Don’t wait. Anthony Fauci, the head of the National Institute of Allergy and Infectious Disease and a medical adviser to Biden, told the audience that if they waited, they would be at risk. “We’re entering the colder months of the late fall and the early winter. We will be spending the holidays with our families and friends. If you are up to date, great. Go get vaccines if you are not.

What can we do about the epidemic? Seven years after COVID-19: how we can make the most of our world’s best defence

Over a third of the US population lives in areas that meet CDC criteria for a high Covid-19 community, including New York City, Los Angeles County and Arizona, which has more than doubled in the last week. And at this level, the CDC recommends wearing a mask indoors.

All of this could have been avoided. No effective vaccines or treatments have been approved against Sudan ebolavirus. The world could have prepared vaccines for clinical testing at the outbreak’s start, if it had learned its lesson from previous infections. They aren’t a global failure.

Our best defence is having vaccines ready to use the moment disaster strikes. Severe acute respiratory syndrome (SARS) and disease X are on a list of nine priority pathogens that the World Health Organization keeps. All nine deserve a full effort: development of several candidate vaccines through the animal-model and early clinical testing stages; vialed and quality-tested vaccines that are ready for immediate testing in an outbreak; and stockpiling of enough doses to control the disease if the vaccine is shown to be efficacious. For disease X, a set of viral vectors and messenger RNA delivery systems should be ready to carry the sequences of whichever antigens prove effective against the disease, and the manufacturing and clinical trials should be worked through as far as possible. By doing much of the preclinical and clinical work in advance, we can have doses as close to ready as possible when we need them.

Seven years ago, I warned about the problem in a Nature column. Yet despite the COVID-19 wake-up call, this remains one of the biggest chinks in our pandemic-preparedness armour.

What will it take to finally catalyse change, so that I’m not writing this again seven years from now? We have come a long way, from not mentioning this issue until it became obvious that it is relevant to daily life. I am optimistic that a change in mindset is in view.

Wealthy countries need to take the lead. They should ensure that agencies such as the Coalition for Epidemic Preparedness Innovations (CEPI), based in Oslo, and the International AIDS Vaccine Initiative (IAVI), based in New York City, are fully funded to do this work, which will involve close collaboration with government research agencies as well as Gavi, the Vaccine Alliance, and the WHO.

This month, Anthony Fauci will step down as director of the US National Institute of Allergy and Infectious Diseases (NIAID) after more than 38 years in the post and 54 years at its parent organization, the US National Institutes of Health (NIH). He led the institute under seven presidents and has led the response to HIV/AIDS and the COVID-19 epidemic. During the H1N1 epidemic, the 81-year-old physician-scientist became a household name despite being a trusted source of advice not always received well. Donald Trump, who saw his advice as inconsistent and churlish, was one of the people who disliked the physician-scientist On 11 December, he was attacked by Musk on the micro-messaging platform. Fauci talked about Musk’s comments, and his own legacy.

The area of HIV is one of the most important. In 1981, when we became aware of the cases of HIV, there was a mysterious disease of unknown origin that was killing almost all the people who had it. It was some of the most trying periods of my career in infectious diseases. We went from that bleak time of not knowing what was killing all of these mostly young gay men to getting the [underlying virus], a diagnostic test and, within a few years, an entire series of drugs, which when used in combination, have completely transformed the lives of people with HIV. We also have developed highly effective prevention methods with pre-exposure prophylaxis and [can treat] people who are infected, bringing the level of virus to below detectable levels, so they don’t transmit it to anybody else.

One of the holy grails of infectious-disease research is a safe and effective vaccine for HIV. We’ve made spectacular advances in the development of therapies, both for treatment and prevention of disease. Despite our best intentions, we have been unsuccessful in getting a vaccine that is safe and effective. One of the things that we are looking forward to is that. It is not certain, but it is possible to eliminate the HIV virus in the absence of any further therapy. We haven’t reached that point yet, but that is an aspirational goal.

Mental Health after COVID-19: Why I’m so sorry for your mom and dad. That’s a problem I don’t want to hear about

The emphasis on mental health and paying attention to the stresses of society that the Pandemic has put on have been brought to the fore by COVID-19. Their growth and development has been shaped by missing in-person school, stress from losing grandparents and parents, and the disruption of their childhood. All of that has had a major negative impact on mental health.

That is not possible to answer. There is a big reason the global public health effort is hampered if countries or groups are not transparent. All the countries of the world have to realize that there is no such thing as a Pandemic because infectious diseases spread by respiratory routes are not a thing of the past. We were so shocked by how COVID spread throughout the world and led to nearly 7 million deaths, that we think it may be a gross underestimate.

I don’t pay attention to that, Max, and I don’t feel I need to respond. I don’t follow anyone on social media. I don’t have a Twitter account. A lot of that stuff is just a cesspool of misinformation, and I don’t waste a minute worrying about it.

It is at risk. That’s why I have armed federal agents with me all the time. That stirs up a lot of hate in people who have no idea why they’re hating — they’re hating because somebody like that is tweeting about it.

Source: https://www.nature.com/articles/d41586-022-04432-7

The Challenge of Vaccine Fatigue: How Many People Will Become a Primary Care Provider? Dr. William Hackell, MD, a Public Health Official at Vanderbilt University Medical Center

I would encourage them to continue with their career in public service and public health because they can make a huge difference to society. It is truly extraordinary. It defeated all of the bad stuff. It is regrettable that we are facing attacks on public-health officials. But the satisfaction and the accomplishments you can [achieve] in the field are great. And it certainly supersedes all that other stuff.

According to CDC data, the number of flu vaccine given in pharmacies this season is more than last year’s, which means that more people are choosing to get their flu shot in a pharmacy. It is a sign that there are more opportunities for people who do not have a primary care provider to be reached.

“There’s a great deal of vaccine fatigue out there. Asking people this year to get not just one vaccine but to get the annual influenza vaccine, as well as the Covid booster, has really been what I have called a hard sell,” said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and professor at Vanderbilt University Medical Center.

“There’s the old saying, ‘familiarity breeds contempt.’ Well, perhaps that’s a bit strong, but familiarity does seem to breed a certain nonchalance,” he said.

The National Adult Immunization Action Coalition used a public health message that said if you don’t protect yourself against flu you can definitely lose your job.

But that double threat didn’t materialize. Flu seasons have been uncharacteristically mild for the past two years, and people have let their guard down, experts say.

Hackell thinks that if it were a vaccine like Measles, where it is really effective, it might be different. “But we have to compare it to Covid and flu vaccines, where the efficacy is less than dramatic, and when there’s a lot of controversy going on, I think that spills over.”

I think that it’s burnout on the part of providers as well. We’re not pushing it as hard,” said Hackell, who is also chair of the American Academy of Pediatrics Committee on Practice and Ambulatory Medicine. “It gets very difficult to keep having these unproductive conversations over and over again. I don’t know where the time is to have these lengthy discussions when you have a lot of sick kids.

The updated Covid-19 booster was approved in the fall, but only a small number of eligible people have gotten one.

But despite the convenience of getting both shots at once, there’s evidence that linking the two isn’t the best way to boost coverage rates for either.

“We give multiple vaccines to our kids at the same time, but we haven’t typically done that for adults,” said Tan, former liaison to the CDC’s vaccine advisory committee for the American Medical Association.

It is possible for a patient to have some confidence in a health-care provider because they can assure them it is safe. “In that personal conversation between the provider and the patient, the patient ends up being converted and getting the vaccine. It’s a testimony also to our remarkable health-care providers.”

The message might finally be sticking. At Walgreens locations, co-administration of the flu and Covid-19 vaccine is 70% higher this year than it was last year, according to data shared with CNN.

Source: https://www.cnn.com/2022/12/13/health/flu-vaccine-fatigue/index.html

COVID-19 does not stop; it does take 10 years to stop. Why do children in rural communities and conflict zones need vaccinating?

“At least we’ve got the uptick now, as opposed to this continuous decline that we were seeing four weeks ago,” he said. I would like to remind everyone that they need to be better than we currently are.

The risks of allowing these infections to flourish are clear. Zimbabwe is currently working to contain a huge measles outbreak that claimed the lives of more than 750 children between April and October. The resurgence of the disease in the US led to a state of emergency in New York.

Better data will also be crucial to helping the health-care community to quickly identify places where intervention is needed to prevent immunization levels from dipping too low. The agency has been helping member nations to adopt its district health information system called DHIS2 which makes it easier to share vaccine administration and coverage information. But she also notes that the real challenge will be catching the ‘zero-dose’ children, most of whom live below the poverty line in settlements with inadequate housing and basic services, rural villages and conflict zones. “They’re born outside of a facility, they’ve never gotten a single vaccination, they’re sort of uncounted and unseen,” she says. “It’s really hard to plan to go out and vaccinate children who you don’t even know exist.” One of the goals of the Immunization Agenda 2030 is to reduce the number of zero-dose children by half, which the WHO estimates could save as many as 50 million lives over the next 10 years.

The organization declared COVID-19 to be a public health emergency in a few weeks. O’Brien says that it shut things down. The absolute decline in the number of doses given in the same month the previous year happened in April, May and June of 2020.

Much of this early impact was directly attributable to the strong measures taken to contain the spread of the SARS-CoV-2 virus, with many jurisdictions limiting travel, closing schools and restricting access to non-urgent medical care. Health-care providers struggled with too little capacity. “Resources and expertise were diverted from many sectors of health care, including immunization systems, to COVID response,” says Mosser. Even when there were no formal impediments to scheduling a visit to a health-care provider, social and psychological factors came into play that further undermined timely vaccination. Fear of even being in contact with the health-care services was created because of Caval.

Concerns about the COVID-19 shots are not fully understood. But some who study vaccine uptake are already concerned. “It’s going to take time to get data, but I would not be surprised if we see substantial drops in routine vaccines — especially in populations that have really been refusing COVID vaccines,” says Salmon. Omer’s research is already picking up some early indications of reduced uptake for the tetanus, diphtheria and pertussis vaccine among people in the United States who are pregnant. And even though these are still preliminary findings, he says “my concern is that this is sort of an iceberg where we’re just beginning to see the tip”.

And the possibility remains that this mistrust will spread globally. Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine, says “there is clearly a globally coordinated, very deep, negative network out there” exploiting pandemic-era mistrust to propagate and promote a broader anti-vaccine agenda through social networks such as Twitter and Facebook. In South Africa, Ndwandwe sees such vaccine hesitancy propagating mainly in more affluent communities that have the time and resources to find information — and misinformation — on the Internet. “TikTok is one of the more dangerous platforms that I have seen,” she says. There are a lot of things happening there. The conversation is driven by radio broadcasts or religious leaders in poorer communities who don’t have easy internet access.

The natural instinct of a parent is to make sure their children are protected from the illnesses that can disrupt their lives. There are still many challenges for researchers, physicians and policymakers to address to make children happy and healthy, in many respects this is easier now than ever before.

New treatments for some childhood illnesses are also badly needed. Drug companies have little incentive to perform the trials necessary to get the treatments approved for children when they are already used in adults. However, some positive strides are being made. Cell-based immunotherapies such as CAR-T-cell therapy have been impressively effective in treating blood cancers — especially acute lymphoblastic leukaemia, the most common childhood cancer. Solid tumours have so far proved to be a trickier foe, but fresh approaches to this problem are showing promise.

Children with Mental Health and Addiction (S56): The Impact of Addiction on Children, Families, and Children’s Mental Health

Children’s mental health is also being taken seriously. Problems such as anxiety and depression can have their roots anchored in something as ubiquitous and seemingly benign as social media, or as obviously traumatic as war. Strategies can be used to help children deal with these challenges. And physicians are developing more effective and compassionate ways of helping mothers and their babies in cases of opioid addiction, which can lead to babies being born with a substance dependency and battling symptoms of withdrawal (S56).

We are pleased to acknowledge the financial support of Sanofi in producing this Outlook. As always, Nature retains sole responsibility for all editorial content.