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Vaccine

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By Richard Tapp

Many TBR News Media readers have been frustrated at the slow, uneven COVID-19 vaccine rollout. With seemingly every friend in England saying, “I’ve just been vaccinated, how about you?” and with no personal appointment in sight, I asked Richard “Dickie” Tapp, of Burgess Hill, West Sussex, why he thought the U.K. vaccination scheme has been so successful.

As of mid-February, it is estimated that 21% of the total U.K. population has received the first dose, but with less than 1% fully vaccinated. In the U.S., the relative figures are 10% and 3%. I would add that the U.K. has a wider vaccination-acceptance culture, dating back to the smallpox and polio eras. Still, there could be rollout lessons for President Joe Biden (D) and Gov. Andrew Cuomo (D). The main difference is that U.S. citizens are having to fight overwhelmed state and big pharmacy websites for a paucity of appointments whereas, in the U.K., appointments are made by invitation for dedicated age groups. And the categories are not extended until each one is almost completed. — John Broven, TBR News Media copy editor

The rationale for the “working down through the age-groups” approach is to relieve pressure on the National Health Service [the publicly funded health care systems], which is on its knees. The “Kent” COVID mutation has driven the current surge in cases, proving to be far more contagious. Consequently, there have been far more hospital admissions than in the first wave in spring 2020. Intensive Care Unit doctors and nurses are exhausted, so it has been imperative to reduce the pressure on them. The older you are, the more likely you are to need hospitalization and possibly intensive care, hence the strategy to get the over-70s vaccinated as quickly as possible.

The main reason for the success of the U.K. vaccination campaign is that has been entrusted to the NHS, rather than one of the private sector companies with close associations to the governing Conservative Party which have made a mess of track and trace. The NHS is well versed in vaccination programs — for example, the annual winter-flu vaccination rollout — and so it’s right it should be entrusted with the task. Thanks heavens they got this one right. After a slow start, the NHS has been “on the money” although it is only fair to point out:

1. The army has been helping with the supply logistics, especially delivery.

2. The paperwork and supervision at vaccination centers are being largely handled by volunteers, such as the Lions and Rotary clubs. Also volunteers with some suitable experience — such as the Red Cross, St John Ambulance, retired nurses, etc.— have been trained in administering the vaccine. So, the burden hasn’t fallen totally on the NHS, which wouldn’t have been able to run the exercise just using its own resources.

The campaign works by the “patient” being contacted by their doctor’s office and offered an appointment, in the same way they would for a flu jab. However, in addition they are also contacted by their local NHS trust with a “we have reached your age group” letter offering an online link and a free telephone number by which to make an appointment. So, it’s a two-pronged approach. The strategy has been to work down though the age bands, first the over-80s, then in five-year bands ending with the 50-to-55 age group. To save general practitioner surgery telephone lines being overwhelmed, the instruction was to wait to be contacted and this has worked well. Dedicated vaccination centers have been set up at local community halls and venues — not just at hospitals and health centers.

The aim was to vaccinate all the 70-and-above group by Feb. 15. I had my doubts initially but the exercise has gone so well that on Feb. 8, Health Secretary Matt Hancock (Conservative) said that anyone over 70 who had not been contacted about an appointment should now get in touch with their GP surgery and/or phone the NHS free telephone number. That’s a reversal of the previous advice to wait to be contacted. Indeed, in some areas the rollout has gone so well that the 65-to-69-year-olds are now being vaccinated. I heard on local radio that the large seaside town of Eastbourne in Sussex is already calling forward this age group.

According to the Department of Health and Social Care, a quarter of adults have already received one dose, including around nine in 10 over-70s. My view is that the five-year age-banding strategy has been a good one. “Don’t bite off more than you can chew in one go” is a good adage.

I think I must add a couple of caveats:

1. The overall age-group percentage figure will be lower as there is still some resistance to the vaccine, especially in Black and
Asian communities.

2. The U.K. figures look good as they are those who have had the first jab. Very few have had the second jab. The U.K. vaccination committee took a gamble in moving the second jab to 12 weeks rather than the three weeks recommended by Pfizer and AstraZeneca. The gamble has paid off as the first jab is being shown to provide 50%-to-60% protection — enough to prevent serious illness — and the strategy has been endorsed by the World Health Organization. Of course, the rollout to the under-65s will slow as the 12-week anniversary of those who’ve had their first jab comes into play.

While I am proud of the vaccination rollout and the way volunteers have come forward, the downside is that is that it has given Prime Minister Boris Johnson (Conservative) his “get out of jail card.” People seem to have forgotten the disgraceful mortality figures and passing 100,000 deaths just four weeks ago. It’s a number which shames the country with so many of these due to the mistakes Johnson’s government made, yet the daily deaths — only recently under 1,000 per day — are now barely mentioned.

State Senator Mario Mattera at the podium. Photo by Kimberly Brown

By Kimberly Brown

Republican elected officials gathered at a press conference in Hauppauge Thursday, Jan. 14, calling out Gov. Andrew Cuomo (D) on the state’s failed vaccine rollout.

Elected officials in Hauppauge. Photo by Kimberly Brown

State senators, including Mario Mattera (R-St. James) and Anthony Palumbo (R-New Suffolk), demanded that Cuomo implement a plan to fix issues that have arisen since the vaccine was authorized to be distributed.

Senior citizen and West Babylon resident, Anna Foley, shared her experience of how difficult it has been to obtain the vaccine, which she has still not received.

“I’m 83 years old, fighting two types of cancer and other underlying medical problems,” she said. “I can’t seem to get anyone to help. I have looked at the New York State website, called pharmacies, doctors, hospitals, and I even tried my union to see if I can get any information, to no avail.”

Foley mentioned the difficulties senior citizens are facing while trying to make an appointment for the vaccine, saying that most people ages 80 and over are not computer savvy, and the locations where the vaccine is administered are too far to drive to.

Mattera pointed out how the federal government still has not released the new vaccine to pharmacy chains like Walgreens and CVS, giving residents fewer options of locations where they can receive the vaccine.

State Senator Mario Mattera at the podium. Photo by Kimberly Brown

In his plea to the governor, Mattera said, “Get the vaccine here and get more locations. Right now, there are four locations, and do you know what they say? They say, ‘We don’t know what to do, we can’t help you.’ It’s unacceptable.”

The partial and full closings of businesses, mandated by Cuomo, were intended to combat rising numbers of COVID-19 cases. However, Palumbo said even though businesses are partially closed, the cases are still increasing.

“The Legislature needs to get involved, we need to get control back,” he said. “We need to get those vaccinations out, and as quickly as possible — not throw them in the garbage.”

Many of the politicians also discussed the bill Cuomo signed into law June 17, which would allow every pharmacist in New York state to administer the COVID-19 vaccine. State Assemblyman Doug Smith (R-Holbrook) demanded to know why the bill has not been put into full force.

“Now we’re in January, governor, where is your plan?” Smith said. “Why is every single pharmacy in the state of New York not able to administer this vaccine?”

 

Photo from Pixabay

By Leah S. Dunaief

Leah Dunaief

One of my favorite days occurred this week. It is the winter solstice, usually considered to be Dec. 21 or 22. Why do I like that day, you might wonder? Some people think of it negatively as the shortest day of the year. In New York, the night was 14 hours and 45 minutes, shorter than in Minnesota at 15 hours and 50 minutes but longer than Miami at 13 hours and 28 minutes. For me it marks the turning point of the seasons, when each subsequent day then begins to have more light. Darkness will be lifting over the next six months, gradually but definitively. And for COVID-19, the pandemic of the century, it is a perfect metaphor. The vaccine is arriving at winter solstice with the promise that the disease, like the days, will lighten.

The vaccine is the match that will eventually banish the darkness. People all over the world, since the beginning of recorded history, have lit fires to ward off the night. It is not a coincidence that the birth of Jesus is celebrated at this time. Houses and trees are brightly decorated with all manner of lights. Hanukkah candles burn brightly at this same time, and in an 8-day sequence, as if prophesying the gradual lighting up of the days. Diwali is a five-day festival of Hindus, Sikhs and others, pushing back the night and celebrating the coming of more light. 

So will the vaccine, perfectly timed, gradually vanquish the pandemic over the same next few months.

Just as a point of information, I looked up the meaning of winter solstice and found the definition as the time during the earth’s orbit around the sun at which the sun is at its greatest distance from the celestial equator. So the other part of the shortest day is the winter season that we have to get through with its long days before we can enjoy more brightness and warmth. And we will also have to endure more illness and death from the novel coronavirus before we can recapture the world as we have known it. We will have to hold on, using our various strategies for survival, until what has been described as the unending “snow days” of lockdown yield to recovery.

Winter can be thought of as a time of intense cold, of scarcity, of starkness and even of death of the earth. But the earth has not died. It is merely resting, and all who live on it are forced to slow down until light and warmth bring growth. For us humans, it can be when we nest with our families, play games, watch movies, tell stories about our ancestors and fill the house with the smells of stick-to-the-rib cooking. Unfortunately, we have been doing just that, unwillingly, for the past 10 months. But the warmth and the light inside the home are especially welcome now that the wind is howling and the snow is sticking. 

When we were in Alaska some years ago, many of the residents we met said that winter was their favorite season, when members of the community come together indoors to socialize and look after each other as the elements rage in the darkness outdoors.

This winter, we will be coming together via zoom and the other miracles of modern technology. As the earth lies fallow, we can just rest. Or we can evaluate our lives and priorities, learn things that, like planted seeds, will flower in the warmth and light of the spring. We can certainly straighten out our closets and desk drawers, if we haven’t already. All the while, we can follow the guidelines of the scientists and physicians and keep ourselves safe for the spring.

This is my last column of the year. The next issue, of 12/31, will be entirely filled with stories about those heroic and tireless residents who kept life going in 2020 and richly deserve to be honored as People of the Year.

We here at TBR News Media wish you and your loved ones holidays that are happy and safe.

We look forward to rejoining you next year.

Stony Brook University Hospital received its first batch of the coronavirus vaccine, helping dozens of frontline workers at the highest risk of exposure.

Kisa King, resident in the Department of Emergency Medicine at the hospital, received the first dose of the Pfizer vaccine, administered by pharmacist Ian Pak.

King said that she was “honored” to be the first one injected.

“I am so excited and thankful to be a part of the solution,” she added. “Not only does this mean that I can continue delivering care to my patients, but it also means I am providing protection to my family, friends and community.”

On Dec. 15, more than 250 personnel at the hospital working in emergency rooms, critical care units and other high-risk hospital units received the vaccine.

“We’ve been through so much altogether as a community, as a nation, as a world and this is really the first steps towards normalcy,” Pak said. “I think it’s really important for everyone to have hope and be able to look towards the future so that everything we’ve done paid off — not to mention the countless lives that will hopefully be saved by this.”

This major milestone comes after the U.S. Food and Drug Administration issued the first emergency use authorization for a vaccine for the prevention of COVID-19 in individuals 16 years of age and older. The emergency use authorization allows the Pfizer-BioNTech COVID-19 vaccine to be distributed in the U.S. The vaccine has been found to be more than 90% effective in preventing COVID-19 after two doses.

Pak said he wasn’t expecting that he’d be the first Stony Brook Hospital pharmacist to help out. “It’s just one tiny part of a humongous machine that everyone has contributed to throughout these months,” he said.

Dr. Shetal Shah gives Assemblyman Steve Englebright a shot at the press conference announcing that the Neonatal Infant Pertussis Act was signed into law in 2012. Photo from Maria Hoffman

A young state law is already breathing new life into the number of newborns burdened with whooping cough.

It has been three years since state Assemblyman Steve Englebright (D-Setauket) saw his Neonatal Infant Pertussis Act signed into law, and last week, members of the Pediatric Academic Societies said it’s already paying off, by reducing infections 50 percent. Both Englebright and Dr. Shetal Shah, who worked alongside the lawmaker in 2012 as a member of the neonatal intensive care unit at Stony Brook University, heralded the legislation as an effective measure to keep newborns healthy across New York State.

Englebright wrote the NPPA with Shah’s help, requiring Tdap, a vaccine against whooping cough, be offered to parents and caregivers in contact with a newborn during birth hospitalization as a way to promote “cocoon” immunity for the infant, according to Shah. Five months later the legislation was signed into law by New York Gov. Andrew Cuomo (D), codifying Shah’s common sense idea into law.

“That year, the New York Department of Health had already reported a three-fold increase in whooping cough since the previous year,” Englebright said. “It is gratifying to learn that this law is working and that children are being protected from whooping cough.”

Whooping cough, also known as pertussis, starts with “cold-like” symptoms such as fever, sneezing or a runny nose.  It may then morph into a mild cough, which becomes more severe in the first or second week.

The NPPA fight started in 2012 when Shah reached out to Englebright’s office with an idea that he said could prevent whooping cough in newborns. In a statement, Shah said newborns are typically the most at risk of serious illness or death if infected. But with help from Englebright’s legislation, vaccinations have been effective in combatting the infection for newborns.

Using the New York Communicable Disease Electronic Surveillance System, Heather L. Brumberg from Maria Fareri Children’s Hospital and her colleagues obtained data from 2010 to 2015 on pertussis cases and hospitalizations for 57 New York counties outside of the city. In addition, they used state population rates in 2011 and 2013 to determine the incidence per 100,000.

During the study period, 6,086 cases of pertussis were detected, 68.8 percent of which occurred before the law passed and 31.2 percent of which occurred after. Overall, the pertussis incidence rate decreased from 37.3 per 100,000 children before the law to 16.9 per 100,000 after.

For children aged younger than 1 year old, pertussis incidence decreased from 304 per 100,000 children to 165 per 100,000 and pertussis hospitalization decreased from 104 per 100,000 children to 63 per 100,000 children. The NPPA was associated with these reductions, especially for those at high-risk, the researchers wrote.

“The data shows that passage of the Neonatal Infant Pertussis Act [NPPA] was associated with a reduced incidence of disease in children in each age group studied,” said Shah, who now works at Maria Fareri Children’s Hospital of the Westchester Medical Center Health Network. “This is associative, as we were unable to track actual parental and caregiver Tdap immunization rates.”

Whooping cough vaccine is a five-shot series that is recommended for children at 2 months, 4 months, 6 months, 15 to 18 months, and again at 4 to 6 years of age.

The pertussis vaccine is short-lived and can wear off within a decade, so some people who were immunized as children are no longer protected in adolescence or adulthood unless they get another booster shot.

“This should provide some degree of scientific impetus to other states and counties to consider this measure as part of a comprehensive strategy to reduce whooping cough,” Shah said.