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Health

Covid Delta Variant Security: Your Questions Answered

Covid Delta Variant Safety: Your Questions Answered

Most experts say they use a good quality medical mask such as an N95 or KF94 when flying. If you don’t have one, double masking is recommended. For a vaccinated person, the risk of briefly removing a mask to eat or drink during a flight is small, but it is better to keep it on for as long as possible. The CDC says that for anyone who has not been vaccinated, including children, it is best to avoid flying.

Dr. Bromage said he had recently traveled by plane and briefly removed his mask to have a drink, but left it for most of the flight. He said he’d rather take off his mask to eat if he knew the people next to him had been vaccinated. He said he would be more concerned if the person next to him didn’t seem to be caring about Covid precautions or was wearing the mask under their nose. “If there is a random person next to you, especially a talkative person, I would keep the mask on,” he said.

Most buses, trains, and subways all still have to wear a mask, which lowers the risk. While vaccinated people are well protected, the risk of virus exposure increases the longer the journey takes and the more crowded the train or bus is. For many people, using public transport is essential to get to work or school, and wearing a well-fitting medical mask or double mask is recommended. If public transport is optional, deciding whether to ride should take into account local vaccination rates and whether the numbers of cases are increasing.

While it is generally considered safe for vaccinated people to hug each other and hang out unmasked, parents of unvaccinated children need to consider more risks, especially when visiting older relatives. In communities with low case numbers and high vaccination rates, unvaccinated children from a single household are generally considered safe to spend time with vaccinated grandparents. But with the spread of the Delta variant and the return of children to school, the risk of close contact also increases for elderly or immunocompromised people, who are more prone to complications from Covid-19, even if they are vaccinated.

If families are planning to visit a high-risk relative, it is a good idea to minimize other exposures, avoid restaurants, or work out at the gym the week before the visit. While the risk of Covid-19 spreading from a vaccinated person is small, vaccinated grandparents should also reduce their personal exposure when spending time with unvaccinated children.

“At the time, I did not mask myself indoors with my eighty-year-old parents because I am still very careful about wearing masks in public places,” said Dr. Huffman, the aerosol scientist. “But if I had more interactions that would increase my overall risk of exposure, I would strongly consider masking myself indoors with people at risk.”

Rapid home tests are an extra precaution when visiting grandparents or an immunocompromised family member. Take a test a few days before the visit, as well as on the day of the visit. Find out more about the home test here.

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Politics

A 2nd New Nuclear Missile Base for China, and Many Questions About Technique

A 2nd New Nuclear Missile Base for China, and Many Questions About Strategy

In the barren desert 1,200 miles west of Beijing, the Chinese government is digging a new field of what appears to be 110 silos for launching nuclear missiles. It is the second such field discovered in the past few weeks by analysts studying commercial satellite imagery.

It could mean a huge expansion of China’s nuclear arsenal – the need for an economic and technological superpower to show that, after decades of reluctance, it is ready to deploy an arsenal the size of Washington or Moscow.

Or it can simply be a creative, albeit costly, negotiating trick.

The new silos are apparently built to be discovered. The latest silo field, which began in March, is located in the eastern part of Xinjiang Province, not far from one of the notorious Chinese “re-education camps” in the city of Hami. It was identified late last week by nuclear experts from the Federation of American Scientists from images of a fleet of Planet Labs satellites and shared with the New York Times.

For decades, since its first successful nuclear test in the 1960s, China has maintained a “minimal deterrent” that most outside experts estimate at around 300 nuclear weapons. (The Chinese won’t say so, and the US government’s assessments will be classified.) If that’s true, that’s less than a fifth of the number deployed by the United States and Russia, and in the nuclear world, China has always considered itself an occupier of moral height and avoids expensive and dangerous arms races.

But that seems to be changing under President Xi Jinping. While China is cracking down on dissent at home, claiming new control over Hong Kong, threatening Taiwan and using cyber weapons much more aggressively, it is breaking new ground with nuclear weapons.

“The silo construction at Yumen and Hami represents the most significant expansion of the Chinese nuclear arsenal of all time,” write Matt Korda and Hans M. Kristensen in a study on the new silo field. They found that China has operated about 20 silos for large liquid-fuel missiles called DF-5s for decades. But the newly discovered field, combined with one hundreds of miles away in Yumen, northeast China, discovered by the James Martin Center for Nonproliferation Studies in Monterey, California, will bring about 230 new silos to the country. The Washington Post previously reported the existence of this first field with around 120 silos.

The puzzle is why China’s strategy has changed.

There are several theories. The simplest is that China now sees itself as a comprehensive economic, technological and military superpower – and wants an arsenal to match that status. Another possibility is that China is concerned about the increasingly effective American missile defense and India’s nuclear build-up, which is advancing rapidly. Then there is Russia’s announcement of new hypersonic and autonomous weapons and the possibility that Beijing may want a more effective deterrent.

A third is that China is concerned that its few ground-based missiles are vulnerable to attack – and by building more than 200 silos spread across two locations, they can play a shell game, move 20 or more missiles, and unit make states guess where they are. This technique is as old as the nuclear arms race.

“Just because you build the silos doesn’t mean you have to fill them all with missiles,” says Vipin Narang, a professor at the Massachusetts Institute of Technology who specializes in nuclear strategy. “You can move them.”

Updated

July 26, 2021, 5:21 p.m. ET

And of course you can swap them. China may believe that sooner or later it will be drawn into arms control negotiations with the United States and Russia – something President Donald J. Trump tried to force in his final year in office when he said he would not renew the New START treaty on Russia unless China, which never participated in nuclear arms control, was included. The Chinese government rejected the idea, saying if Americans were so concerned they should cut their arsenal by four-fifths to Chinese levels.

The result was a standstill. At the very end of the Trump administration, Secretary of State Mike Pompeo and his arms control officer Marshall Billingslea wrote: “We have asked Beijing for transparency and, together with the United States and Russia, to work out a new arms control agreement covering all categories of nuclear weapons.”

“It is time for China to stop posing and acting responsibly,” they wrote.

But the Biden government had come to the conclusion that it would be unwise to phase out New START with Russia just because China refused to join. After his term in office, President Biden acted quickly to renew the treaty with Russia, but his administration has said that at some point it would like China to make some kind of deal.

These conversations have yet to begin. Assistant Secretary of State Wendy Sherman is this week for the first visit by a senior American diplomat to China since Mr Biden took office, although it is not clear that nuclear weapons are on the agenda. In addition to leading nuclear talks with Russia.

At the White House, the National Security Council declined to comment on evidence of China’s growing arsenal.

It is likely that American spy satellites picked up the new build months ago. But it all came public after Mr. Korda, a research analyst with the Federation of American Scientists, a private group in Washington, used civilian satellite imagery to survey the arid hinterland of Xinjiang Province, a rugged area of ​​mountains and deserts in northwest China . He looked for visual clues about the silo construction that matched what the researchers had already discovered.

In February, the Federation of American Scientists reported the expansion of missile silos at a military training area near Jilantai, a city in Inner Mongolia. The group found 14 new silos under construction. Then came the discovery in Yumen.

While searching the wilderness of Xinjiang Province, Mr. Korda specifically looked for inflatable domes – similar to those that house some tennis courts. Chinese engineers erect them over the construction sites of underground missile silos to hide the work underneath. Suddenly, about 250 miles northwest of the recently discovered base, he found a series of inflatable domes, almost identical to those in Yumen, on another sprawling military compound.

The new construction site is in a remote area that the Chinese authorities have cut off from most of the visitors. It is about 60 miles southwest of the city of Hami, known as the site of a re-education camp where the Chinese government detains Uyghurs and members of other minorities. And it’s about 260 miles east of a tidy complex of buildings with large roofs that can open to the sky. Recently, analysts identified the site as one of five military bases where the Chinese armed forces have built lasers that can fire concentrated beams of light at reconnaissance satellites, which are mainly sent into the air by the United States. The lasers blind or deactivate fragile optical sensors.

Working with his colleague, Mr. Kristensen, a weapons expert who leads the group’s nuclear information project, Mr. Korda used satellite photos to explore the site.

The new silos are a little less than two miles apart, according to their report. In total, the sprawling construction site covers around 300 square miles – similar in size to the Yumen base, also in the desert.

Mr. Narang said the two new silo fields gave the Chinese government “many options”.

“It’s not crazy,” he said. “You are making the United States target many silos that may be empty. They can slowly fill these silos when they need to build their strength. And they get influence in arms control. “

“I’m surprised they didn’t do that a decade ago,” he said.

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Health

Olympics Covid Circumstances Increase Tough Questions About Testing

Olympics Covid Cases Raise Tricky Questions About Testing

In addition, questions about transmission remain unanswered. Vaccinated people with asymptomatic or breakthrough infections may still be able to pass the virus on to others, but it is not yet clear how often this happens.

Until this science is more definitive or vaccination rates go up, it’s best to stay on the safety and regular testing side, many experts said. At the Olympics, for example, frequent testing could help protect the wider Japanese population, who have relatively low vaccination rates, as well as support staff, who may be older and at higher risk.

“It is these people that I really worry most about,” said Dr. Lisa Brosseau. on Research Advisor at the Center for Infection Disease Research and Policy at the University of Minnesota.

Not only can they become infected with the virus, which puts a strain on the Japanese health system, but they can also become sources of transmission: “Everyone is at risk and anyone could potentially be infected,” she said.

According to the Tokyo 2020 Press Office, all Olympics staff and volunteers were given the opportunity to get vaccinated, although officials did not provide any information about how many had received the syringes.

Instead of testing less frequently, officials could rethink how they respond to positive tests, said Dr. Binney. For example, if someone who is vaccinated and tested positive asymptomatically should still be isolated – but maybe close contacts could just be monitored instead of being quarantined.

“You are trying to balance the disruptive nature of what you do when someone tests positive against any benefits in slowing or stopping the spread of the virus,” said Dr. Binney.

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Health

A New Alzheimer’s Drug Gives Extra Questions Than Solutions

A New Alzheimer’s Drug Offers More Questions Than Answers

“It puts us in a bad place,” agreed Dr. Karina Bishop, a geriatrician at the University of Nebraska Medical Center. Ethically, she added, “if this drug was available right now, I would not feel able to prescribe it.”

Even as individual doctors grapple with advising patients, hospitals and health systems are devising protocols for when Aduhelm becomes available, probably within weeks.

At the Mayo Clinic, said Dr. Ronald Petersen, a neurologist who directs the Alzheimer’s Disease Research Center there, “we’re going to stick pretty close to the inclusion and exclusion criteria used in the trial.”

That means only patients with mild cognitive impairment or early Alzheimer’s disease would qualify, after an M.R.I. to rule out certain conditions and risks, and a P.E.T. scan or lumbar puncture to confirm the presence of amyloid. The Mayo protocols, like the clinical trials, would exclude people taking blood thinners like Warfarin or Eliquis.

“It’s not like you come in and say, ‘I’m a little forgetful,’ and we say, ‘Here’s this drug,’” said Dr. Petersen. But not every provider, he acknowledged, will employ such safeguards.

Dr. Eric Widera, a geriatrician at the University of California, San Francisco, expressed a similar concern: “If doctors were extremely cautious and limited this drug to the very specific population included in the study, with very careful monitoring, it would be the first time in medicine that was ever done.”

He pointed out another consequence of federal approval: a rift between some doctors and the Alzheimer’s Association, the national advocacy group, which this spring mounted a campaign it called More Time. Intended to demonstrate public support for approval of aducanumab, the effort included newspaper ads and social media posts.

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Health

Biogen faces robust questions on $56Okay-a-year worth of latest Alzheimer’s drug

Biogen faces tough questions on $56K-a-year price of new Alzheimer's drug

A person skates past Biogen Inc. headquarters in Cambridge, Massachusetts on Monday, June 7, 2021.

Adam Glanzman | Bloomberg | Getty Images

Biogen faced tough questions from Wall Street analysts Tuesday about the annual cost of $ 56,000 for its newly approved Alzheimer’s drug Aduhelm – a price that executives call “fair” and “responsible”.

Biogen’s shares rose 38% Monday after the FDA announced it had approved the company’s drug scientifically known as aducanumab. It’s the first drug approved by U.S. regulators to slow cognitive decline in people with Alzheimer’s, and the first new drug for the disease in nearly two decades.

The biotech company said it is charging $ 56,000 for an annual course of the new treatment, more than the $ 10,000-25,000 price some Wall Street analysts expected. This is the wholesale price, and the cost that patients actually pay depends on their health insurance plan.

Some analysts and stakeholders immediately questioned how the company could justify the price – about five times higher than expected – especially as medical experts continue to debate whether there is enough evidence that the drug actually works and the industry has been criticized for drug prices .

The FDA departed from the advice of its independent panel of external experts, which unexpectedly declined to approve the drug last fall, citing inconclusive data.

“Our only concern here is the annual cost of aducanumab and whether the sticker shock at $ 56,000 a year (we were at $ 10,000) could further stimulate drug price reviews,” Stifel analyst Jeff Preis told investors Monday in a note.

On a call to investors Tuesday morning, Evercore ISI analyst Umer Raffat congratulated the Massachusetts-based company on US approval of the drug before asking executives to explain the price.

“I think there is a discrepancy between some of the words you shared in your press releases like responsibility, access, health equity, and price, especially given the basic care population,” he told executives.

JP Morgan analyst Cory Kasimov later asked executives how much the state health insurance program Medicare is likely to pay for the drug and how concerned executives are about the “backlash” the industry will face on pricing.

Biogen executives said the overall price of the new treatment is “underpinned” by the value it is expected to bring to patients, caregivers and society. They insisted that the price was “responsible” and stated that the disease costs the US billions each year.

The Alzheimer’s Association estimates that more than 6 million Americans are living with the disease. The company said it currently has the capacity to deliver the drug to 1 million patients annually, with more than 900 locations in the U.S. poised to launch the new drug.

“We want to ensure that Aduhelm is affordable for patients and sustainable for health systems,” said one executive.

The company has pledged not to increase the price of the new drug over the next four years. However, executives said they were “open-minded” and suggested reconsidering the price as the company assesses demand over the next few years.

Michel Vounatsos, CEO of Biogen, joined CNBC on Monday and said the drug’s price will allow the company to continue investing in its pipeline of drugs for other diseases. He added that the company works closely with Medicare as well as private insurers.

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Business

Apple’s Fortnite Antitrust Trial Ends With Pointed Questions

Apple's Fortnite Antitrust Trial Ends With Pointed Questions

Tim Cook took the position as CEO of Apple for the first time. The billionaire of one of the world’s most popular video games led a federal judge through what is known as the Metaverse. And lawyers in masks discussed whether an anthropomorphic banana without pants should be shown in a federal court.

For the past three weeks, Apple has defended itself in a federal courtroom in Oakland, California against allegations of abusing its power over the iPhone App Store in one of the largest antitrust proceedings in Silicon Valley history. Epic Games, the maker of the popular game Fortnite, sued Apple last year for allowing apps to avoid the 30 percent commission the iPhone maker takes on many app sales.

On Monday, the trial, which included esoteric definitions of markets as well as strange video game characters, ended with Judge Yvonne Gonzalez Rogers of the U.S. District Court for the Northern District of California urging companies to see what, if anything, should change in Apple’s business. The decision on the case as well as the future of the $ 100 billion market for iPhone apps is now in their hands. Judge Gonzalez Rogers said she hoped to reach a verdict by mid-August.

Yet even at a time of antitrust control over the world’s largest tech companies, the trial showed the difficulty of acquiring a corporate titan like Apple worth $ 2.1 trillion.

Epic spared little expense to sue Apple. The Cary, NC-based game maker sacrificed a valuable product when Apple ripped the Fortnite iPhone app from the App Store, which had sales of more than $ 1 billion. Epic also spent millions of dollars on lawyers, economists, and subject matter experts. Still, the trial started at a downside, as antitrust laws tended to favor defendants, according to legal experts prosecuting the case.

While Judge Gonzalez Rogers signaled openness to Epic’s arguments during the trial, a decision in favor of the video game maker could not lead to significant changes in the mobile app market. Any judgment is likely to be involved in appeal proceedings for years. At this point in time, rapid change in the technology industry could invalidate its impact.

“To start a credible antitrust campaign, you have to have a significant war chest,” said David Kesselman, a Los Angeles antitrust attorney who has prosecuted the case. “And the problem for a lot of smaller businesses and smaller businesses is that they don’t have the resources to fight that kind of battle.”

The case centered on how Apple exercises control over the iPhone App Store to calculate its commission on app sales. Businesses big and small have argued that the fee shows Apple is abusing its dominance, while Apple responded that the cut in sales is helping to fund efforts to keep iPhones safe. Regulators and lawmakers have looked into the issue and made it the center of antitrust complaints against the company.

Epic’s lawsuit was the biggest test of those claims yet – and the best shot for app developers looking to weaken Apple’s influence on the iPhone app market. Tim Sweeney, CEO of Epic and a longtime opponent of large technology companies, said he is fighting “for open platforms and policy changes that benefit all developers equally”.

Throughout the process, lawyers, investors, and journalists analyzed Judge Gonzalez Rogers’ comments and questions for clues as to their thinking. When Epic brought its witnesses to the booth, they appeared to agree with Apple’s arguments in some places. But the perspective of their questions changed when Apple presented its witnesses, including Mr. Cook, last week.

In a sharp back-and-forth with the Apple CEO on Friday, Judge Gonzalez Rogers told Mr. Cook that it was clear that his company had made changes to the App Store fees due to public pressure. She then asked him why Apple didn’t want to give iPhone users more choices about where to buy apps. In response, Mr. Cook effectively admitted that Apple wanted to maximize its profits.

On Monday, Judge Gonzalez Rogers’ comments indicated that she believed Apple deserved to benefit from its innovations. But she also questioned some possibilities.

“The 30 percent figure has been around since it was founded. And if there was real competition, that number would move. And it didn’t, ”she said of Apple’s commission for the sale of apps. She also said it was anti-competitive for Apple to prohibit companies from telling customers that they could buy items outside of iPhone apps.

At other times on Monday, she seemed reluctant to force Apple to change its business. “Courts don’t do business,” she said.

Judge Gonzalez Rogers also suggested that the outcome requested by Epic in the case would require a substantial change in Apple’s business, questioning whether there is a precedent for that. “Can you give me an example that survived the appeals test when the court so restricted or fundamentally changed the economic model of a monopoly company?” she asked Epic’s lawyers.

The judge has announced that she expects her decision to be appealed to the U.S. Court of Appeals for the Ninth Circuit. If so, a three-person jury in this court could review their decision. Apple or Epic could then try to appeal this ruling to the US Supreme Court.

If Judge Gonzalez Rogers stands up for Epic, Apple will most likely try to prevent her decision from taking effect until the appeals court weighs it up, and she would likely be open to that request, antitrust attorney Kesselman said. Courts are generally reluctant to force changes to companies that could then be overturned on appeal, so changes to the App Store could take years.

A win for Epic would still be a boost to the broader cartel war against Apple. The Justice Department is investigating Apple’s control of its app store, and some federal lawmakers have stated that app stores are monopoly and ripe for law enforcement. Apple is also facing two other federal lawsuits over its app fees – one from consumers and one from developers – both of which are seeking class action lawsuit status. Judge Gonzalez Rogers will also hear these cases.

Likewise, a win for Apple could undo these challenges. Regulators could be cautious about pursuing a case against Apple that has already been dismissed by a federal judge.

Judge Gonzalez Rogers can also make a decision that doesn’t make any company happy. While Epic wants to be able to host its own app store on iPhones, and Apple wants to continue to work as it has for years, they could order minor changes.

Former President Barack Obama appointed Judge Gonzalez Rogers, 56, to the federal court in 2011. Given her base in Oakland, her cases have often been tech-related, and she has overseen at least two cases in the past with Apple. In both cases, Apple won.

She closed the process on Monday with thanks to the lawyers and court officials who mainly used masks and face shields during the trial. Months ago, in the midst of the coronavirus pandemic, it was unclear whether the trial could be held in person, but Judge Gonzalez Rogers ruled that it was a sufficiently important case and ordered special rules to minimize health risks, including limiting it the number of people in court.

Epic chose to involve its managing director through an additional attorney, and Mr. Sweeney spent the trial in the courtroom, watching him from his attorneys’ table. Mr Sweeney, who is usually productive on Twitter, has not made any public comments in the past three weeks. On Monday, he broke his silence by thanking the Popeyes fried chicken restaurant next to the courthouse.

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Health

Covid-19 Vaccine Facet Results: Your Questions Answered

Covid-19 Vaccine Side Effects: Your Questions Answered

Almost three million people in the United States receive the Covid-19 vaccine every day. And each new burst raises new questions about what to expect after vaccination.

Last week I asked readers to send me their questions about vaccinations. Here are some of the answers.

Short-lived side effects such as fatigue, headache, muscle pain, and fever are more common after the second dose of the Pfizer BioNTech and Moderna vaccines, which each require two shots. (The Johnson & Johnson vaccine only requires a single shot.) Patients who experience uncomfortable side effects after the second dose often describe feeling like they have a bad flu and use phrases like “it blew me out” or ” I was useless for two days. “During vaccine studies, patients were advised to take a few days off after the second dose, just in case they had to spend a day or two in bed.

The data collected by v-safe, the app that anyone can use to track side effects after vaccination, also shows an increase in reported side effects after the second dose. For example, about 29 percent of people reported fatigue after the first Pfizer BioNTech shot, but that increased to 50 percent after the second dose. The muscle pain increased from 17 percent after the first shot to 42 percent after the second. While only about 7 percent of people had chills and a fever after the first dose, that number rose to about 26 percent after the second dose.

The New York Times interviewed several dozen of the people who were newly vaccinated in the following days. They reported a wide range of reactions, from no reaction to symptoms such as uncontrolled tremors and “brain fog”. While these experiences are not pleasant, they are a sign that your own immune system is having a strong response to the vaccine.

An analysis of the first 13.7 million Covid-19 vaccine doses given to Americans found that side effects were more common in women. While severe reactions to the Covid vaccine are rare, almost all cases of anaphylaxis or life-threatening allergic reactions have occurred in women.

The finding that women are more likely to report and experience unpleasant side effects from the Covid vaccine is consistent with other vaccines as well. Women and girls after flu vaccinations and vaccines against measles, mumps and rubella (MMR) and hepatitis A and B can produce up to twice as many antibodies. One study found that in nearly three decades, women accounted for 80 percent of all anaphylactic diseases in adults.

Although women report side effects more often than men, the higher rate of side effects in women also has a biological explanation. Estrogen can stimulate an immune response, while testosterone can weaken it. In addition, there are many immune-related genes on the X chromosome, of which women have two copies and men only one. These differences may explain why far more women than men suffer from autoimmune diseases, which occur when a robust immune response attacks healthy tissues in the body. You can read more about women and vaccine side effects here.

Side effects get all the attention, but when you look at data from vaccine clinical trials and the real world, you will find that many people don’t experience side effects beyond an aching arm. In the Pfizer vaccine studies, about one in four patients reported no side effects. In the Moderna studies, 57 percent of patients (64 or younger) reported side effects after the first dose – these jumped to 82 percent after the second dose, meaning that almost one in five patients reported no reaction after the second shot.

A lack of side effects doesn’t mean the vaccine isn’t working, said Dr. Paul Offit, professor at the University of Pennsylvania and a member of the Food and Drug Administration’s Vaccine Advisory Board. Dr. Offit found that a significant number of people reported no side effects during the vaccine trials, and yet the studies showed that around 95 percent of people were protected. “That proves you don’t have to have side effects to be protected,” he said.

Nobody really knows why some people have a lot of side effects and others don’t. We know that younger people develop a stronger immune response to vaccines than older people, whose immune systems become weaker as they get older. Women usually have stronger immune responses than men. But even these differences don’t mean you aren’t protected if you don’t feel a lot after the shot.

Scientists still aren’t sure how effective the vaccines are in people whose immune systems may be weakened by certain conditions, such as cancer treatments, HIV infection, or because they are taking immunosuppressive drugs. However, most experts believe that the vaccines still offer these patients some protection against Covid-19.

Updated

April 1, 2021, 11:02 p.m. ET

The bottom line is that although individual immune responses can vary, the data collected so far shows that all three US-approved vaccines – Pfizer-BioNTech, Moderna, and Johnson & Johnson – are effective against serious illness and death from Covid-19 .

You shouldn’t try to prevent discomfort by taking a pain reliever before receiving the shot. The concern is that premedication with a pain reliever like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), which can prevent side effects like arm pain, as well as fever or headache, could also weaken your body’s immune response.

While it’s possible that taking a pain reliever before your shots may have dampened your body’s immune response, vaccine experts say you shouldn’t worry and shouldn’t try to get another shot. Studies of other vaccines suggest that while premedication can reduce the body’s immune response to a vaccine, your immune system can build strong enough defenses to fight infection. A review of studies involving more than 5,000 children compared antibody levels in children who took pain relievers before and after vaccinations and in children who did not. They found that pain medication had no significant effect on the immune response and that children in both groups produced adequate levels of antibodies after their shots.

The high effectiveness of all Covid vaccines suggests that even if taking Tylenol before the shot weakens your body’s immune response, there is some margin and you are likely still well protected against Covid-19. “You should feel reassured that you have enough immune response to be protected, especially with vaccines that are this good,” said Dr. Offit.

“It’s okay to treat side effects with pain relievers,” said Dr. Offit, but if you don’t really need one, “don’t take it”.

While most experts believe it is safe to take a pain reliever to relieve post-vaccination discomfort, they do not recommend taking it preventively after the shot or if your symptoms are manageable without the drug. The concern about taking an unnecessary pain reliever is that it may weaken some of the effects of the vaccine. (In terms of vaccine, there is no significant difference if you choose acetaminophen or ibuprofen.)

During the Moderna study, about 26 percent of people took acetaminophen to reduce side effects, and the vaccine’s overall effectiveness was still 94 percent.

Research and individual reports suggest that people with a previously diagnosed Covid-19 infection may react more strongly and experience more side effects after their first dose of vaccine than people who have never been infected with the virus. A strong reaction to your first dose of vaccine could also be a sign that you were previously infected, even if you weren’t aware of it.

If you’ve previously tested positive for Covid-19 or had a positive antibody blood test, be prepared for a stronger reaction to your first dose and plan a few days off just in case. Not only will it be more convenient to stay at home and rest in bed, the vaccine side effects may be similar to symptoms of Covid-19, and your staff won’t want to be around you anyway.

Studies suggest that a dose might be appropriate for people with a previously confirmed case of Covid-19, but medical guidelines have not changed so far. If you received the Pfizer-BioNTech or Moderna vaccines, you should plan to receive your second dose, even if you have had Covid-19. Skipping your second dose can cause problems if your employer or airline requests proof of vaccination in the future. If you live in an area where Johnson & Johnson’s single-dose vaccine is available, you can be fully vaccinated after just one dose. Read more about the vaccine response in people with Covid-19 here.

The vaccines appear to be effective against a new variant that originated in the UK and is rapidly dominating the US. However, some variants of the coronavirus, especially one first identified in South Africa and one in Brazil, appear to be better able to evade antibodies in vaccinated individuals.

That sounds worrying, but there is reason to be hopeful. Vaccinated individuals exposed to a more resistant variant still appear to be protected from serious diseases. And scientists have a sufficiently clear understanding of the variants that they are already working on to develop booster shots that target the variants. The variants identified in South Africa and Brazil are not yet widespread in the United States.

People who are vaccinated should continue to wear masks in public and follow public health guidelines, but they shouldn’t live in fear of variations, said Dr. Peter J. Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. “If you are vaccinated you should feel pretty sure how protected you are,” said Dr. Hotez. “It is unlikely that you will ever go to a hospital or intensive care unit with Covid-19. In time, you will see a recommendation for a booster. “

I hope these answers will reassure you about your own vaccine experience. For a more complete list of questions and answers, see our dedicated vaccine tool, “Answers to All Your Covid-19 Vaccination Questions”.

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Health

‘How Did You Qualify?’ For the Younger and Vaccinated, Impolite Questions and Raised Eyebrows

‘How Did You Qualify?’ For the Young and Vaccinated, Rude Questions and Raised Eyebrows

“I think in New York people are trying to figure out those dynamic, whether you’re getting the dose because it’s leftover or a condition that qualified you or lied about something,” said Mr. Das. “The honest reality is I know people who have crossed the line and lied about things – 29 year old people who have been given vaccines who have no pre-existing conditions. But I think most people don’t lie. The goal is to vaccinate everyone. “

Rhonda Wolfson, who lives in Toronto, said that another privacy issue has arisen in places where the vaccination process is still age-restricted, highlighting the fact that a person is over a certain age. Ms. Wolfson qualified for a pilot vaccination program in Ontario for people ages 60 to 64, and she realized that talking about her vaccination would reveal her as a sexagenarian to people who thought she was younger.

“I have a girlfriend in her forties and she knows I’m older, but she doesn’t know my exact age,” said Ms. Wolfson. “She never asked and I never offered. I spoke to her last week and in my excitement I said, “Oh my god, I’ve been vaccinated.” I could almost hear her pause, ‘Oh, you’re so old.’ “

In some circles, the stigma of early vaccination is even more worrying as it could deter those at risk from getting the shot. For example, in the gay community, a young person who is vaccinated in the early group may be considered immunocompromised.

“There is an assumption in the gay community that if you get the vaccine now, you must be secretly HIV positive,” said gay Mr Das. “It has become an assumption in the community that if you are gay and you post a picture of the vaccination card, then you are positive and you didn’t tell us. I always talk to my friends and tell them, ‘Don’t take things. ‘“

Mr Das said he hoped any stigmatization or privacy issues related to early vaccination would go away once vaccination dates are open to everyone. President Biden has urged all states to extend medical eligibility to the general population by May 1, and many states, including Alaska, Arizona, Georgia, and Mississippi, have already made the change.

“The sooner we can all vaccinate, the more I think about this question: ‘Oh, what qualified you? ‘will stop, ”said Mr Das. “Once that is gone, hopefully these barriers will collapse and people will stop asking these very personal questions.”

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Business

Determined for a Journey? Right here Are the Inquiries to Ask Earlier than You Go.

Desperate for a Trip? Here Are the Questions to Ask Before You Go.

“Many of our guests were reluctant to come here at first,” said Jason Kycek, senior vice president of sales and marketing at Casa de Campo. “Many were borderline ready to cancel.”

Mr. Malbon said his family felt safe during the vacation. “There were five other families in the entire water park,” he said. “You could do the rides as often as you wanted.”

Of course, the length it takes people to be sure can still backfire. My doctor in Greenwich, Connecticut told me about three couples who flew back on a private plane from Aspen, Colorado after a ski trip, and all six subsequently tested positive for the coronavirus. It turned out that they had been infected from the person who owned the plane.

Choosing a hotel is even more complicated. Hotels of the same brand can have different owners or management companies. Therefore, the Covid-19 protocols can be very different in two resorts using the same brand.

Sarah Eustis is the managing director of Main Street Hospitality, which owns or manages nine hotels in the northeast, including the historic Red Lion Inn in Stockbridge, Massachusetts and the Hammetts Hotel in Newport, RI. She traveled to Boca Grande, Florida with her husband last week to escape the gloomy Massachusetts winter.

“We are in the hospitality industry and we find the protocols work,” said Ms Eustis. “You can go to restaurants and be safe. But friendship and family lines are drawn on this issue. “

She said she was only moderately concerned about Covid-19 while traveling. But, she said, there is something that many people on both sides of this issue do not recognize.

“People with funds can fly through combat,” said Ms. Eustis. “I just had a massage and I felt completely safe. I had my mask on and so did the masseuse. Having the opportunity to decompress after a very stressful year is a real privilege. “

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Health

J&J Covid vaccine distribution in poor, Black communities raises race questions

J&J Covid vaccine distribution in poor, Black communities raises race questions

Johnson & Johnson Covid-19-Impfstoff in einem Impfzentrum, das am 5. März 2021 im Hilton Chicago O’Hare Airport Hotel in Chicago, Illinois, eingerichtet wurde.

Kamil Krzaczynski | AFP | Getty Images

Logan Patmon aus Detroit weiß, dass der Covid-19-Impfstoff von Johnson & Johnson einfacher zu verteilen ist als die Schüsse von Moderna und Pfizer.

Der 28-jährige Black-Anwalt sagte, er sehe es als minderwertig an, da Daten aus klinischen Studien gezeigt haben, dass J & J in den USA zu 72% gegen Covid schützt, verglichen mit etwa 95% bei den beiden anderen Impfstoffen.

“Warum für 70 gehen, wenn Sie 95 bekommen können?” er sagte.

Für Beamte ist der Schuss von J & J ein Segen, da er monatelang bei Kühlschranktemperatur gelagert werden kann und nur eine Dosis benötigt – im Gegensatz zu Pfizer und Moderna, für die Gefrierschränke und zwei Runden Stöße im Abstand von etwa einem Monat erforderlich sind. Das macht J & Js Schuss zu einem wichtigen Instrument, um Menschen, die möglicherweise nicht zu einem zweiten Termin zurückkehren können, lebensrettende Impfstoffe zukommen zu lassen. Es ist besonders wertvoll, um die Aufnahmen an schwer erreichbare Orte zu bringen, an denen möglicherweise keine zuverlässige Kühlung vorhanden ist, z. B. in Stammesgebieten, in ärmeren Gegenden sowie in ländlichen und Grenzgemeinden.

“Nur weil es am einfachsten ist, heißt das nicht, dass es das Richtige ist”, sagte Patmon gegenüber CNBC. “Sie möchten nicht, dass es eine Situation gibt, in der getrennte, wohlhabendere Gebiete den besseren Impfstoff erhalten und den armen, mehr Minderheitengebieten gesagt wird: ‘Sei einfach glücklich.'”

Beamte stoßen bei der Verteilung der Aufnahmen von J & J auf ein unvorhergesehenes Problem. Obwohl unbeabsichtigt, stellen einige Leute aufgrund ihrer niedrigeren Wirksamkeitsrate die Frage, ob dies nur ein weiteres Beispiel für eine subtil rassistische Behandlung von Minderheiten in Amerika ist. Während der Impfstoff von J & J hochwirksam ist, insbesondere gegen schwere Krankheiten und Todesfälle, sehen Patmon und andere Amerikaner ihn immer noch als minderwertig an. Durch den Versand an ärmere Postleitzahlen in Großstädten und ländlichen Gemeinden riskieren Beamte laut Gesundheitsexperten Vorwürfe der Diskriminierung.

Dies könnte das Vertrauen in die Einführung von Impfstoffen weiter untergraben, insbesondere in Farbgemeinschaften, sagen Experten, da mehr Daten aus Staaten zeigen, dass Schwarze und Hispanics weiterhin einen überproportionalen Anteil an Covid-19-Todesfällen ausmachen, die Impfstoffe jedoch mit deutlich geringeren Raten erhalten als Weiße Menschen.

In New York zum Beispiel machen Schwarze etwa 16% der Bevölkerung des Bundesstaates aus und machen 23% der Todesfälle durch Covid-19 aus, haben aber laut einem Bericht des gemeinnützigen Kaisers vom 3. März bisher nur 8% der Schüsse erhalten Family Foundation, die staatlich gemeldete Daten analysierte. Hispanics machen 19% der Bevölkerung und 23% der Todesfälle in Covid aus, haben aber nur 9% der Schüsse erhalten.

Weiße Menschen machen 63% der Bevölkerung und 40% der Todesfälle aus, aber laut KFF-Analyse haben sie 81% der Impfungen erhalten.

Die Verwendung des Impfstoffs von J & J hauptsächlich in schwer erreichbaren Gebieten kann zu einem “Maß an Misstrauen” und “erhöhtem Zögern” führen, sagte Dr. Sonja Hutchins, eine ehemalige CDC-Beamtin, am 1. März gegenüber dem Beratenden Ausschuss für Immunisierungspraktiken der Agentur sehr vorsichtig zu sein und zu verstehen, was einige der unbeabsichtigten Folgen der Ausrichtung auf Farbgemeinschaften sein könnten, von denen einige glauben, dass sie schwer zu lesen sind, wenn sie erreichbar sind “, sagte Hutchins, der jetzt Professor an der Morehouse School of Medicine ist.

Impfstoffe vergleichen

Der Impfstoff von J & J wurde am 27. Februar für die Verwendung in den USA zugelassen. Der J & J-Schuss zeigte in den USA etwa einen Monat nach der Inokulation eine Wirksamkeit von 72%, 66% in Lateinamerika und 64% in Südafrika, wo das ansteckendere und virulentere B. Die Variante .1.351 breitet sich schnell aus. Insbesondere verhinderte es 100% der virusbedingten Krankenhausaufenthalte und Todesfälle. Die klinischen Phase-3-Studien von Pfizer und Moderna, die im November abgeschlossen wurden, zeigten, dass beide Impfstoffe eine Wirksamkeitsrate von etwa 95% aufwiesen.

Die Berechnung der Wirksamkeit eines Impfstoffs ist schwierig und kann variieren, je nachdem, wo die Studie durchgeführt wird, welche Arten von Varianten in der Region vorherrschen und wie weit die Gemeinschaft verbreitet ist.

Die dritte Phase der Studie von J & J begann ungefähr zwei Monate hinter der von Pfizer und Moderna und wurde weltweit und in Ländern durchgeführt, in denen bereits infektiösere Varianten, die sich den Impfstoffen entziehen können, bereits eingesetzt hatten.

Dr. Anthony Fauci, Chefarzt des Weißen Hauses, sagte, es sei unmöglich, die drei zu vergleichen, da sie nicht in direkten klinischen Studien bewertet wurden.

“Wir sagen also nicht, dass einer besser oder schlechter ist als der andere, wir sagen, dass alle drei wirklich ziemlich gut sind”, sagte er am Samstag gegenüber MSNBC. “In Bezug auf die Verbreitung in verschiedenen Gruppen hat der Präsident sehr, sehr deutlich gemacht, dass wir Gerechtigkeit haben werden, was bedeutet, dass wir diese gleichmäßig auf die verschiedenen Komponenten verteilen werden, genauso wie wir es mit den anderen beiden getan haben . “

Er sagte, jemand könnte den Impfstoff von J & J bevorzugen, weil nur ein Schuss erforderlich ist, “aber es wird keine absichtliche Versendung an eine demografische Gruppe gegenüber einer anderen geben”, sagte er.

Die Bundesregierung hat letzte Woche fast 4 Millionen Dosen des Impfstoffs von J & J an Bundesstaaten, Apotheken und kommunale Gesundheitszentren verteilt und plant, bis Ende dieses Monats weitere 16 Millionen zu versenden. Das Unternehmen hat bis Ende Juni einen Vertrag mit der US-Regierung über 100 Millionen Dosen abgeschlossen.

Ein wichtiges Verkaufsargument für den Impfstoff von J & J ist, dass er mindestens 3 Monate bei 36 bis 46 Grad Fahrenheit gelagert werden kann und eine Einzeldosis ist. Im Vergleich dazu handelt es sich bei den Impfstoffen von Pfizer und Moderna um zwei Dosierungen. Pfizers Schuss muss in ultrakalten Gefrierschränken gelagert werden, die zwischen minus 112 und minus 76 Grad Fahrenheit liegen, obwohl die FDA dem Unternehmen kürzlich gestattet hat, ihn zwei Wochen lang bei Temperaturen zu lagern, die üblicherweise in pharmazeutischen Gefriergeräten zu finden sind. Moderna muss mit 13 unter null bis 5 Grad Fahrenheit verschickt werden.

Zuordnung zu Staaten

Jeff Zients, Covid-Zar von Präsident Joe Biden, sagte, dass der Impfstoff von J & J Staaten auf der Grundlage ihrer gesamten erwachsenen Bevölkerung zugeteilt wird – genau wie Pfizer und Moderna. Sobald der Impfstoff eingetroffen ist, können die Staaten die Dosen nach eigenem Ermessen verteilen, obwohl die CDC empfiehlt, die am stärksten gefährdeten Personen zu priorisieren.

In New York City sagte Bürgermeister Bill de Blasio, der J & J-Impfstoff sei für Senioren im Heimatland und andere bestimmt, die nicht einfach zu Vertriebszentren gelangen können. Er räumte ein, dass der Impfstoff aufgrund seiner geringeren Wirksamkeitsrate eine “Kommunikationsherausforderung” für staatliche und lokale Gesundheitsbehörden darstellen könnte.

“Es gibt viele Fehlinformationen, die wir überwinden müssen”, sagte er am 1. März gegenüber Reportern. “Sobald Sie geimpft sind, sind Sie geschützt. Es macht so viel Sinn, sie zu verwenden. Und das macht mir wirklich Sorgen.” Die Leute werden das falsche Verständnis davon bekommen und dann zögern, sich genau dann impfen zu lassen, wenn wir sie am dringendsten brauchen, um geimpft zu werden. “

In Louisville, Kentucky, sagten Gesundheitsbeamte, sie würden den Impfstoff für vorübergehende Menschen einsetzen, die einem hohen Risiko ausgesetzt sind und nicht einfach für einen zweiten Schuss zurückkehren können, wie die Obdachlosen. In Harris County, Texas, wo sich Houston befindet, wird der J & J-Impfstoff an mobilen Impfstellen verabreicht, die jede Woche den Standort wechseln, wenn Anbieter versuchen, unterversorgte Gruppen zu erreichen, die am anfälligsten für Covid sind.

Der Bürgermeister von Detroit, Mike Duggan, lehnte letzte Woche eine erste Zuteilung des Impfstoffs von J & J ab und sagte: “Johnson & Johnson ist ein sehr guter Impfstoff. Moderna und Pfizer sind die besten. Und ich werde alles tun, um sicherzustellen, dass die Bewohner der Stadt von Detroit bekommen das Beste. “

Später ging er diese Kommentare zurück und teilte CNBC in einer Erklärung mit, dass die Stadt bereits über genügend Kapazitäten mit Moderna und Pfizer verfügt, um Tausende von Einwohnern zu impfen. Er sagte, die Stadt werde eine neue Impfstelle für J & J-Aufnahmen eröffnen, wenn die Nachfrage der berechtigten Bewohner das Angebot an Moderna- und Pfizer-Dosen übersteigt.

“Sehr vorsichtig”

Kasisomayajula Viswanath, Professor für Gesundheitskommunikation an der Harvard TH Chan School of Public Health, sagte gegenüber CNBC, er sei besorgt darüber, wie Staaten den Impfstoff verteilen würden, auch wenn ihr Plan sinnvoll sei.

Viswanath, dessen Forschung sich auf die Beseitigung von Ungleichheiten im Gesundheitswesen konzentriert, sagte, dass staatliche und lokale Gesundheitsbehörden mitteilen müssen, warum der Impfstoff von J & J auf eine bestimmte Weise verteilt wird, oder dass sie Vorwürfe von Rassismus und Misstrauen riskieren.

“Wir müssen äußerst vorsichtig sein”, sagte er und fügte hinzu, dass die Impfstoffe von Moderna und Pfizer J & J überlegen seien.

Viswanath empfahl den Staaten, die Hilfe lokaler Organisationen, denen Gemeinschaften vertrauen, wie Kirchen oder Aktivistengruppen, für ihre Kommunikationsbemühungen zu gewinnen.

“Wenn Sie anfangen, diesen Impfstoff an bestimmte Gruppen und bestimmte Stadtteile zu verteilen, ohne zu erklären, warum dies so gemacht wird, besteht wahrscheinlich die Wahrnehmung, dass meine Gruppe, meine Nachbarschaft, meine Stadt diesen Impfstoff mit geringer Wirksamkeit im Vergleich zu erhält diese Gruppe, diese Nachbarschaft oder diese Stadt “, sagte er.

Insbesondere in schwarzen Gemeinden gibt es bereits Bedenken aufgrund der anhaltenden Diskriminierung, die sie “Tag für Tag” vom Gesundheitssystem erfahren, sagte er.

“Die tägliche Diskriminierung, die tägliche Respektlosigkeit, das ist es, was Misstrauen erzeugt”, sagte er.

Umdenken

Dr. Stephen Schrantz, der Teil des Teams war, das eine J & J-Impfstoffstudie an der Medizin der Universität von Chicago leitete, sagte, Kommunikation sei der Schlüssel. Er fügte hinzu, dass Anbieter nicht möchten, dass ihre Patienten glauben, sie würden “einen wirksameren Impfstoff erhalten als eine andere Person”.

Die Wahrnehmung der Menschen kann sich ändern, fügte er hinzu, zumal mehr Daten über die Impfstoffe herauskommen und die Menschen von den Menschen ihre eigenen inneren Kreise hören.

Veronica Takougang, eine schwarze Medizinstudentin im ersten Jahr in Cincinnati, sagte, sie habe von Gleichaltrigen und anderen viele Bedenken über den J & J-Impfstoff gehört und darüber, ob er vorwiegend in Farbgemeinschaften eingesetzt wird.

Sie sagte, dass sie den Menschen sagt, dass der Impfstoff viele Vorteile hat, einschließlich der Tatsache, dass er schwere Krankheiten verhindert und eine Einzeldosis darstellt, so dass etwa einen Monat später kein zweiter Termin vereinbart werden muss.

“Die Leute achten sehr auf die Zahlen”, sagte sie. Sie fügte hinzu, dass ihre Bedenken hinsichtlich des Impfstoffs von J & J “gültig” seien und dass Menschen nicht davon ausgeschlossen werden sollten, die anderen Impfstoffe zu erhalten, nur weil sie möglicherweise nicht in der Lage sind, eine zusätzliche Stunde frei zu nehmen.

Geimpft werden

Das Weiße Haus fordert die Öffentlichkeit auf, den ersten Impfstoff zu nehmen, den Sie bekommen können.

“Wir haben drei hochwirksame Impfstoffe mit einem sehr guten Sicherheitsprofil”, sagte Fauci am Freitag gegenüber Reportern. “Jeder von ihnen ist sehr wirksam bei der Vorbeugung klinisch offensichtlicher Krankheiten. Wichtig ist jedoch, dass alle drei einen sehr wichtigen Effekt haben, da sie außerordentlich wirksam gegen schwere Krankheiten sind und Krankenhausaufenthalte und Todesfälle verhindern.”

“Das Wichtigste ist, sich impfen zu lassen und nicht herauszufinden, ob einer besser ist als der andere”, fügte er hinzu.

Alex Gorsky, CEO von J & J bei CNBC, sprach am 1. März ebenfalls über die niedrigere Wirksamkeitsrate und sagte, der Impfstoff werde ein wichtiges Instrument im Kampf gegen das Virus sein, da er Krankenhausaufenthalte und Todesfälle verhindert.

“Es gibt viele verschiedene Möglichkeiten, Vergleiche anzustellen”, sagte Gorsky in einem Interview mit CNBCs “Squawk Box”. “Aber wenn man sich wirklich ansieht, was hier das Ziel ist, Menschen aus dem Krankenhaus herauszuhalten und Menschen vor dem Sterben zu bewahren, glauben wir, dass dies ein unglaublich wichtiges Instrument ist, das hinzugefügt werden muss – zu Gesundheitssystemen, geschweige denn zu Patienten auf der ganzen Welt.”