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Daydreaming Can Be Good for You

Dr. Nathanson often urges patients to develop this technique further by engaging with metaphors and visual symbolism. When their patients are feeling stuck, they can create a scene of them standing behind a wall that represents their cul-de-sac. She helps them interpret the symbol and can also use it as a tool. “I’ll say, ‘What are you wearing in front of the wall? What’s under your feet What’s around you What do you see? What do you smell ‘”, She said.

The more senses you can put into action, the more real you can make the scene in your head feel when you focus on your daydreams.

Dr. Nathanson then urges them to take action “by actively engaging with their spontaneous metaphor,” as she puts it. They could climb over the wall, knock it down, or do whatever suited their fancy.

While overcoming past trauma is not as easy as tearing down an imaginary wall, this action can have real, tangible effects. While indulging in the moment of success may keep us from achieving future goals, visualizing the actions you are taking along the way can be of great importance. When you see this movie in your head, you are more likely to be chasing it. Since you have already imagined these scenarios, you will be calm when they play out in real life.

Athletes like rugby players, golfers, and martial artists who purposely dream about their techniques with pictures and narration have found that they can improve their performance. Studies by surgeons and musicians have found similar results. However, some have trouble coming to terms with their resourceful creative sides.

Like Dr. Westgate’s study has shown that voluntary daydreaming is particularly difficult without inspiration. Cognitive flexibility and creativity peak in childhood and decrease with age. That creativity is still there, but it might take a prompt. When TM Robinson-Mosley, a consulting psychologist for the National Basketball Association, advises players on how to harness the power of their daydreams, the first thing she does is help them break down mental blocks and brainstorm ideas to focus on.

To help players lose their inhibitions, Dr. Robinson-Mosley with free writing, drawing, or using whatever medium is appropriate for them. This “allows them to reconnect with the creativity we really enjoy as kids,” she said.

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Analysts level to promising pipeline regardless of Covid vaccine jitters

A healthcare worker prepares to inject a vaccine against AstraZeneca coronavirus disease (COVID-19).

Eloisa Lopez

The AstraZeneca Covid-19 vaccine controversy has sparked some investor concerns about its stock, according to Jefferies – but it’s not all bad news for the UK pharmaceutical company.

Australia, the Philippines and the African Union have either contained or abandoned proposed Oxford-AstraZeneca University coronavirus purchases due to possible links to blood clots.

This came after UK health and vaccine regulators issued a change to guidelines on Wednesday on who should get the shot, suggesting that those under 30 should be given an alternative vaccine. Both UK and European Medicines Regulators (MHRA and EMA, respectively) have stressed that the benefits of the sting still outweigh the risks, but EU leaders have yet to agree on a common policy on the shots.

In a research report earlier this week, Jefferies Research Analyst Peter Welford said he received a pushback from customers because he recently decided to buy AstraZeneca’s shares to buy based on the “noise” about the vaccine .

This is despite the fact that the company has promised that the vaccine will be non-profit making for the “duration of the pandemic” and that it will be offered to low- and middle-income countries on a permanent basis.

The overall risk of blood clots has been estimated at around one in 250,000 and British policymakers and health experts have rushed to defend the vaccine in recent days.

Welford noted that, despite the company’s “notable successes” in gaining regulatory approval and accelerating the manufacture of its profitable vaccine, safety concerns expressed in Europe “are of paramount concern to many generalists.”

“We see FDA emergency use approval and UK / EU dose distribution agreements as key to moving the debate beyond the COVID-19 vaccine, despite concerns that it will be a distraction for management,” he explained.

The vaccine has been approved for use in the UK, Europe and other countries, and hundreds of millions of doses have been ordered from countries around the world. However, no emergency permit has yet been issued in the United States

Jefferies thought outside the box and upgraded AstraZeneca to buy in mid-March. He noted its “compelling growth profile within the EU pharmaceuticals industry” and its relative discount based on the expected strategic benefits of the $ 37 billion acquisition of Alexion Pharmaceuticals in the third quarter.

Welford defended the move by highlighting that 15 times the company’s estimated price-earnings ratio by 2022 – a mechanism for determining whether a company’s stock is fairly valued – is similar to its peers despite its “leading growth profile” .

Promising pipeline

AstraZeneca was trading on the London Stock Exchange on Friday at £ 7,337 a share and Jefferies has set a price target of £ 8,850. In Wednesday’s research note, Welford again pointed to several catalysts in the pipeline that could drive stocks higher in the coming months.

The phase 3 study data for the breast cancer treatment enhertu is expected to be available in the second half of 2021, along with possible approvals for the anifrolumab drug for the treatment of lupus. Jefferies is also anticipating approvals for the asthma drug tezepelumab in the first half of 2022 after “impressive” phase three data and a long delayed approval for the anemia candidate Roxadustat in the second half of 2021. Updated first and second phase data from Lung cancer datopotamab is also expected soon.

In a recent announcement, Damien Conover, Director of Healthcare Equity Research at Morningstar, said of AstraZeneca, “The strong overall innovation that has come from the vaccine and pipeline strengthens our beliefs in the company’s vast moat.”

He added that AstraZeneca had “made progress in addressing areas of unmet medical need” and forecast that data from the company’s Phase 3 trial of Farxiga treatment for conserved heart failure would likely lead to approval of the drug.

Conover rated anifrolumab as a “higher regulatory risk”, while roxadustat was rated as a “medium risk” and tezepelumab as a “lower risk”.

“In the longer term, we are encouraged by the robustness of the early-stage pipeline and the opportunities to develop combinations with Farxiga appear well-positioned to address several major cardiometabolic indications where unmet medical needs remain high,” said Conover. He added that Morningstar also remains bullish on AstraZeneca’s cancer drugs pipeline.

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Kati Kariko Helped Defend the World From the Coronavirus

She grew up in Hungary, daughter of a butcher. She decided she wanted to be a scientist, although she had never met one. She moved to the United States in her 20s, but for decades never found a permanent position, instead clinging to the fringes of academia.

Now Katalin Kariko, 66, known to colleagues as Kati, has emerged as one of the heroes of Covid-19 vaccine development. Her work, with her close collaborator, Dr. Drew Weissman of the University of Pennsylvania, laid the foundation for the stunningly successful vaccines made by Pfizer-BioNTech and Moderna.

For her entire career, Dr. Kariko has focused on messenger RNA, or mRNA — the genetic script that carries DNA instructions to each cell’s protein-making machinery. She was convinced mRNA could be used to instruct cells to make their own medicines, including vaccines.

But for many years her career at the University of Pennsylvania was fragile. She migrated from lab to lab, relying on one senior scientist after another to take her in. She never made more than $60,000 a year.

By all accounts intense and single-minded, Dr. Kariko lives for “the bench” — the spot in the lab where she works. She cares little for fame. “The bench is there, the science is good,” she shrugged in a recent interview. “Who cares?”

Dr. Anthony Fauci, director of the National Institutes of Allergy and infectious Diseases, knows Dr. Kariko’s work. “She was, in a positive sense, kind of obsessed with the concept of messenger RNA,” he said.

Dr. Kariko’s struggles to stay afloat in academia have a familiar ring to scientists. She needed grants to pursue ideas that seemed wild and fanciful. She did not get them, even as more mundane research was rewarded.

“When your idea is against the conventional wisdom that makes sense to the star chamber, it is very hard to break out,” said Dr. David Langer, a neurosurgeon who has worked with Dr. Kariko.

Dr. Kariko’s ideas about mRNA were definitely unorthodox. Increasingly, they also seem to have been prescient.

“It’s going to be transforming,” Dr. Fauci said of mRNA research. “It is already transforming for Covid-19, but also for other vaccines. H.I.V. — people in the field are already excited. Influenza, malaria.”

For Dr. Kariko, most every day was a day in the lab. “You are not going to work — you are going to have fun,” her husband, Bela Francia, manager of an apartment complex, used to tell her as she dashed back to the office on evenings and weekends. He once calculated that her endless workdays meant she was earning about a dollar an hour.

For many scientists, a new discovery is followed by a plan to make money, to form a company and get a patent. But not for Dr. Kariko. “That’s the furthest thing from Kate’s mind,” Dr. Langer said.

She grew up in the small Hungarian town of Kisujszallas. She earned a Ph.D. at the University of Szeged and worked as a postdoctoral fellow at its Biological Research Center.

In 1985, when the university’s research program ran out of money, Dr. Kariko, her husband, and 2-year-old daughter, Susan, moved to Philadelphia for a job as a postdoctoral student at Temple University. Because the Hungarian government only allowed them to take $100 out of the country, she and her husband sewed £900 (roughly $1,246 today) into Susan’s teddy bear. (Susan grew up to be a two-time Olympic gold medal winner in rowing.)

When Dr. Kariko started, it was early days in the mRNA field. Even the most basic tasks were difficult, if not impossible. How do you make RNA molecules in a lab? How do you get mRNA into cells of the body?

In 1989, she landed a job with Dr. Elliot Barnathan, then a cardiologist at the University of Pennsylvania. It was a low-level position, research assistant professor, and never meant to lead to a permanent tenured position. She was supposed to be supported by grant money, but none came in.

She and Dr. Barnathan planned to insert mRNA into cells, inducing them to make new proteins. In one of the first experiments, they hoped to use the strategy to instruct cells to make a protein called the urokinase receptor. If the experiment worked, they would detect the new protein with a radioactive molecule that would be drawn to the receptor.

“Most people laughed at us,” Dr. Barnathan said.

One fateful day, the two scientists hovered over a dot-matrix printer in a narrow room at the end of a long hall. A gamma counter, needed to track the radioactive molecule, was attached to a printer. It began to spew data.

Their detector had found new proteins produced by cells that were never supposed to make them — suggesting that mRNA could be used to direct any cell to make any protein, at will.

“I felt like a god,” Dr. Kariko recalled.

She and Dr. Barnathan were on fire with ideas. Maybe they could use mRNA to improve blood vessels for heart bypass surgery. Perhaps they could even use the procedure to extend the life span of human cells.

Dr. Barnathan, though, soon left the university, accepting a position at a biotech firm, and Dr. Kariko was left without a lab or financial support. She could stay at Penn only if she found another lab to take her on. “They expected I would quit,” she said.

Universities only support low-level Ph.D.s for a limited amount of time, Dr. Langer said: “If they don’t get a grant, they will let them go.” Dr. Kariko “was not a great grant writer,” and at that point “mRNA was more of an idea,” he said.

But Dr. Langer knew Dr. Kariko from his days as a medical resident, when he had worked in Dr. Barnathan’s lab. Dr. Langer urged the head of the neurosurgery department to give Dr. Kariko’s research a chance. “He saved me,” she said.

Updated 

April 10, 2021, 6:01 p.m. ET

Dr. Langer thinks it was Dr. Kariko who saved him — from the kind of thinking that dooms so many scientists.

Working with her, he realized that one key to real scientific understanding is to design experiments that always tell you something, even if it is something you don’t want to hear. The crucial data often come from the control, he learned — the part of the experiment that involves a dummy substance for comparison.

“There’s a tendency when scientists are looking at data to try to validate their own idea,” Dr. Langer said. “The best scientists try to prove themselves wrong. Kate’s genius was a willingness to accept failure and keep trying, and her ability to answer questions people were not smart enough to ask.”

Dr. Langer hoped to use mRNA to treat patients who developed blood clots following brain surgery, often resulting in strokes. His idea was to get cells in blood vessels to make nitric oxide, a substance that dilates blood vessels, but has a half-life of milliseconds. Doctors can’t just inject patients with it.

He and Dr. Kariko tried their mRNA on isolated blood vessels used to study strokes. It failed. They trudged through snow in Buffalo, N.Y., to try it in a laboratory with rabbits prone to strokes. Failure again.

And then Dr. Langer left the university, and the department chairman said he was leaving as well. Dr. Kariko again was without a lab and without funds for research.

A meeting at a photocopying machine changed that. Dr. Weissman happened by, and she struck up a conversation. “I said, ‘I am an RNA scientist — I can make anything with mRNA,’” Dr. Kariko recalled.

Dr. Weissman told her he wanted to make a vaccine against H.I.V. “I said, ‘Yeah, yeah, I can do it,’” Dr. Kariko said.

Despite her bravado, her research on mRNA had stalled. She could make mRNA molecules that instructed cells in petri dishes to make the protein of her choice. But the mRNA did not work in living mice.

“Nobody knew why,” Dr. Weissman said. “All we knew was that the mice got sick. Their fur got ruffled, they hunched up, they stopped eating, they stopped running.”

It turned out that the immune system recognizes invading microbes by detecting their mRNA and responding with inflammation. The scientists’ mRNA injections looked to the immune system like an invasion of pathogens.

But with that answer came another puzzle. Every cell in every person’s body makes mRNA, and the immune system turns a blind eye. “Why is the mRNA I made different?” Dr. Kariko wondered.

A control in an experiment finally provided a clue. Dr. Kariko and Dr. Weissman noticed their mRNA caused an immune overreaction. But the control molecules, another form of RNA in the human body — so-called transfer RNA, or tRNA — did not.

A molecule called pseudouridine in tRNA allowed it to evade the immune response. As it turned out, naturally occurring human mRNA also contains the molecule.

Added to the mRNA made by Dr. Kariko and Dr. Weissman, the molecule did the same — and also made the mRNA much more powerful, directing the synthesis of 10 times as much protein in each cell.

The idea that adding pseudouridine to mRNA protected it from the body’s immune system was a basic scientific discovery with a wide range of thrilling applications. It meant that mRNA could be used to alter the functions of cells without prompting an immune system attack.

“We both started writing grants,” Dr. Weissman said. “We didn’t get most of them. People were not interested in mRNA. The people who reviewed the grants said mRNA will not be a good therapeutic, so don’t bother.’”

Leading scientific journals rejected their work. When the research finally was published, in Immunity, it got little attention.

Dr. Weissman and Dr. Kariko then showed they could induce an animal — a monkey — to make a protein they had selected. In this case, they injected monkeys with mRNA for erythropoietin, a protein that stimulates the body to make red blood cells. The animals’ red blood cell counts soared.

The scientists thought the same method could be used to prompt the body to make any protein drug, like insulin or other hormones or some of the new diabetes drugs. Crucially, mRNA also could be used to make vaccines unlike any seen before.

Instead of injecting a piece of a virus into the body, doctors could inject mRNA that would instruct cells to briefly make that part of the virus.

“We talked to pharmaceutical companies and venture capitalists. No one cared,” Dr. Weissman said. “We were screaming a lot, but no one would listen.”

Eventually, though, two biotech companies took notice of the work: Moderna, in the United States, and BioNTech, in Germany. Pfizer partnered with BioNTech, and the two now help fund Dr. Weissman’s lab.

Soon clinical trials of an mRNA flu vaccine were underway, and there were efforts to build new vaccines against cytomegalovirus and the Zika virus, among others. Then came the coronavirus.

Researchers had known for 20 years that the crucial feature of any coronavirus is the spike protein sitting on its surface, which allows the virus to inject itself into human cells. It was a fat target for an mRNA vaccine.

Chinese scientists posted the genetic sequence of the virus ravaging Wuhan in January 2020, and researchers everywhere went to work. BioNTech designed its mRNA vaccine in hours; Moderna designed its in two days.

The idea for both vaccines was to introduce mRNA into the body that would briefly instruct human cells to produce the coronavirus’s spike protein. The immune system would see the protein, recognize it as alien, and learn to attack the coronavirus if it ever appeared in the body.

The vaccines, though, needed a lipid bubble to encase the mRNA and carry it to the cells that it would enter. The vehicle came quickly, based on 25 years of work by multiple scientists, including Pieter Cullis of the University of British Columbia.

Scientists also needed to isolate the virus’s spike protein from the bounty of genetic data provided by Chinese researchers. Dr. Barney Graham, of the National Institutes of Health, and Jason McClellan, of the University of Texas at Austin, solved that problem in short order.

Testing the quickly designed vaccines required a monumental effort by companies and the National Institutes of Health. But Dr. Kariko had no doubts.

On Nov. 8, the first results of the Pfizer-BioNTech study came in, showing that the mRNA vaccine offered powerful immunity to the new virus. Dr. Kariko turned to her husband. “Oh, it works,” she said. “I thought so.”

To celebrate, she ate an entire box of Goobers chocolate-covered peanuts. By herself.

Dr. Weissman celebrated with his family, ordering takeout dinner from an Italian restaurant, “with wine,” he said. Deep down, he was awed.

“My dream was always that we develop something in the lab that helps people,” Dr. Weissman said. “I’ve satisfied my life’s dream.”

Dr. Kariko and Dr. Weissman were vaccinated on Dec. 18 at the University of Pennsylvania. Their inoculations turned into a press event, and as the cameras flashed, she began to feel uncharacteristically overwhelmed.

A senior administrator told the doctors and nurses rolling up their sleeves for shots that the scientists whose research made the vaccine possible were present, and they all clapped. Dr. Kariko wept.

Things could have gone so differently, for the scientists and for the world, Dr. Langer said. “There are probably many people like her who failed,” he said.

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5 issues to know earlier than the inventory market opens Friday, April 9

Here are the top news, trends, and analysis that investors need to get their trading day started:

1. Stocks relatively flat after another S&P 500 record high

People are seen on Wall Street in front of the New York Stock Exchange (NYSE) in New York City on March 19, 2021.

Brendan McDermid | Reuters

US stock futures were mixed on Friday, the day after modest gains pushed the S&P 500 to another closing record and the Dow Jones Industrial Average within 24 points of Monday’s record close. The Nasdaq was the real winner on Thursday, posting gains of 1% in technical names. The Nasdaq was less than 2% from its record high in February. Federal Reserve Chairman Jerome Powell backed stocks Thursday, calling the US economy’s recovery from the Covid pandemic “uneven”. Temporarily higher prices would not lead to worrying inflation. These comments reassured investors that the highly accommodative monetary policy of the Covid era is not going to change anytime soon.

2. The yields on government bonds rise according to the data on producer prices

The 10-year government bond yield rose but stayed below 1.7%, hitting a 14-month high in March. The Labor Department reported Friday morning that producer prices rose 1% in March, with core inflation excluding food and energy rising 0.5%. Both were stronger than expected. A website outage at the Department of Labor delayed the normal 8:30 a.m.CET by about 25 minutes. The bond market has been at odds with the Fed this year as traders pushed yields higher, believing that stronger economic growth and inflation will force central bankers to hike short-term interest rates near zero and the massive ones Decrease asset purchases earlier than forecast.

3. Covid cases in the US are on the rise even as vaccinations go up

A member of the Maryland National Guard hands out post-it notes with numbers to people who arrive without an appointment at the mass coronavirus vaccination center at Hagerstown Premium Outlets on April 7, 2021 in Hagerstown, Maryland.

Chip Somodevilla | Getty Images

U.S. coronavirus cases are on the rise as infections skyrocket in many parts of the world. Even if the US vaccinates about 3 million people every day and nearly 20% of the American population is fully vaccinated, the average daily Covid cases and deaths averaged over 66,000 and nearly 1,000, respectively. In a rapidly deteriorating situation in Brazil, that country was only the third country after the US and Peru to report a 24-hour list of Covid deaths with more than 4,000 deaths. In the state of Rio de Janeiro, the emergency services have been the most strained since the beginning of the pandemic.

4. Florida is suing CDC for cruises to resume US crossings

Royal Caribbean’s Explorer of the Seas cruise ship docks in Miami, Florida, in Port Miami on March 2, 2021.

Joe Raedle | Getty Images

Florida Republican Governor Ron DeSantis announced Thursday that the state would file a lawsuit against the Centers for Disease Control and Prevention. He demanded that cruise ships be allowed to resume US voyages immediately. Richard Fain, CEO of Royal Caribbean, said he would like the cruise industry to be “treated very much like the airlines” that have been allowed to fly. However, Fain was optimistic about the possible resumption of U.S. crossings in the second half of this year, citing President Joe Biden’s goal for society to return to normal appearances by July 4th.

5. Amazon leadership expands in Alabama warehouse union vote

A RWDSU union representative holds a sign outside the Amazon fulfillment warehouse at the center of a union action on March 29, 2021 in Bessemer, Alabama.

Elijah Nouvelage | Getty Images

With roughly half the ballots counted, Amazon had a dominant lead in US workers’ historic union formation vote in one of the e-commerce giant’s warehouses in Alabama. The count continues on Friday. There were hundreds of contested ballots, most of which were challenged by Amazon. Approximately 55% of eligible workers in Amazon’s Bessemer warehouse voted. For many years, major unions have been quietly talking to Amazon workers about the organization. You faced major challenges in the United States, where none of the company’s warehouses are organized. Unions are widespread among Amazon employees in Europe.

– The Associated Press contributed to this report. Follow all market action like a pro on CNBC Pro. Get the latest information on the pandemic on CNBC’s coronavirus blog.

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AstraZeneca Vaccine and Blood Clots: What Is Recognized So Far

Still, German researchers have said these clots were more common in recipients of the AstraZeneca-Oxford vaccine than in people who had never received the shot.

European regulators had recommended that recipients of the vaccine seek medical help for a number of possible symptoms, including leg swelling, persistent abdominal pain, severe and persistent headache or blurred vision, and tiny spots of blood under the skin outside of the area where the Injection was given was given.

However, these symptoms were so vague that the UK emergency departments almost immediately saw an increase in patients worried they were as they were described. As a result, some emergency physicians have asked for more central guidance on how to deal with what they termed largely unnecessary hospital visits.

German researchers have described special blood tests that can help diagnose the disorder and have suggested treatment with a blood product called intravenous immunoglobulin, which is used to treat various immune disorders.

Drugs called anticoagulants or blood thinners can also be given but are not used frequently – heparin – because the vaccine-related condition is very similar to that rarely seen in people given heparin.

Other vaccines, particularly those given to children for measles, mumps, and rubella, have been linked to transient low levels of platelets, an essential component of blood clotting.

Reduced platelet counts have been reported in a small number of patients who received the Moderna, Pfizer-BioNTech and AstraZeneca vaccines. One recipient, a doctor in Florida, died of a cerebral haemorrhage when his platelet counts failed to restore, and others were hospitalized. US health officials have stated that the cases are being investigated, but they have not reported the results of those reviews and have yet to advise that they are linked to the vaccines.

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Are you able to combine and match Covid vaccines? Here is what we all know up to now

With new guidelines following reports of rare blood clots, the global medical community is evaluating whether it is possible and safe to give two different vaccine candidates to the same person.

This week, the European Medicines Agency and the UK Medicines and Health Products Regulatory Agency found a possible link between the AstraZeneca University Oxford vaccine and very rare cases of unusual blood clots with low platelets.

Neither the European nor the UK health authorities recommended age restrictions on the use of the vaccine. However, the UK regulator noted that the data suggests a slightly higher incidence is reported in the younger age groups of adults, so recommends that these evolving findings be taken into account when using the vaccine.

The EMA also reiterated that the vaccine is safe and effective, but noted that the use of the vaccine at national level will also take into account the pandemic situation and availability of vaccines in each country.

As a result, the UK, various EU countries and other governments around the world have recommended the use of alternative vaccines for younger people.

With the change in guidelines, younger people are now asking, if I’ve already had one dose of the vaccine, should I come back for the second?

Governments have different answers to this question. Health professionals generally agree that mixing and matching vaccines should be safe. However, clinical studies are still ongoing.

Instructions vary

The UK Joint Committee on Vaccination and Immunization advises: “Anyone who has received a first dose of the AstraZeneca COVID-19 vaccine, regardless of age, should continue to be offered a second dose of the AstraZeneca COVID-19 vaccine. The second dose will be important for longer lasting protection against COVID-19. “

In contrast, the French health authority recommends that people under the age of 55 who received their first dose of AstraZeneca should be given Pfizer or Moderna for their second shot. In these cases, a break of 12 weeks between these first and second recordings is recommended. The regulator stated that if you had the first AstraZeneca burst and then switched to an mRNA burst for the second, there was no reason to fear certain adverse events.

Germany followed a similar path. The German vaccine committee recommended people under 60 who had received a shot of AstraZeneca jab to opt for a different vaccine for their second dose.

The Prime Minister of Baden-Württemberg, Winfried Kretschmann (R), will receive the AstraZeneca vaccine against the novel corona virus in Stuttgart on March 19, 2021.

MARIJAN MURAT | AFP | Getty Images

Try running

“The guidelines are the guidelines. But, as a basic immunologist, can I see an argument as to why it would be unsafe or bad to mix and match vaccines? No, I can’t see any at all. It would still produce great immunity. None Problem with that, “Danny Altmann, professor of immunology at Imperial College London, told CNBC’s” Squawk Box Europe “on Friday.

Andrew Freedman, an infectious disease reader at Cardiff University’s School of Medicine, told CNBC, “Studies are currently underway to examine the concept of mix and match. There is no theoretical reason why this should not be feasible or safe, but we have to wait for these studies. “

Regarding a possible booster dose that might be needed in the fall or winter, he added, “I don’t think there is any real concern that you would not be able to take two doses of the AstraZeneca vaccine with either of the others administer messenger RNA vaccines. ”

Meanwhile, Franz-Werner Haas, CEO of vaccine maker CureVac, told CNBC this week, “The good news is that all of these vaccines code for the same spike protein, so there are clinical trials and data that you mix and match mix can fit these different vaccine platforms. ”

“In that regard, I have high hopes that this will work out quite well,” he added.

CureVac’s own candidate is still in clinical trials. The data read is on track for the second quarter of this year.

The Centers for Disease Control and Prevention claim that the safety and effectiveness of a mixed line of products have not been rated.

Several studies are examining the effects of mixing vaccines. The UK started a study in February that specifically mixed the AstraZeneca-Oxford vaccine with the Pfizer BioNtech shot. The results are not expected to be available until summer. Independently of this, studies are carried out in which a combination of the vaccines AstraZeneca-Oxford and Russian Sputnik V is examined.

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Vaccine Passports: What Are They, and Who May Want One?

With vaccinations against Covid-19 on the rise, attention is turning to tools that can help people prove they have been vaccinated and potentially bypass the stifling restrictions put in place to fight the pandemic.

Although the idea has met with opposition over privacy and equity concerns, there are already several types of coronavirus vaccination records, sometimes referred to as “vaccination records,” in paper and digital form. Hundreds of airlines, governments, and other organizations are experimenting with new electronic versions, and the number is growing every day, even though their use has been very limited.

Portable vaccine records are an old idea: travelers to many parts of the world, children enrolling in school, and some health care workers have long had to show them as evidence that they were vaccinated against diseases.

However, vaccination records use digital tools that take the concept to a new level, and experts predict that electronic verification will soon become part of everyday life, especially for international air travel, but also for access to crowded spaces like theaters.

Here are some of the most important questions to be asked.

In general, the term is understood to mean an electronic vaccination record, possibly in the form of a QR code, which is easily accessible via a smartphone or possibly stored on the device, but can also be printed out.

At its simplest, the documentation is a physical card created by the Centers for Disease Control and Prevention and usually given to people who receive their first Covid-19 shot in the US, or the ” yellow card “of the World Health Organization for decades by travelers vaccinated against diseases such as yellow fever. But these are on paper, filled in by hand, and are quite prone to forgeries.

The tool may need to take into account several variables: it is unclear how long it will take to vaccinate, poor batches can occur, and the emergence of new variants of the virus will likely require new vaccines. In the long run, an electronic record may need to indicate which specific vaccine a person received from which batch and when.

More than a dozen competing versions are already being developed and promoted.

In the short term, the clearest application may be in international travel, and the reason is obvious at every major airport: the number of passengers is a fraction of the prepandemic, but there are enormous lines at airline counters and passport control.

Many countries already require proof of a recent negative coronavirus test for entry. So far, this documentation has existed almost exclusively on paper or on the passenger’s phone and has to be confirmed by human eyes at the airport. Therefore, it is not possible to check in for a flight online or even at an electronic kiosk in the terminal.

As travel restrictions wear off, the volume will increase and many nations are expected to start demanding proof of vaccination (or previous coronavirus infection) to enter, or simply skip the quarantine requirement. More passengers and more documentation requirements make processing even more unwieldy.

“We need to automate this,” said Nick Careen, senior vice president of the International Air Transport Association, an airline industry trading group. “Even if compulsory vaccination has never been approved, there will still be a test requirement and we cannot do it manually.”

(Even with an electronic system, officials say there will be some people who will have to use paper health documents because they don’t have access to digital tools.)

No major country has publicly released vaccine reviews for domestic travel. However, some governments and companies are already requiring proof of a negative coronavirus test for access to certain crowded places, and some are now requiring proof of vaccination, increasing the desire for an electronic alternative.

Updated

April 9, 2021, 7:09 p.m. ET

To be most useful, a digital record would need to be widespread – from governments controlling travelers, airlines and shipping lines screening passengers, corporations restricting admission, and the conglomeration of healthcare providers, government agencies and pharmacies that give the shots.

This in turn means that it has to be easy to use and relatively inexpensive. It would be an obstacle if companies had to spend a lot of money or introduce new software.

In February, the Israeli government began issuing their digital Green Pass or physical certificate to vaccinated people. She has to enter places like hotels and theaters.

In the past month, hundreds more companies around the world – airlines, governments, drugstore chains, and others – began using privately controlled digital systems to review health records. Most use the systems – including one called CommonPass and the International Air Transport Association’s own system, Travel Pass – on a trial basis to check for negative coronavirus tests.

The systems are designed to also provide evidence of vaccination if required.

In March, Aruba and JetBlue allowed US passengers to show CommonPass, a negative test developed by the Commons Project, a Switzerland-based nonprofit organization, with support from the World Economic Forum. Lufthansa passengers flying to the USA can also use it.

In the same month, Singapore Airlines became the first airline to use the Travel Pass only to a limited extent for passengers between Singapore and London and will use it on a large scale in May.

Also in March, New York State became the first US government to introduce a system developed with IBM, the Excelsior Pass, which some venues could use to prove vaccination. Florida and Texas governors have vowed to block such a system in their states, calling it a violation of government and privacy invasion.

Iceland this month eased entry restrictions for people who have been vaccinated, and the UK is about to experiment with a vaccine review requirement to attend sporting events. So far, however, neither country has implemented a digital system.

The Biden government admits that private entities will use such systems, but says the federal government will not be involved in creating such a system. “There won’t be a federal vaccination database or federal mandate that requires everyone to receive a single vaccination record,” White House press secretary Jen Psaki said this week.

However, this does not preclude a federal agency from using a privately developed electronic health record to screen international travelers.

Many of the concerns raised are about privacy, but the people who develop the systems say they can be addressed.

For example, CommonPass and its app do not contain any health information about the user, said Paul Meyer, executive director of the Commons Project Foundation. If a participating airline needs to know if a passenger had a negative test or vaccination and a participating pharmacy has the information, CommonPass can communicate with both and return a simple yes or no answer without providing any specific data.

“You shouldn’t have to give your health record to Yankee Stadium or an airline,” Meyer said.

Many technology and health institutions have come together as the Vaccine Credential Initiative to develop a commonly agreed set of open standards. This means that the software underlying a verification system is transparent and can be easily adapted to other systems, while at the same time protecting privacy. The WHO has a similar initiative, the Smart Vaccination Certificate.

However, some companies create closed, proprietary systems that they want to sell to customers, and some appear to have access to user information.

One concern is that a variety of systems may not be compatible, defeating the purpose of making it easier to verify a person’s status.

Another objection is that any requirement to prove vaccination status would discriminate against those who can’t get the shot or refuse the shot, and there is still uncertainty about how well vaccination prevents virus transmission.

For these reasons, the WHO said this week that it does not support asking for proof of vaccination for travel – for now.

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How Covid protected bubble could be created on cruises

Dr. Scott Gottlieb, who advised cruise lines on Covid protocols, told CNBC on Friday that he believed a safe environment could be created on the ships.

Gottlieb’s comments came a day after Florida Republican Governor Ron DeSantis said the state had sued the Centers for Disease Control and Prevention and demanded that the public health agency see cruise ships leave US ports immediately allowed to sail.

Gottlieb, co-chair of an advisory board for Norwegian Cruise Line Holdings and Royal Caribbean, told Squawk Box that companies have reasonable guidelines to prepare for when to cease operations after a Covid hiatus that is longer than longer allowed to record one year.

“They are committed to things like mandatory screening of passengers. Norwegian Cruise Line recently announced that they will require vaccination of all of their passengers,” said Gottlieb, who served as the US Food and Drug Administration representative from 2017-2019 – The state was active in the Trump Administration.

Gottlieb also noted that social distancing was possible on the ships, saying “these cruises will not be operated at full capacity.”

“When you start implementing all of these public health recommendations, you start creating an environment that could be pretty safe,” he explained. “I believe you can create a safe bubble around this experience, especially if you compare it to other vacation experiences where you have no control over the surroundings,” he added.

Cruise ships were a hotspot for Covid outbreaks in the early days of the global health crisis last year, leading the CDC to issue their no-sail order in mid-March 2020. While the CDC has issued some guidelines for cruise lines as part of its conditional sailing to help achieve this, the agency has not yet set a date when operators can resume voyage from U.S. ports.

In response to a request from CNBC to comment on Gottlieb’s comments, the CDC said via email that it “has an obligation to work with the cruise industry and seaport partners to continue the cruise on the phased approach set out in the conditional sailing order This goal is in line with the desire for resumption of passenger operations in the United States, expressed by many of the major cruise lines and travelers, hopefully by midsummer. “

However, the cruise industry is growing impatient after companies borrowed billions in debt and issued new shares to fund operations while sailing revenues dried up. Late last month, a trade group asked the CDC to allow a gradual restart in early July. Operators have stated that they are seeing strong demand for bookings, suggesting that people are starting to feel comfortable returning to cruises.

In a CNBC interview on Wednesday, Carnival CEO Arnold Donald pointed out differences between restrictions in America and other countries around the world where cruises have resumed in some locations.

“A person can fly from the US to another country today. Get on a cruise ship and then return to the US, regardless of whether they have been vaccinated or not,” Donald said at Closing Bell. “But here in the US at the time, even if you were vaccinated, you couldn’t get on a cruise ship.”

Donald commended the Biden government for their work in distributing Covid vaccinations in the US, where approximately 20% of the population is fully vaccinated. He believes the cruise industry and CDC can work together to reach an agreement on sailing.

“The government has made great strides on vaccinations and has taken command of this matter,” said Donald. “We are confident that we can work together and come up with something that would be a workable solution and hope we have some more sailing out of the US this summer.”

Richard Fain, CEO of Royal Caribbean, told CBS This Morning on Thursday that he would like the cruise industry to be treated “very much like the airlines” that have been allowed to fly. However, Fain is optimistic about the possible resumption of U.S. crossings in the second half of this year, citing President Joe Biden’s goal of getting society back to normal by July 4th.

– CNBC’s Katie Tsai contributed to this report.

Disclosure: Scott Gottlieb is a CNBC employee and a member of the boards of directors of Pfizer, genetic testing startup Tempus, health technology company Aetion Inc., and biotech company Illumina. He is also co-chair of Norwegian Cruise Line Holdings and Royal Caribbean’s Healthy Sail Panel.

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Blood Clots Linked to AZ Vaccine Stem From Uncommon Antibody Response

The antibodies resulted in a condition called thrombotic thrombocytopenia, which caused both clotting and abnormal bleeding. The researchers suggested calling the newly identified version in these patients “vaccine-induced immunothrombotic thrombocytopenia” or VITT.

Scientists have put forward various theories of what triggers the immune response. The AstraZeneca vaccine uses a chimpanzee adenovirus to transport DNA into recipients and trigger an immune response against the coronavirus. Laboratory research has shown that the chimpanzee virus or DNA could be causing the problem. Some researchers have suggested that bleeding from the injection mixed with the vaccine could bring platelets into the crosshairs of the immune system.

Dr. Greinacher called the theories plausible but unproven.

The article described special blood tests that could help diagnose the disorder and differentiate it from other, more common, clotting problems unrelated to the vaccine. The research team suggested treatment with a blood product called intravenous immunoglobulin, which is used to treat various immune disorders. Dr. Greinacher compared the treatment to putting out a fire.

Medicines called anticoagulants or blood thinners can also be given. However, the researchers advised against prescribing a commonly used heparin because the vaccine-induced condition is very similar to a severe reaction that is rarely seen in people given heparin.

The second report from Norway described five patients, one male and four female health workers aged 32 to 54, who had blood clots and bleeding seven to ten days after receiving the AstraZeneca vaccine. Four had severe blood clots in the brain and three died. Severe headache was one of her early symptoms. Like the German patients, they all had high levels of antibodies that could activate blood platelets.

The team from Norway also recommended intravenous immunoglobulin treatment. The researchers said the disorder is rare but “a new phenomenon with devastating effects on otherwise healthy young adults,” and they suggested it might be more common than previous studies with the AstraZeneca vaccine had shown.

On Friday, European regulators also said they were reviewing reports of some blood clot cases that have occurred in people who had received the Johnson and Johnson vaccine. In the United States, federal agencies are investigating reports of another type of unusual blood disorder in which a few dozen people who received either the Pfizer-BioNTech or Moderna vaccines experienced steep decreases in platelet counts.

Benjamin Mueller and Melissa Eddy contributed to this.

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U.S. sees rising Covid instances related to youth sports activities, CDC director says

Youth hockey has had more positive coronavirus cases across the country than most sports.

Adam Glanzman | The Washington Post | Getty Images

There are increasing reports of Covid-19 cases related to youth sports in the US, said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention on Friday.

The connection between youth sports and increased coronavirus cases is that the highly infectious B.1.1.7 variant identified for the first time in Great Britain has become the most common Covid strain in the USA

There are growing numbers of Covid cases related to variant B.1.1.7 in Michigan and Minnesota, Walensky said. “Both states have concerns about transmission in youth sports, both club and sport.” connected in schools. “

“What is happening in Michigan and Minnesota is similar to what we are seeing across the country: increasing reports of cases related to youth sports,” Walensky said at a White House press conference on Covid-19 Friday.

There were 291 outbreaks in Michigan between January and March that came from youth sports teams that involved at least 1,091 people, health officials said at a separate news conference on Friday. Governor Gretchen Whitmer urged schools and clubs to pause personal exercises and games for two weeks to control the outbreak. She also urged schools to stop personal learning during this time.

In Minnesota, the B.1.1.7 strain quickly spread throughout Carver County, with at least 68 cases of coronavirus linked to participants in school and club sports activities such as hockey, wrestling, basketball, alpine skiing, and other sports, the state reported Health Department March.

A Covid outbreak at a wrestling tournament in Florida in December resulted in at least 38 coronavirus cases, according to a CDC study.

Walensky emphasized that Covid-19 cases related to youth sports are not necessarily related to an increased risk of transmission in classrooms.

“As cases increase in the community, we expect the cases seen in schools to increase too. This is not necessarily indicative of school-based transmission,” Walensky said.

“We haven’t seen any evidence of significant transmission of Covid-19 within schools once schools have fully implemented the CDC’s harm control guidelines,” she said.

The CDC director also highlighted an increase in Covid-19 cases and emergency rooms in younger adults, most of whom have not yet been vaccinated.