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Coronavirus vaccines cutting hospitalization after first dose – POLITICO



First data from England and Scotland suggests vaccines are reducing hospitalizations and deaths from COVID-19 and appear to be preventing transmission, English and Scottish public health officials reported on Monday.

Based on the latest data, scientists in England estimate that hospitalization and death rates will fall around 75 percent in those who receive a single dose of the BioNTech/Pfizer vaccine. And this may be an “underestimate,” according to Mary Ramsay, head of immunization at Public Health England, since the analysis included people vaccinated 14 days ago and therefore doesn’t measure the four weeks it takes to fully account for the increase in protection, especially in older people.

Limiting data to more than four weeks ago “would see an even more profound drop,” she said.

The news comes as the U.K. announces plans to lift lockdown restrictions — in place since before Christmas — including letting all children return to school on March 8, and allowing groups of up to six people meet outdoors starting on March 29.

In the over 80s, the jab is 57 percent effective at preventing symptomatic COVID-19 three to four weeks after the first dose. This rises to more than 85 percent after the second dose.

In this group, those who become infected after vaccination are around 40 percent less likely to be hospitalized, compared with the non-vaccinated. And they are 56 percent less at risk of dying at least 14 days after receiving the first dose. Hospitalizations and deaths rates are falling fastest in this cohort since the peak in mid-January, suggesting that vaccination is having a positive impact.

The younger vaccinated group — health care workers under 65 — showed a 72 percent protection against infection with a single dose, rising to 85 percent after the second dose. Health care workers in the study are tested every two weeks.

“Reducing the people with infection, both symptomatic and asymptomatic, is the biggest thing that will reduce transmission,” said Susan Hopkins, strategic response director to Public Health England.

While the study hasn’t yet reported data on participants’ viral loads, Hopkins said they also expect to see lower levels of the virus. The study will also follow up contacts of health care workers to see if any become positive.

The data published by Public Health England looks only at the BioNTech/Pfizer vaccine, since this has been distributed the longest. It also demonstrates it is effective at protecting against the so-called U.K. or Kent variant (B.1.1.7).

To date, more than 17.5 million people have received a first dose of either vaccine.

Research from Scottish universities and Public Health Scotland, meanwhile, finds that the Oxford/AstraZeneca vaccine reduced the risk of hospitalization by 94 percent four weeks after the first dose, while the BioNTech/Pfizer jab reduced the risk by 85 percent.

Overall, the vaccination program in Scotland has cut hospital admissions by more than 85 percent, according to the study.

This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.





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Israel Secretly Agrees to Fund Vaccines for Syria as Part of Prisoner Swap


JERUSALEM — When a young Israeli woman was released from detention in Syria this week, after having been arrested for crossing illegally into Syria, the official story was that she had been the beneficiary of a straightforward prisoner swap. In return for her freedom, the Israeli government announced, she had been exchanged for two Syrian shepherds captured by the Israelis.

But if this deal between two enemy states, which have never shared diplomatic relations, sounded too swift and easy, it was. In secret, Israel had in fact also agreed to a far more contentious ransom: the financing of an undisclosed number of coronavirus vaccines for Syria, according to an official familiar with the content of the negotiations.

Under the deal, Israel will pay Russia, which mediated it, to send Russian-made Sputnik V vaccines to the regime of President Bashar al-Assad of Syria, the official said. Israel has given at least one vaccine shot to nearly half its population of 9.2 million, while Syria — now entering its 11th year of civil war — has yet to begin its vaccine rollout.

The Israeli government declined to comment on the vaccine aspect of the deal, while a Syrian state-controlled news outlet, the Syrian Arab News Agency, denied that vaccines were part of the arrangement. Asked about the vaccines in a television interview on Saturday night, Prime Minister Benjamin Netanyahu of Israel evaded the question, saying only that no Israeli vaccines were being sent to Syria.

“We’ve brought the woman, I’m glad,” Mr. Netanyahu said. He expressed thanks to President Vladimir V. Putin of Russia and said, “I won’t add any more.”

The deal constitutes a rare moment of uneasy cooperation between two states that have fought several wars and still contest the sovereignty of a tract of land, the Golan Heights, that Israel captured from Syria in 1967.

It also highlights how vaccines are increasingly a feature of international diplomacy. And it reflects a vast and growing disparity between wealthy states, like Israel, that have made considerable headway with coronavirus vaccines and may soon return to some kind of normality — and poor ones, like Syria, that have not.

Among Palestinians, news reports about the Israel-Syria deal have increased frustrations about the low numbers of vaccines provided by Israel to Palestinians living in the occupied territories. Israel has supplied only a few thousand vaccines to the approximately 2.8 million Palestinians living in the occupied West Bank, and last week the Israeli government briefly delayed the delivery of a first batch of vaccines to Gaza, where nearly two million people live.

Israel maintains that the Oslo Accords absolve it of a responsibility to provide for Palestinian health care. But rights campaigners and Palestinians cite the fourth Geneva convention, which obliges an occupying power to coordinate with the local authorities to maintain public health within an occupied territory.

Israeli officials have said they must vaccinate their own population before turning to the Palestinians. But the Syria deal sends a different message, said Khaled Elgindy, a researcher and former adviser to the Palestinian leadership.

“Israel is willing to provide vaccines to Syrians outside their borders, but at the same time not provide them to an enormous occupied population that they are legally responsible for,” Mr. Elgindy said. “That seems to be sending a message that they are deliberately trying to avoid their legal responsibility to look after the welfare of that occupied population.”

Among Israelis, the prisoner swap has raised concerns about how a civilian was able to cross the highly policed and tense border with Syria undetected by the Israeli authorities.

The woman, 23, crossed into Syria near Mount Hermon on Feb. 2 without initially being spotted by Israeli or Syrian forces, the official said. Her name currently cannot be published, by court order.

Israel learned that she had disappeared only when her friends informed the police that she was missing. She entered Syrian detention only after a Syrian civilian who approached her realized she was Israeli and called the police.

Israel then asked Russia — a Syrian ally with a strong military presence in the country — for help in mediating her release. Russia and Israel have coordinated during similar episodes in the past. In 2016, Russia helped mediate the return of an Israeli tank seized by Syrian forces in 1982 in Lebanon. In 2019, Moscow facilitated the return of the body of an Israeli soldier killed during the same clash, Zachary Baumel.

The woman grew up in an ultra-Orthodox family in a settlement in the West Bank, and she was said to have a history of attempting to illegally enter Israel’s Arab neighbors — once in Jordan, and once in Gaza. Both times, she was apprehended by Israeli forces, returned, questioned and warned not to do so again.

Israeli negotiators sought to act quickly, to avoid a replay of the crisis that followed the disappearance in Gaza of Avera Mengistu, a man with a history of mental illness who marched into the strip in 2014 and has been held ever since by Hamas, the militant group, which frequently raises the price for his release.

Mr. Netanyahu spoke twice directly with Mr. Putin, while the Israeli national security adviser, Meir Ben-Shabbat, communicated with his Russian counterpart, Nikolai Patrushev.

The Syrians first demanded the release of two Syrian residents of the Golan Heights imprisoned in Israel, but that arrangement broke down after it turned out that the two did not wish to return to Syria.

Israel then offered the release of the two shepherds, and at some point in negotiations, the possibility of vaccines was raised.

The Israeli cabinet voted to agree to the terms of the deal on Tuesday, the same day that the 23-year-old was flown to Moscow. Following further negotiations between Israeli and Russian officials, she was returned to Israel on Thursday.

In Moscow, officials had offered no confirmation of such an arrangement by late Saturday, and Russian news media carried only reports citing Israeli publications.

But the Russian government has for months been deftly using its vaccine in diplomacy from Latin America to the Middle East. As recently as Thursday Mr. Putin’s special envoy to Syria, Alexander Lavrentiev, suggested that Russia would be supplying its Sputnik V vaccine to Syria in an interview with the Tass news agency.

Patrick Kingsley reported from Jerusalem, Ronen Bergman from Tel Aviv and Andrew E. Kramer from Moscow. Hwaida Saad contributed reporting from Beirut and Carol Sutherland from Moshav Ben Ami, Israel.



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EU, US must share coronavirus vaccines with developing countries, Macron says – POLITICO



French President Emmanuel Macron has called for 3 to 5 percent of the European and U.S. vaccine supply to be sent to developing countries to prevent Russia and China from extending their influence over these nations.

In an interview with the Financial Times by video link, he said Moscow and Beijing are offering developing countries, whose vaccination campaigns have barely begun, cheaper vaccines while African countries were made to pay exorbitant prices for Western jabs. This has allowed Russia and China to promote their own vaccines.

“It’s an unprecedented acceleration of global inequality and it’s politically unsustainable too because it’s paving the way for a war of influence over vaccines,” Macron warned.

He said the diversion of a small percentage of doses would not dramatically impact European vaccine rollout campaigns, which have already been criticized for being too slow.

“It won’t change our vaccination campaigns, but each country should set aside a small number of the doses,” he said, adding this should be done “very fast, so that people on the ground see it happening.”

German Chancellor Angela Merkel also agrees that this should be a concerted European effort, he said. “It’s not about vaccine diplomacy, it’s not a power game — it’s a matter of public health,” Macron added, saying he welcomed the global provision of Russian and Chinese vaccines provided they were certified by scientists for use against the appropriate variants of the virus.

However, when asked by POLITICO, an Elysée adviser said: “I cannot so far tell you in what measure and in what volumes France will give doses. The decision has not been formally taken yet. So, we will inform you evidently when the time comes. But obviously, France is at the forefront when it comes to vaccine solidarity.”

COVAX — the global mechanism put in place to equally distribute vaccines — admitted that the majority of first-round deliveries would only start in March. In response, WHO Director General Tedros Adhanom Ghebreyesus called for leaders to increase their countries’ contributions to COVAX.





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Coronavirus Vaccines Are Reaching American Arms


President Biden is pressing for speedier inoculations as well — a case he is expected to make on Friday, when he travels to Kalamazoo, Mich., to visit the manufacturing plant of Pfizer, one of the two manufacturers of federally authorized vaccine.

Federal officials estimate that as many as six million vaccine doses are still being unnecessarily stowed away. Freeing them up could increase the number of doses used by more than 10 percent — significantly stepping up the pace of the nation’s inoculation program at a time when speed is of the essence to save lives, curb disease and head off more contagious variants of the virus. So far, 56 million shots have been administered, and only 12 percent of Americans have received one or more doses.

The idea that doses are sitting in cold storage while millions of people languish on waiting lists has deeply frustrated government officials. The roots of the problem are twofold.

First, when the federal vaccination program for long-term-care facilities began late last year, the C.D.C. based allotments on the number of beds, even though occupancy rates are the lowest in years. According to the American Health Care Association, a trade group, only 68 percent of nursing home beds and 78 percent of assisted living beds are now filled.

Then the C.D.C. doubled that allotment to cover staff. But while four-fifths of long-term-care residents agreed to be vaccinated in the first month of the program, 63 percent of staff members refused, the agency reported. More have since agreed, although it is not clear exactly how many more.

Despite the lack of uptake, the pharmacy chains that administer the program continued tapping their allotments from the federal government. At one point in Virginia, Dr. Avula said, they had used fewer than one in every three doses they had on hand.

As “good, corporate, risk-averse companies,” Clark Mercer, the chief of staff to Gov. Ralph Northam of Virginia, said, “if they can draw down, they are going to draw down.”



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As States Expand Access to Vaccines, Supply Isn’t Keeping Up


Racing to ramp up Covid-19 vaccinations, states have opened mass inoculation sites and expanded eligibility. But a big problem remains: The supply is not increasing quickly enough.

The United States, facing a growing threat from more contagious and possibly deadlier virus variants, is gradually administering more doses every day, now up to an average of about 1.7 million, according to a New York Times database.

But states are also steadily widening access beyond the most vulnerable groups, frontline health care workers and nursing home staff and residents. Now, some state officials say they would be ready to administer thousands more shots every day — if they could get them.

New York State had used about 85 percent of its first and second doses, Gov. Andrew M. Cuomo said on Monday, but is forging ahead to expand eligibility to people with underlying health issues. He said his state would be vaccinating more people if it had more doses.

On Sunday, the first day that appointment sign-ups opened for New Yorkers with chronic health conditions, tens of thousands flooded websites and many were left waiting for appointment openings. Still, state officials said that they considered the expansion a success. They said that 250,924 people had successfully made vaccination appointments on Sunday, more than any single day since the registration system was introduced in mid-January.

Those who are now eligible include adults who have certain health conditions that may increase their risk of severe illness or death from the coronavirus. Aside from obesity and hypertension, other conditions that qualify New Yorkers for the vaccine include pulmonary diseases and cancer, Mr. Cuomo said this month. He also made pregnancy a qualifying condition.

The expansion comes as concern grows about new variants circulating. In an interview with “Axios on HBO” that aired Sunday, Dr. Anthony S. Fauci, President Biden’s chief medical adviser, warned Americans not to become complacent as more people are vaccinated.

“We still might have a stumbling block coming with the appearance of variants that would dominate the picture,” he said.

American officials have said that the more contagious virus circulating in Britain, B.1.1.7, could become dominant in the United States by March. British government scientists are increasingly finding that variant to be linked to a higher risk of death.

Coronavirus vaccines appear to protect against B.1.1.7, but are less effective against the B.1.351 variant, which has become dominant in South Africa.

Last week, California announced that it would soon become one of just a handful of states to expand vaccine access to people of any age with underlying health issues or severe disabilities. But supply is short.

The mass vaccination site at Dodger Stadium shut over the weekend because Los Angeles had exhausted its supply, Mayor Eric Garcetti said. He said the city received just 16,000 doses last week — roughly a day’s worth.

“When vaccines do get to Los Angeles, we know how to administer them,” Mr. Garcetti told reporters. “We have a great infrastructure set up, of amazing people, and we will give them to folks efficiently and safely. But the problem is, we still aren’t receiving enough doses soon enough.”

Officials in Georgia say constrained supply is getting in the way of expanding eligibility. When the Atlanta Board of Education called on Gov. Brian Kemp earlier this month to make teachers eligible for vaccinations, the governor said the state was not getting enough doses for residents who were already eligible.

Many districts around Atlanta, he said, had stopped scheduling new vaccine appointments because federal deliveries were falling so far short of the demand.

Experts say expanding eligibility requires a delicate balance of prioritizing those most at risk and ensuring doses do not go to waste.

“I don’t think anyone would want to be the person to receive the vaccine at the expense of someone else who is higher risk,” said Dr. Sarita Shah, an epidemiologist at Emory University in Atlanta.

Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said expanding eligibility too quickly could backfire. “People are going to be angry when they are promised a second dose and don’t get it on time,” he said.

Some experts, like Dr. Robert Murphy, the director of Northwestern’s Institute for Global Health, have called for more flexibility for places that have already vaccinated their most vulnerable residents.

“I think the dangerous thing is some places are too regimented with the current rules,” Dr. Murphy said. “If you’ve got an extra 50 vials, that’s 500 doses, and nobody is coming, and this thing is going to expire in a matter of days or weeks — give it out.”



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Biden Announces Deal For 200 Million More COVID-19 Vaccines : NPR


During remarks at the National Institutes of Health, President Joe Biden said his administration has secured enough Covid-19 vaccines to ensure the nation is on track to vaccinate 300 million Americans by mid-July.

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During remarks at the National Institutes of Health, President Joe Biden said his administration has secured enough Covid-19 vaccines to ensure the nation is on track to vaccinate 300 million Americans by mid-July.

Evan Vucci/AP

President Biden has finalized deals to buy 200 million more COVID-19 vaccine doses from Pfizer and Moderna by the end of July, increasing the likelihood of delivering on his promise to have all Americans inoculated by mid-summer.

Biden announced the latest deals, which are part of a plan he unveiled two weeks ago, during remarks made at the National Institutes of Health on Thursday.

“We’ve now purchased enough vaccine supplies to vaccinate all Americans,” Biden said. “Now we’re working to get those vaccines into the arms of millions of people.”

Additionally, Biden said, Pfizer and Moderna have agreed to expedite the delivery of 100 million doses each by a month — moving them up to May instead of June.

“That’s a month faster,” Biden said. “That means lives will be saved.”

The new orders of the vaccines come on top of doses that are already scheduled to be delivered by the two companies in March.

“That means we’re now on track to have enough supply for 300 million Americans.”

The aggressive push to increase the supply of hard-to-come by lifesaving injections is part of the “around the clock work” of the new administration and the nation’s leading health care officials, he said.

“In just three weeks we’ve deployed over 1,000 federal staff at vaccination sites around the country,” Biden added.

Among the many setbacks his administration faced upon entering office and taking the reins of the pandemic, the president noted he was misled about the true supply of vaccines obtained by the Trump administration.

“My predecessor, to be very blunt about it, did not do his job,” Biden said. “We won’t have everything fixed for a while. But we’re going to fix it.”

Biden added: “What I was upset with was not having all the facts that were available to the last outfit. We were under the distinct impression there were significantly more vaccines available to begin to be distributed.”

Even more relief may come from Johnson & Johnson, which has developed a vaccine that can inoculate recipients with a single dose. That company is prepared to deliver 100 million more doses upon authorization from the Food and Drug Administration.





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Does Loose Enforcement Of COVID-19 Vaccine’s Eligibility Rules Lead To Cheating? : Shots


Workers and patients at a pop-up COVID-19 vaccination site near downtown Seattle in January. “The vast majority who are coming in do appear to be meeting the eligibility criteria,” says Dr. Jeff Duchin, King County’s public health officer.

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Workers and patients at a pop-up COVID-19 vaccination site near downtown Seattle in January. “The vast majority who are coming in do appear to be meeting the eligibility criteria,” says Dr. Jeff Duchin, King County’s public health officer.

Grant Hindsley/AFP via Getty Images

At a recent mass vaccination clinic run by Virginia Mason Health System in Seattle, Steve Baruso, 57, sat in a chair, recovering after getting his shot.

When asked what made him eligible to get the vaccine, he replied that he actually wasn’t.

“I hit the ‘other’ on the form,” he said. That was the option for people who were not currently eligible but wanted to join the waitlist anyway.

“Then I got an email confirmation,” he said. “I don’t know how that happened.”

Baruso wasn’t the only person who somehow managed to jump the line that day; many others told us they didn’t fit into one of the state’s current eligibility categories.

The Washington state department of health told us they aren’t keeping track of who’s eligible and who’s not among those vaccinated, but anecdotal evidence suggests ineligible people are getting vaccines at many clinics across the state. This happens because each provider must come up with its own process for checking eligibility, and most rely on the honor system.

Right now in the state, workers in health care settings, nursing home residents and staff, first responders, people 65 or older, and people 50 or older who live in multi-generational homes are eligible for the vaccine. But, in some cases, younger people, and people who work in professions not yet eligible, have received vaccine appointments.

To be sure, not everyone is cutting the line intentionally. Like Baruso, they may have been confused about why they were offered appointments after checking “other.”

Gale Robinette, a spokesperson for Virginia Mason, said a technical glitch resulted in Baruso and others getting appointments, even though they had told the hospital system they weren’t eligible yet.

Robinette wouldn’t say how many of the thousands of people Virginia Mason has given shots to were affected. He said the problem has been fixed.

Technical issues aren’t the only reason people are getting the vaccine before it’s their turn.

When you sign up for a COVID-19 vaccine in Washington, it’s up to you to tell the truth about your situation. It’s an honor system.

“I have heard and seen stories from many people who do not meet eligibility criteria, who’ve been vaccinated,” said Dr. Jeff Duchin, King County’s public health officer.

Duchin said Washington state is giving out vaccines on an honor system because it’s too hard to make sure that every single person who gets a vaccine is eligible for one.

“We shouldn’t let the perfect be the enemy of the good here,” he said. “We do want to get as many vaccines out as possible. We know that some people will not be honest; they will be line jumpers, so to speak. But the vast majority who are coming in do appear to be meeting the eligibility criteria.”

At Overlake Medical Center in Bellevue, Tom DeBord, chief operating officer said they administer thousands of vaccines every week.

“We do everything we can do to communicate to people: Please, schedule only if you’re eligible,” DeBord said. “It would really be difficult for every hospital to take it to the nth level to see if somebody really answered every question honestly. It’s almost impossible.”

The Columbia Basin Hospital in central Washington has a different procedure. They give out about 100 vaccines a week.

Administrator Rosalinda Kibby said that when people come in for their vaccine appointments, they get a few more questions than at Overlake.

“We can look them up usually in several systems to see if they’re eligible or not — but, if they’re not, it’s a very bad conversation,” Kibby said. “They are irate, and difficult for staff to deal with.”

Some states have a more centralized approach. Massachusetts, for example, requires all vaccine providers to collect a form that people have to sign to certify that they’re eligible “under the penalties of perjury.” That form is available in 11 languages on the Massachusetts government’s website.

In some cases, the ambiguity of the categories has led to questions about who may or may not be eligible.

Archbishop of Seattle, Paul Etienne, 61, for example, got his first dose at the Swedish clinic on Seattle University’s campus. At the time, only workers in health care settings and nursing home residents and staff were eligible for the vaccine.

“I’m actually kind of a PR ploy on this one, as the Archbishop, to get my own vaccination and encourage other people to do the same,” he said, “not only for our own health, but for the common good of the broader community.”

Later, the Archdiocese of Seattle said that Etienne received the dose because he anoints the sick in hospitals, and therefore is considered a worker in a health care setting.

Dr. William Moss, at Johns Hopkins University’s School of Public Health, researches how to design vaccination campaigns. He said confusing, unclear eligibility categories are causing problems with the vaccine rollout in Washington state and around the country.

“That was definitely well intentioned when it was thought out,” Moss said. “But people didn’t take the next step, ‘How would we actually pull this off and operationalize this?'”

Without a plan to roll out the vaccines in the intended order, Moss said, “You create confusion, and then you create opportunities for people to cut the line.”

Moss said simple, age-based categories would have been easier to communicate to the public and easier for providers to enforce, and would have accomplished the goal of reducing hospitalizations and deaths.

But because the categories are confusing, it’s easier if you have a computer, so you can walk through the Department of Health website to check your eligibility. That means people with access to technology — and technical know-how — get vaccines first.

“The attempt to have equity created more inequity,” Moss said.

It is still early in the rollout, though, and providers are making adjustments.

In mid-January, all you needed to get into the Virginia Mason clinic was an appointment. Now, says Robinette, the Virginia Mason spokesperson, a photo ID and screenshot or printout of eligibility confirmation from the department of health are required.

Eilis O’Neill has been reporting on the SARS-CoV-2 pandemic for NPR affiliate KUOW, where this story originally appeared.





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Digital Race For COVID-19 Vaccines Leaves Seniors Without Computer Skills Behind : Shots


Seniors and first responders try to snag one of 800 doses available at a vaccination site in Fort Myers, Fla.

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Seniors and first responders try to snag one of 800 doses available at a vaccination site in Fort Myers, Fla.

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With millions of older Americans eligible for coronavirus vaccines and limited supplies, many continue to describe a frantic and frustrating search to secure a shot, beset by uncertainty and difficulty.

The efforts to vaccinate people who are 65 and older have strained under the enormous demand that has overwhelmed cumbersome, inconsistent scheduling systems.

The struggle represents a shift from the first wave of vaccinations — health care workers in health care settings — which went comparatively smoothly. Now, in most places, elderly people are pitted against each other competing on an unstable technological playing field for limited shots.

“You can’t have the vaccine distribution be a race between elderly people typing and younger people typing,” says Jeremy Novich, a clinical psychologist in New York City, who has begun a group to help people navigate the technology to get appointments. “That’s not a race, that’s just cruel.”

While the demand is an encouraging sign of public trust in the vaccines, the challenges facing seniors also speak to the country’s fragmented approach that has left many confused and enlisting family members to hunt down appointments.

“It’s just maddening,” says Bill Walsh with AARP. It should be a smooth pathway from signing up to getting the vaccine and that’s just not what we’re seeing so far.”

Glitchy websites, jammed phone lines and long lines outside clinics have become commonplace as states expand who’s eligible — sometimes triggering a mad dash for shots that can sound more like trying to score a ticket for a music festival than obtaining a life-saving vaccine.

After being inundated, some public health departments are trying to hire more staff to handle their vaccination hotlines and to specifically target seniors who may not be able to navigate a complicated online sign up process.

“Just posting a website and urging people to go there is not a recipe for success,” says Walsh.

“Terribly competitive”

Like many seniors, Colleen Brooks, 85, had trouble sorting through the myriad online resources about how to find the vaccine where she lives, on Vashon Island in the Puget Sound near Seattle, Wash.

“It was an overwhelming amount of information,” she says. “I knew it was here some place, but it wasn’t easy to find out how to get it.”

After making calls, Brooks eventually got a tip from a friend who had spotted the vaccines being unloaded at their town pharmacy. When she dropped by her health clinic to inquire about how to sign up, it happened they were giving out shots on that same day.

That was totally serendipitous for me, but I actually personally know several seniors who just kind of gave up,” says Brooks.

Finding out how to get a vaccine appointment was more straightforward for Gerald Kahn, 76, who lives in Madison, Conn.

Kahn got an email notice from the state’s vaccine registration system telling him to make an appointment, but he ran into problems at the very end of the sign up process.

“As much as I would pound my finger on the face of my iPad, it didn’t do me any good,” he says.

So Kahn did what many have and called a younger family member who was able to help him finish the sign up process.

“I think there are a lot of people my age, maybe the preponderance, who can only go so far into the Internet, and then we’re not only stymied but also frustrated,” he says.

When Helen Francke, 92, logged on for a vaccine at the designated time, she discovered the spots available in Washington D.C. filled up almost instantaneously.

“It was evident that I was much too slow,” she says. “It’s terribly competitive and clearly favors those with advanced computer skills.”

The next week, Francke tried calling and going online — this time with the help of her neighbors — without success.

“If I had had to depend on the D.C. vaccination website and telephone, I’d still be anxious and unsuccessful,” says Francke, who only got a shot after finding information on her neighborhood listserv that directed her to a local hospital.

In Arizona, Karen Davis, 80, ended up on a roundabout quest through state and hospital websites with no clear sense of how to actually book an appointment.

I kept trying to do it and kind of banged my head against the wall too many times,” she says.

Davis, who’s a retired nurse, called her doctor and the pharmacy, and then eventually turned to a younger relative who managed to book a 5 A.M. appointment at a mass vaccine site.

“I’m sure they did not expect older people to be able to do this,” she says.

Meanwhile, Miguel Lerma, who lives in Phoenix, says his 69-year-old mother has been unsuccessful in finding a shot.

“She’s not an English speaker and doesn’t know technology well, and that’s how everything is being done,” says Lerma, 31.

Lerma says it’s especially painful to watch his mother struggle to get the vaccine — because he lost his father to COVID-19 last year..

“She’s mourning not only for my dad, but she’s also suffering as an adult now because she depended on him for certain tasks,” Lerma says. “He would’ve handled all this.”

“Desperate” for a shot, seniors look for help

When the vaccine rollout began it lacked federal coordination, which resulted in a patchwork of different rules and systems that vary state-to-state and even county-to-county.

Seniors feel those shortcomings acutely because of the reliance on digital systems and other barriers to access like transportation, says Vivian Nava-Schellinger at the National Council on Aging and National Institute of Senior Centers.

Nava-Schellinger thinks the government should be more aggressively recruiting senior centers and community organizations to help reach older adults.

“When you don’t have a coordinated effort, you will leave seniors behind and most likely they will be seniors who are in the more vulnerable populations,” she says.

Philip Bretsky, a primary care doctor in Southern California, says his older patients would typically call him or visit their local pharmacy for vaccines like the annual flu shot, rather than rely on online scheduling systems.

“That’s not how 85-year-olds have interacted with the health care system, so it’s a complete disconnect,” Bretsky says. “These folks are basically just investing a lot of time and not getting anything out of it.”

California’s recent decision to change its vaccination plan and open it up to those over 65 only adds to the confusion.

Bretsky says his patients are being told to call their doctor for information, but he isn’t even sure when his office, which is authorized to give the vaccine, will receive any.

Patients in this age group want to know that they’re at least being heard or somebody is thinking about the challenges they have,” he says.

There are some local efforts to make that happen.

In the village of Los Lunas, New Mexico, public health workers held an in-person sign-up event for seniors who needed assistance or simply a device connected to the internet.

A Florida senior center recently held a vaccination registration event and a clinic specifically for people over 80 who might not have a computer.

Jeremy Novich, the clinical psychologist in New York, teamed up with a few people to create an informal help service for older adults. It began as a small endeavor, advertised through a few synagogues and his Facebook page. They’ve now helped more than 100 people get shots.

“We have a huge number of requests that are just piling up,” says Novich.

“People are really desperate and they’re also confused because nobody has actually explained to them when they are expected to get vaccinated… it’s a big mess.”

The ongoing shortage of vaccines has led Novich to halt the service for now.

This story is from NPR’s partnership with Kaiser Health News.



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Your questions about coronavirus vaccines, answered



That depends on your job, your age and your health. For the most up-to-date information, see The Washington Post’s vaccine distribution tracker.

A CDC advisory committee has said the first group to receive the vaccines should be health-care workers and residents of long-term care facilities. States, however, have the final say. Government officials had said they anticipated having enough doses of the two vaccines to inoculate 20 million people with their first shots by the end of 2020 — a goal they failed to reach.

The next priority group for the vaccines should be essential workers — grocery store employees, teachers, emergency workers and others who are on the front lines of the nation’s labor force — and adults 75 years old and older, the CDC advisory panel said. Those groups could get shots early in 2021.

A third group that should get priority includes other essential workers, adults 65 to 74 and people 16 to 64 with high-risk medical conditions, the committee advised.

Who exactly is an “essential worker” already is setting off debate around the country. Complicating the situation: There will not be enough vaccine to meet demand any time soon.

Healthy younger adults who don’t have medical conditions or high-risk jobs are likely to begin to get vaccinated starting in April, but not everyone will be able to get the shots immediately. And children aren’t even included in most coronavirus vaccine trials — Pfizer is the first company to expand its trial to people 12 and older — so they probably will be among the last to get access.

“I would say starting in April, May, June, July — as we get into the late spring and early summer — that people in the so-called general population, who do not have underlying conditions or other designations that would make them priority, could get” shots, said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.



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Are the coronavirus vaccines safe for someone with cancer, dementia or MS?



Experts’ advice may be helpful since states are beginning to offer vaccines to adults over age 65, 70 or 75, including those with serious underlying medical conditions.

Q: My 80-year-old mother has chronic lymphocytic leukemia. For weeks, her oncologist would not tell her “yes” or “no” about the vaccine. After much pressure, he finally responded: “It won’t work for you, your immune system is too compromised to make antibodies.” She asked if she can take the vaccine anyway, just in case it might offer a little protection, and he told her he was done discussing it with her.

A: First, some basics. Older adults, in general, responded extremely well to the two vaccines that have received special authorization from the Food and Drug Administration. In large clinical trials sponsored by drugmakers Pfizer and Moderna, the vaccines achieved substantial protection against significant illness, with efficacy for older adults ranging from 87 percent to 94 percent.

But people 65 and older undergoing cancer treatment were not included in these studies. As a result, it’s not known what degree of protection they might derive.

Tobias Hohl, chief of the infectious diseases service at Memorial Sloan Kettering Cancer Center in New York, suggested that three factors should influence patients’ decisions: Are vaccines safe, will they be effective, and what is my risk of becoming severely ill from covid-19? Regarding risk, he noted that older adults are the people most likely to become severely ill and perish from covid-19, accounting for about 80 percent of deaths to date — a compelling argument for vaccination.

Regarding safety, there is no evidence at this time that cancer patients are more likely to experience side effects from the Pfizer-BioNTech and Moderna vaccines than other people. Generally, “we are confident that these vaccines are safe for [cancer] patients,” including older patients, said Armin Shahrokni, a Memorial Sloan Kettering geriatrician and oncologist.

The exception, which applies to everyone, not just cancer patients: people who are allergic to the coronavirus vaccine components or who experience severe allergic responses after getting a first shot shouldn’t get the vaccines.

Efficacy is a consideration for patients whose underlying cancer or treatment suppresses their immune systems. Notably, patients with blood and lymph node cancers may experience a blunted response to vaccines, along with patients undergoing chemotherapy or radiation therapy.

Even in this case, “we have every reason to believe that if their immune system is functioning at all, they will respond to the vaccine to some extent,” and that’s likely to be beneficial, said William Dale, chair of supportive care medicine and director of the Center for Cancer Aging Research at City of Hope, a comprehensive cancer center in Los Angeles County.

Balancing the timing of cancer treatment and immunization may be a consideration in some cases. For those with serious disease who “need therapy as quickly as possible, we should not delay [cancer] treatment because we want to preserve immune function and vaccinate them” against covid-19, Hohl said.

One approach might be trying to time vaccination “in between cycles of chemotherapy, if possible,” said Catherine Liu, a professor in the vaccine and infectious-disease division at Fred Hutchinson Cancer Research Center in Seattle.

In new guidelines published Jan. 22, the National Comprehensive Cancer Network, an alliance of cancer centers, urged that patients undergoing active treatment be prioritized for vaccines as soon as possible. A notable exception: Patients who’ve received stem cell transplants or bone marrow transplants should wait at least three months before getting vaccines, the group recommended.

The American Cancer Society’s chief medical and scientific officer, William Cance, said his organization is “strongly in favor of cancer patients and cancer survivors getting vaccinated, particularly older adults.” Given vaccine shortages, he also recommended that cancer patients who contract covid-19 get antibody therapies as soon as possible, if their oncologists believe they’re good candidates. These infusion therapies, from Eli Lilly and Regeneron Pharmaceuticals, rely on synthetic immune cells to help fight infections.

Q: Should my 97-year-old mom, in a nursing home with dementia, even get the vaccine?

A: The federal government and all 50 states recommend vaccines for long-term care residents, most of whom have Alzheimer’s disease or other types of cognitive impairment. This is an effort to stem the tide of covid-related illness and death that has swept through nursing homes and assisted-living facilities — 37 percent of all covid-19 deaths as of mid-January.

The Alzheimer’s Association also strongly encourages immunization against covid-19, “both for people [with dementia] living in long-term care and those living in the community,” said Beth Kallmyer, vice president of care and support.

“What I think this question is trying to ask is, ‘Will my loved one live long enough to see the benefit of being vaccinated?’ ” said Joshua Uy, medical director at a Philadelphia nursing home and geriatric fellowship director at the University of Pennsylvania’s Perelman School of Medicine.

Potential benefits include not becoming ill or dying from covid-19, having visits from family or friends, engaging with other residents and taking part in activities, Uy said. (This is a partial list.) Since these benefits could start accruing a few weeks after residents in a facility are fully immunized, “I would recommend the vaccine for a 97-year-old with significant dementia,” Uy said.

Minimizing suffering is a key consideration, said Michael Rafii, associate professor of clinical neurology at the University of Southern California’s Keck School of Medicine. “Even if a person has end-stage dementia, you want to do anything you can to reduce the risk of suffering. And this vaccine provides individuals with a good deal of protection from suffering severe covid,” he said.

“My advice is that everyone should get vaccinated, regardless of what stage of dementia they’re in,” Rafii said. That includes dementia patients at the end of their lives in hospice care, he said.

If possible, a loved one should be at hand for reassurance since being approached by someone wearing a mask and carrying a needle can evoke anxiety in dementia patients. “Have the person administering the vaccine explain who they are, what they’re doing and why they’re wearing a mask in clear, simple language,” Rafii suggested.

Q: I’m 80 and I have Type 2 diabetes and an autoimmune disease. Should I get the vaccine?

A: There are two parts to this question. The first has to do with “comorbidities” — having more than one medical condition. Should older adults with comorbidities get the coronavirus vaccines?

Absolutely, because they’re at higher risk of becoming seriously ill from covid-19, said Abinash Virk, an infectious diseases specialist and co-chair of the Mayo Clinic’s vaccine rollout.

“Pfizer’s and Moderna’s studies specifically looked at people who were older and had comorbidities, and they showed that vaccine response was similar to [that of] people who were younger,” she noted.

The second part has to do with autoimmune illnesses such as lupus or rheumatoid arthritis, which also put people at higher risk. The concern here is that a vaccine might trigger inflammatory responses that could exacerbate these conditions.

Philippa Marrack, chair of the Department of Immunology and Genomic Medicine at National Jewish Health in Denver, said there’s no scientifically rigorous data on how patients with autoimmune conditions respond to the Pfizer and Moderna vaccines.

So far, reasons for concern haven’t surfaced. Millions of people have been vaccinated at this point, “including some who probably had autoimmune disease, and there’s been no systematic reporting of problems,” Marrack said. If patients with autoimmune disorders are really worried, they should talk with their physicians about delaying immunization until other vaccines with different formulations become available, she suggested.

The National Multiple Sclerosis Society recently recommended that most patients with multiple sclerosis — another serious autoimmune condition — get the Pfizer or Moderna vaccines.

“The vaccines are not likely to trigger an MS relapse or to worsen your chronic MS symptoms. The risk of getting COVID-19 far outweighs any risk of having an MS relapse from the vaccine,” it said in a statement.

This column is produced by Kaiser Health News, is nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente. To submit a question, go to khn.org/columnists.



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