#Vaccination coverage during the pandemic

[gumjrop]

You might be forgiven for thinking it’s been a very quiet few months for the Covid-19 pandemic. Besides the rollout of new boosters, the coronavirus has largely slipped out of the headlines. But the virus is on the move. Viral levels in wastewater are similar to what they were during the first two waves of the pandemic. Recent coverage of the so-called Pirola variant, which is acknowledged to have “an alarming number of mutations,” led with the headline “Yes, There’s a New Covid Variant. No, You Shouldn’t Panic.”

Even if you haven’t heard much about the new strain of the coronavirus, being told not to panic might induce déjà vu. In late 2021, as the Omicron variant was making its way to the United States, Anthony Fauci told the public that it was “nothing to panic about” and that “we should not be freaking out.” Ashish Jha, the Biden administration’s former Covid czar, also cautioned against undue alarm over Omicron BA.1, claiming that there was “absolutely no reason to panic.” This is a telling claim, given what was to follow—the six weeks of the Omicron BA.1 wave led to hundreds of thousands of deaths in a matter of weeks, a mortality event unprecedented in the history of the republic.

Indeed, experts have been offering the public advice about how to feel about Covid-19 since January 2020, when New York Times columnist Farhad Manjoo opined, “Panic will hurt us far more than it’ll help.” That same week, Zeke Emanuel—a former health adviser to the Obama administration, latterly an adviser to the Biden administration—said Americans should “stop panicking and being hysterical.… We are having a little too much [sic] histrionics about this.”

This concern about public panic has been a leitmotif of the Covid-19 pandemic, even earning itself a name (“elite panic”) among some scholars. But if there’s one thing we’ve learned, three and a half years into the current crisis, it’s that—contrary to what the movies taught us—pandemics don’t automatically spawn terror-stricken stampedes in the streets. Media and public health coverage have a strong hand in shaping public response and can—under the wrong circumstances—promote indifference, incaution, and even apathy. A very visible example of this was the sharp drop in the number of people masking after the CDC revised its guidelines in 2021, recommending that masking was not necessary for the vaccinated (from 90 percent in May to 53 percent in September).

As that example suggests, emphasizing the message “don’t panic” puts the cart before the horse unless tangible measures are being taken to prevent panic-worthy outcomes. And indeed, these repeated assurances against panic have arguably also preempted a more vigorous and urgent public health response—as well as perversely increasing public acceptance of the risks posed by coronavirus infection and the unchecked transmission of the virus. This “moral calm”—a sort of manufactured consent—impedes risk mitigation by promoting the underestimation of a threat. Soothing public messaging during disasters can often lead to an increased death toll: Tragically, false reassurance contributed to mortality in both the attacks on the World Trade Center and the sinking of the Titanic.

But at a deeper level, this emphasis on public sentiment has contributed to confusion about the meaning of the term “pandemic.” A pandemic is an epidemiological term, and the meaning is quite specific—pandemics are global and unpredictable in their trajectory; endemic diseases are local and predictable. Despite the end of the Public Health Emergency in May, Covid-19 remains a pandemic, by definition. Yet some experts and public figures have uncritically advanced the idea that if the public appears to be tired, bored, or noncompliant with public health measures, then the pandemic must be over.

But pandemics are impervious to ratings; they cannot be canceled or publicly shamed. History is replete with examples of pandemics that blazed for decades, sometimes smoldering for years before flaring up again into catastrophe. The Black Death (1346–1353 AD), the Antonine Plague (165–180 AD), and the Plague of Justinian (541–549 AD), pandemics all, lacked the quick resolution of the 1918 influenza pandemic. A pandemic cannot tell when the news cycle has moved on.

Yet this misperception—that pandemics can be ended by human fiat—has had remarkable staying power during the current crisis. In November 2021, the former Obama administration official Juliette Kayyem claimed that the pandemic response needed to be ended politically, with Americans getting “nudged into the recovery phase” by officials. It is fortunate that Kayyem’s words were not heeded—the Omicron wave arrived in the US just weeks after her article ran—but her basic premise has informed Biden’s pandemic policy ever since.

Perhaps even less responsibly, the physician Steven Phillips has called for “new courageous ‘accept exposure’ policies”—asserting that incautious behavior by Americans would be the true signal of the end of the pandemic. In an essay for Time this January, Phillips wrote: “Here’s my proposed definition: the country will not fully emerge from the Covid-19 pandemic until most people in our diverse nation accept the risk and consequences of exposure to a ubiquitous SARS-CoV-2, the virus that causes Covid-19.”

This claim—that more disease risk and contagion means the end of a disease event—runs contrary to the science. Many have claimed that widespread SARS-CoV-2 infections will lead to increasingly mild disease that poses fewer concerns for an increasingly vaccinated (or previously infected) population. In fact, more disease spread means faster evolution for SARS-CoV-2, and greater risks for public health. As we (A.C. and collaborators) and others have pointed out, rapid evolution creates the risk of novel variants with unpredictable severity. It also threatens the means that we have to prevent and treat Covid-19: monoclonal antibody treatments no longer work, Paxlovid is showing signs of viral resistance, and booster strategy is complicated by viral evolution of resistance to vaccines.

But these efforts to manage and direct public feelings are not just more magical thinking; they are specifically intended to promote a return to pre-pandemic patterns of work and consumption. This motive was articulated explicitly in a McKinsey white paper from March 2022, which put forward the invented concept of “economic endemicity”—defined as occurring when “epidemiology substantially decouples from economic activity.” The “Urgency of Normal” movement similarly used an emotional message (that an “urgent return to fully normal life and schooling” is needed to “protect” children) to advocate for the near-total abandonment of disease containment measures. But in the absence of disease control measures, a rebound of economic activity can only lead to a rebound of disease. (This outcome was predicted by a team that was led by one of the authors [A.C.] in the spring of 2021.)

A pandemic is a public health crisis, not a public relations crisis. Conflating the spread of a disease with the way people feel about responding to that spread is deeply illogical—yet a great deal of the Biden administration’s management of Covid-19 has rested on this confusion. Joe Biden amplified this mistaken perspective last September when he noted that the pandemic was “over”—and then backed that claim by stating, “If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape.” The presence or absence of health behaviors reveals little about a threat to health itself, of course—and a decline in mask use has been shaped, in part, by the Biden administration’s waning support for masking.

Separately, long Covid poses an ongoing threat both at an individual and a public health level. If our increasingly relaxed attitude toward public health measures and the relatively unchecked spread of the virus continue, most people will get Covid at least once a year; one in five infections leads to long Covid. Although it’s not talked about a lot, anyone can get long Covid; vaccines reduce this risk, but only modestly. This math gets really ugly.

The situation we are in today was predictable. It was predictable that the virus would rapidly evolve to evade the immune system, that natural immunity would wane quickly and unevenly in the population, that a vaccine-only strategy would not be sufficient to control widespread Covid-19 transmission through herd immunity, and that reopening too quickly would lead to a variant-driven rebound. All of these unfortunate outcomes were predicted in peer-reviewed literature in 2020–21 by a team led by one of the authors (A.C.), even though the soothing public messaging at the time called it very differently.

As should now be very clear, we cannot manifest our way to a good outcome. Concrete interventions are required—including improvements in air quality and other measures aimed at limiting spread in public buildings, more research into vaccine boosting strategy, and investments in next-generation prophylactics and treatments. Rather than damping down panic, public health messaging needs to discuss risks honestly and focus on reducing spread. Despite messages to the contrary, our situation remains unstable, because the virus continues to evolve rapidly, and vaccines alone cannot slow this evolution.

In the early months of the pandemic, many in the media drew parallels between the public’s response to Covid-19 and the well-known “stages of grief”: denial, bargaining, anger, depression, and acceptance. The current situation with Covid-19 calls for solutions, not a grieving process that should be hustled along to the final stage of acceptance.

[covid-safer-hotties]

The US Government Is Shutting Down A Key Covid Website

Tomorrow the US government agency responsible for biomedical and public health research, The National Institutes of Health, will shut down its Covid-19 ‘special populations’ website.

This site hosts a huge amount of information about how to treat covid and long covid in the immunocompromised and in people with HIV, cancer and similar immune supressing conditions - so-called ‘special populations.’

The site is going totally offline.

It’s a shameful dereliction of duty by the NIH which, behind Harvard, is the second largest publisher of biomedical research papers in the world. Doctors and clinicians all over the world use the NIH site for advice and treatment ideas.

And it’s going offline during a massive summer surge of covid infections in the US, a surge that is now topping 1.3 million infections per day. (One of whom was Anthony Fauci, who was infected for the third time last week). A surge killing 750 people a week in the US. Many of whom will be precisely the type of people this website is intended to help clinicians treat.

It’s a scandal.

The message it sends to vulnerable people could hardly be clearer - when it comes to covid, there’s nothing else we can do for you. Sorry. That’s it. We’re done.

It’s so terrifying.

It also sends a terrible signal to the medical community about where we are with covid

and will be materially damaging in efforts to treat vulnerable people, both in the acute stage of the disease and those with long covid.

The move to shut the page down is premised on an entirely false assumption: that we already know everything we’ll ever know about how to manage covid so there’s no point keeping a live web resource because they’ll never be anything to update it with ever again.

This is simply not true. While we know a lot about treating covid four years in, we absolutely do not know everything, not by a long stretch. As evidenced by the hundreds still dying every week in summer 2024. And as for long covid, we know very little about how to treat it. For a start, there is no agreed treatment plan. Absolutely none. But apparently we also know so much about this disease we can start shutting down online resources dedicated to it.

Please imagine for a second if a Trump administration rather than a Biden-Harris administration was doing this.

There would be an outcry.

But this move has so far been greeted by media silence.

It is left to a few disability activists and the covid aware to shout into the social media void.

Not that this is a surprise. This is how it has been for the last two years at least, guided by the business as usual, vax-and-forget strategy. More people have died of covid under the Biden-Harris administration than died under Trump. Despite having vaccines since 2021. You’d never know it by mainstream media coverage.

Some people have written to the director of the NIH, Monica Bertagnolli, and asked them to keep the advice live and up-to-date. If you want to do this her email address is:

monica.bertagnolli@nih.gov

Long Covid Action has archived the site here

Maybe if enough people write to her and enough noise is made the decision will be reversed. Worth a try.

Overall it’s just another grim episode in the handling of the pandemic by the current US administration, an administration who, we should never forget, won power in large part due to the outrage at Trump’s handling of the first nine months of covid.

Solidarity to everyone still trying to protect themselves and their communities from covid against all the odds.

At least we can keep fighting for each other.

[thoughtportal]

COVID-19 makes a worrying comeback, WHO warns amid summertime surge

COVID-19 infections are surging globally, including at the Paris Olympics, and are unlikely to decline anytime soon, the World Health Organization (WHO) says. The UN health agency is also warning that more severe variants of the coronavirus may soon be on the horizon.

“COVID-19 is still very much with us,” and circulating in all countries, Dr. Maria Van Kerkhove of WHO told journalists in Geneva.

“Data from our sentinel-based surveillance system across 84 countries reports that the percent of positive tests for SARS-CoV-2 has been rising over several weeks,” she said. “Overall, test positivity is above 10 per cent, but this fluctuates per region. In Europe, percent positivity is above 20 per cent,” Dr. Van Kerkhove added.

New waves of infection have been registered in the Americas, Europe and Western Pacific. Wastewater surveillance suggests that the circulation of SARS-CoV-2 is two to 20 times higher than what is currently being reported. Such high infection circulation rates in the northern hemisphere’s summer months are atypical for respiratory viruses, which tend to spread mostly in cold temperatures.

“In recent months, regardless of the season, many countries have experienced surges of COVID-19, including at the Olympics where at least 40 athletes have tested positive,” Dr. Van Kerkhove said.

As the virus continues to evolve and spread, there is a growing risk of a more severe strain of the virus that could potentially evade detection systems and be unresponsive to medical intervention. While COVID-19 hospital admissions, including for Intensive Care Units (ICUs), are still much lower than they were during the peak of the pandemic, WHO is urging governments to strengthen their vaccination campaigns, making sure that the highest risk groups get vaccinated once every 12 months.

“As individuals it is important to take measures to reduce risk of infection and severe disease, including ensuring that you have had a COVID-19 vaccination dose in the last 12 months, especially, if you are in an at-risk group,” stressed Dr. Van Kerkhove.

Vaccines availability has declined substantially over the last 12-18 months, WHO admits, because the number of producers of COVID-19 vaccines has recently decreased.“It is very difficult for them to maintain the pace,” Dr. Van Kerkhove explained. “And certainly, they don't need to maintain the pace that they had in 2021 and 2022. But let's be very clear, there is a market for COVID-19 vaccines that are out there.”

Nasal vaccines are still under development but could potentially address transmission, thereby reducing the risk of further variants, infection and severe disease.

“I am concerned, “ Dr. Van Kerkhove said. “With such low coverage and with such large circulation, if we were to have a variant that would be more severe, then the susceptibility of the at-risk populations to develop severe disease is huge,” Dr. Van Kerkhove warned.

[saddiedotdk]

Kamala Harris accomplishments as VP:

Cast tie-breaking vote for the American Rescue Plan of 2021.

Passed the American Rescue Plan, resulting in $1.9 trillion in economic stimulus.

Extended the Child Tax Credit through the American Rescue Plan.

Extended unemployment benefits through the American Rescue Plan.

Passed the $1 trillion bipartisan infrastructure bill.

Secured funding for electric school buses in the infrastructure bill.

Secured funding to combat wildfires and droughts in the infrastructure bill.

Secured funding for replacing lead water service lines.

Engaged with lawmakers at least 150 times for infrastructure investment.

Led diplomatic mission to Guatemala and Mexico to address migration issues.

Launched the "Central America Forward" initiative.

Secured $4.2 billion in private sector commitments for Central America.

Visited Paris to strengthen US-France relations.

Visited Singapore and Vietnam to bolster economic and strategic ties.

Visited Poland to support NATO allies during the Russia-Ukraine conflict.

Visited Romania to support NATO allies during the Russia-Ukraine conflict.

Launched the "Fight for Reproductive Freedoms" tour.

Visited a Planned Parenthood clinic in Minnesota.

Passed the COVID-19 Hate Crimes Act.

Promoted racial equity in pandemic response through specific initiatives.

Chaired the National Space Council.

Visited NASA's Goddard Space Flight Center to promote space policies.

Passed the Freedom to Vote Act in the House.

Passed the John Lewis Voting Rights Advancement Act in the House.

Built coalitions for voting rights protections.

Supported the Affordable Care Act through specific policy measures.

Expanded healthcare coverage through policy initiatives.

Passed initiatives for debt-free college education.

Hosted a STEM event for women and girls at the White House.

Championed criminal justice reform through specific legislation.

Secured passage of the bipartisan assault weapons ban.

Expanded background checks for gun purchases through legislation.

Increased the minimum wage through specific policy actions.

Implemented economic justice policies.

Expanded healthcare coverage through policy initiatives.

Secured funding for affordable housing.

Secured funding for affordable education initiatives.

Launched the "Justice is Coming Home" campaign for veterans' mental health.

Proposed legislation for easier legal actions against financial institutions.

Strengthened the Consumer Financial Protection Bureau.

Secured investment in early childhood education.

Launched maternal health initiatives.

Launched the "Call to Action to Reduce Maternal Mortality and Morbidity".

Made Black maternal health a national priority through policy actions.

Increased diversity in government appointments.

Passed legislation for renewable energy production.

Secured funding for combating climate change.

Passed infrastructure development initiatives.

Secured transportation funding through the infrastructure bill.

Developed a plan to combat climate change.

Reduced illegal immigration through policy actions.

Equitable vaccine distribution through specific policy measures.

Supported small businesses through pandemic recovery funds.

Secured educational resources during the pandemic.

Promoted international cooperation on climate initiatives.

Secured international agreements on climate change.

Passed economic policies benefiting the middle class.

Criticized policies benefiting the wealthy at the expense of the working class.

Promoted racial equity in healthcare through specific actions.

Promoted racial equity in economic policies.

Reduced racial disparities in education through specific initiatives.

Increased mental health resources for underserved communities.

Secured funding for affordable childcare.

Secured federal funding for community colleges.

Increased funding for HBCUs.

Increased vaccinations during the COVID-19 pandemic.

Secured policies for pandemic preparedness.

Ensured equitable vaccine distribution through policy actions.

Secured international cooperation for COVID-19 responses.

Reduced economic disparities exacerbated by the pandemic.

Passed digital equity initiatives for broadband access.

Expanded rural broadband through specific policies.

Secured cybersecurity policies through legislation.

Protected election integrity through specific actions.

Secured fair and secure elections through policy measures.

Strengthened international alliances through diplomacy.

Supported the Paris Climate Agreement through policy actions.

Led U.S. climate negotiations through international initiatives.

Passed initiatives for clean energy jobs.

Secured policies for energy efficiency.

Reduced carbon emissions through specific legislation.

Secured international climate finance.

Promoted public health policies through specific initiatives.

Passed reproductive health services policies.

Supported LGBTQ+ rights through specific actions.

Secured initiatives to reduce homelessness.

Increased veterans' benefits through legislation.

Secured affordable healthcare for veterans.

Passed policies to support military families.

Secured initiatives for veteran employment.

Increased mental health resources for veterans.

Passed disability rights legislation.

Secured policies for accessible infrastructure.

Increased funding for workforce development.

Implemented economic mobility policies.

Secured consumer protection policies through legislation.

Engaged in community outreach through public events.

Organized public engagement efforts.

Participated in over 720 official events, averaging three per day since taking office.

Supported efforts to modernize public health data systems.

[justinspoliticalcorner]

Gideon Taaffe at MMFA:

Last week, Robert F. Kennedy Jr. suspended his independent campaign for president and endorsed the Republican presidential nominee, Donald Trump. Kennedy’s campaign — and arguably his political career — was founded on anti-vaccine beliefs. However, Fox News’ coverage of Kennedy’s endorsement has barely mentioned the former candidate’s record of spreading dangerous vaccine misinformation. Fox personalities have been quick to whitewash Kennedy’s beliefs by calling him a public health advocate, citing his views on food and chronic illness. While Fox has discussed Kennedy a significant amount, the network spent only 3 minutes talking about his unfounded anti-vaccine and COVID-19 beliefs.

RFK Jr. has taken his dangerous conspiracy theories on vaccines to the Trump campaign

Long before COVID-19, Kennedy made a career out of pushing a litany of anti-vaccine conspiracy theories and spread the debunked claim that vaccines are linked with autism. He became an anti-vaccine activist with the Children’s Health Defense, where he spread unfounded claims about so-called vaccine injury, global surveillance through microchips, and censorship of vaccine misinformation. [Media Matters, 4/7/23]

Kennedy later was a vector of misinformation during the pandemic, even dubbing the COVID-19 vaccine “the deadliest vaccine ever made.” Kennedy attacked Dr. Anthony Fauci in his book “The Real Anthony Fauci,” which is dedicated to numerous anti-vaccine figures. [FactCheck.org, 8/11/23]

Kennedy has since announced he will be working with Donald Trump should Trump win the election. The former presidential candidate was also linked to “health-focused summits” with TPUSA founder Charlie Kirk. [The New Republic, 8/27/24; Real America’s Voice, The Charlie Kirk Show, 8/26/24]

GOP propaganda organ Fox “News” embrace RFK Jr.’s endorsement of Donald Trump (while still remaining on the ballot in most states), yet ignores his anti-vaxxer extremism.

[mariacallous]

Today’s newsletter is about a recent report from the White House Council of Economic Advisers.

But it’s also about a major policy initiative that helped lots of Americans even though almost nobody seems to have noticed — and how that lack of attention has made it more difficult to renew the program now that it has expired.

The subject of the report is child care. As you may know firsthand ― or if you’ve read HuffPost’s coverage of the issue ― finding quality, affordable child care providers in the U.S. is difficult. A big reason is that it costs a lot of money to run a high-performing child care center, and the fees to sustain that kind of operation are more than many families can afford.

These problems have existed for years but got even worse during the coronavirus pandemic, when public health closures and illness-related absences reduced revenue for providers, putting some into debt while forcing others to reduce capacity or close. Those that survived struggled to hire (or rehire) workers once demand returned, in part because they were increasingly competing with retail and hospitality industries that could raise wages more easily.

The federal government stepped in by providing $24 billion in emergency assistance as part of the American Rescue Plan, which Democrats in Congress passed and President Joe Biden signed in early 2021. The money went directly to state governments, which, in turn, gave it to providers. Some used it for workers, while others used it to maintain equipment or acquire equipment. Others paid off debts.

All of this made a big difference, according to that new Council of Economic Advisers report I mentioned.

In particular, the council’s economists determined, emergency child care money:

“Saved families with young children who rely on paid child care,”

“Helped hundreds of thousands of women with young children enter or reenter the workforce more quickly,” and

“Boosted the child care workforce and helped raise the real wages of child care workers.”

These conclusions make intuitive sense. And although the council is part of the White House, its staff is composed of well-credentialed economists who have a legal mandate to provide objective analysis ― and these conclusions make intuitive sense. In other words, there’s good reason to think this Biden-Democratic initiative propped up child care at a moment of crisis, preserving access for a significant number of families.

That’s a big deal. Just ask any working parent — or any employer, for that matter. But few Americans even realize Biden and the Democrats in Congress took this action, let alone that it had such an impact.

So what happened? And what does that tell us about how politics works nowadays? I have a few ideas about that...

Why Nobody Noticed The Child Care Money

For one thing, the child care assistance was part of a larger bill that never generated much of a substantive debate, except when it came to its overall size. And it went through Congress at a time when other news stories, such as the distribution of (still new) COVID vaccines, were getting a lot more attention.

What’s more, the assistance wasn’t in the form of checks with Biden’s name on them that went to families. It was money that went through states directly to providers.

Then there’s the fact that the program’s effects consisted primarily of things that didn’t happen rather than things that did. Child care costs didn’t rise as fast as they would otherwise. Providers that would have closed stayed open. Workers who might have left child care for positions in retail or hospitality didn’t. Working parents, especially women, didn’t cut back hours or leave the workforce.

You’re not going to recognize this kind of effect unless you contemplate the counterfactual ― in other words, what might have happened without the assistance in place. And that’s just not how most people think.

What’s Happening To Child Care Now

As it happens, a version of that counterfactual may be starting to play out now, because the temporary assistance program has expired. On Oct. 1, the federal government stopped writing new assistance checks.

That might not seem significant, given that the pandemic emergency is effectively over. But the system’s pre-existing problems are still there ― and now appear to be compounded by other, newer factors, like those tight labor markets that make it even harder for providers to hire and retain qualified workers.

It takes a while for money to work its way through government bureaucracies, so it’s going to take time to see just how big a deal the end of federal emergency funds will be. Many experts (including several quoted in this October Vox article) have raised questions about the most dire predictions, which suggest 3 million child care slots could vanish nationwide.

But it’s hard to imagine there won’t be some fallout. Already there are reports of sporadic closures around the country. That includes in rural communities of western North Carolina, where a nonprofit agency called the Southwestern Child Development Commission announced in late October that seven centers were shutting down.

Sheila Hoyle, the commission’s executive director, confirmed to me by phone that the end of federal emergency funds was the catalyst that led to the closings, which in turn reduced available slots for children by more than 300. And while many of the kids ended up with other providers, Hoyle said, the new arrangements for families — at least, the ones that were able to find them — are generally less well-suited to parent working hours, came with higher expenses for parents, or both.

“We’re asking our parents to patch together programs that weren’t designed to fulfill the needs of working parents, and we need to ask what happens to that child,” Hoyle said. “There’s Grandma or Grandpa on Tuesday, and Daddy gets off early on Fridays, and Mama tries to do Monday and Wednesday, and then you take them to a relative’s house or a next-door neighbor’s house.”

“It’s all just getting by,” Hoyle added, “and just getting by is not what we intend for young children who need a good solid early childhood learning experience while their families work, so that they can succeed in school and eventually become successful young adults.”

How ‘Invisible’ Policy Creates Political Problems

The Biden administration and Democratic leaders in Congress want to do something about that, by restoring at least some of the funding, starting with $16 billion for the coming year. The hope is to attach something to a must-pass spending bill whenever an opportunity presents itself.

But it will take political pressure to round up the votes, especially given Republican skepticism of federal spending and conservative doubts about the structure of federal child care assistance. And it’s hard to generate pressure to restore a program most Americans never knew existed.

Of course, this is not exactly a new problem for Biden, or for Democrats more generally.

Programs nowadays frequently operate invisibly through indirect grants to states or via the tax code, in what political scientist Susan Mettler has called “the submerged state.” Other initiatives are more visible but, like the pandemic child care finding, have primarily prevented bad outcomes rather than creating good ones.

Those problems help explain why, for example, Democrats weren’t able to extend another pandemic measure, a tax credit for children, even though its existence had caused child poverty to plummet. It expired at the end of 2021. Now child poverty is back up, and virtually nobody seems to recognize what it accomplished or Biden’s role in initially reducing it ― making it even harder to get such a program going again. It’s even possible that the expiration of these programs is contributing to voter frustration with Biden, saddling him with blame for the end of assistance that he’s been trying to save.

Politics is like that sometimes, with credit or blame for policy falling in ways that align poorly with what elected officials have actually done. But if Biden and the Democrats lose next November, the chances of meaningful new investments in child care — and plenty of other, similar needs — will be even lower than they are now.

[autisticadvocacy]

On May 11th, 2023, the Biden administration will end the national emergency and public health emergency (PHE) related to COVID-19. The COVID-19 pandemic is not over. Ending the public health emergency will harm many people. Over a million people have died. The number of COVID cases are at record highs, and over 3,000 people in the United States are still dying of COVID every week. Less than 20% of the US has the bivalent booster. This is especially true for marginalized people. For all of these reasons, COVID is continuing to harm our communities.

Ending the public health emergency gives the dangerous impression that the COVID-19 pandemic is over. People need to continue to think about risk and community transmission. People need to continue to mask, people need to ensure that they are up to date with all boosters. People with developmental disabilities are especially vulnerable to COVID-19. Many in our community have additional risk factors, like heart or lung issues. COVID-19 is especially dangerous in congregate settings such as nursing homes, and it will continue to spread. COVID-19 was the leading cause of death for people with intellectual and developmental disabilities (I/DD) in 2020. People with disabilities, low income people, and people of color are more likely to have bad outcomes from COVID-19, including death.

Ending the PHE will negatively impact health care and health care coverage, especially for marginalized people who had difficulty accessing care even before the pandemic. During the public health emergency, Medicaid coverage has been more open and flexible than usual in many states. Medicaid has had enhanced federal funding. States could also not take people off of Medicaid. Over 19 million people enrolled in Medicaid since February 2020, whether due to this expansion or people who newly qualified due to changes in disability status, financial status, or age. On April 1, states will be able to reduce coverage and will no longer have the enhanced federal funding for Medicaid. Millions of people will no longer qualify and lose Medicaid coverage. Even more will lose coverage even though they still qualify, because the requirements to keep this coverage will be more demanding. The groups who will lose the most coverage despite qualifying will disproportionately be children and people of color. This is expected to be the biggest increase in uninsured children in the history of the United States.

Hospitals that relied on pandemic-response higher reimbursement rates for Medicare and flexible waivers and eligibility requirements for certain classes of health care will no longer receive these payments. This will result in decreased access to care. Ending these reimbursements will leave hospitals worse-equipped to handle future Covid cases. This is especially bad because COVID-19 is a mass disabling event. Health systems serving hard-hit communities will struggle to meet the additional medical need COVID has brought about. This will mean that many people who need health care because they became disabled from COVID will not have access to it.

Cost sharing provisions for COVID-19 tests for people on private insurance, Medicaid, and Medicare are ending. People on these plans will have to pay more for COVID tests. Tests will become less available as a result, leading to more spread and less-accurate information about COVID risk in communities. Uninsured people used to be covered for COVID-19 tests, treatments, and vaccines, but without additional federal funding for these programs, people without insurance have been left vulnerable since last spring.

Ending the public health emergency also means there will be fewer tools to help people make informed decisions about COVID. States will stop having to report COVID-19 data to the government. ASAN had to end our COVID-19 case tracker for congregate settings in January of this year due to lack of data. This lack of information will make it hard for people to find out how much COVID is circulating in their communities. It also makes it more difficult to see the impact specifically on marginalized communities.

The public health emergency status provided care to many people who need care to survive the pandemic. Ending it harms our communities. COVID-19 is not over.

[broadlyepi]

MMWR Booster #7: Progress Toward Measles and Rubella Elimination — India, 2005–2021

Top 5 Takeaways

Increased Vaccine Coverage: From 2005 to 2021, coverage with the first dose of a measles-containing vaccine (MCV) increased from 68% to 89%, and the second dose from 27% to 82%.

Decline in Disease Incidence: Measles and rubella incidence decreased by 62% and 48% respectively during 2017–2021.

Implementation of National Strategies: This includes the introduction of the rubella-containing vaccine (RCV) in 2017 and large-scale supplementary immunization activities (SIAs).

Challenges During COVID-19: The pandemic led to a decrease in routine vaccination coverage and challenges in surveillance sensitivity.

Future Goals: The “Roadmap to Measles and Rubella Elimination in India by 2023” aims to intensify efforts towards eliminating these diseases with a focus on district-level implementation.

link to full summary: BroadlyEpi.com

Enjoying these summaries? Check back every day at 8am and 4pm Pacific Time (UTC - 8) for a new MMWR Booster. A reblog would also be greatly appreciated, and thanks to everyone who already has! BroadlyEpi hopes to make Epidemiology and Public Health more approachable to anyone who's interested.

[dreaminginthedeepsouth]

LETTERS FROM AN AMERICAN

April 3, 2023

Heather Cox Richardson

On Saturday, April 1, the emergency measures Congress put in place to extend medical coverage at the beginning of the Covid-19 pandemic expired. This means that states can end Medicaid coverage for people who do not meet the pre-pandemic eligibility requirements, which are based primarily on income. As many as 15 million of the 85 million people covered by Medicaid could lose coverage, although most will be eligible for other coverage either through employers or through the Affordable Care Act. The 383,000 who will fall through the cracks are in the 10 states that have refused to expand Medicaid.

The pandemic prompted the United States to reverse 40 years of cutbacks to the social safety net. These cuts were prescribed by Republican politicians who argued that concentrating money upward would promote economic growth by enabling private investment in the economy. That “supply side” economic policy, they said, would expand the economy so effectively that everyone would prosper. In 2017, Republicans passed yet another tax cut, primarily for the wealthy and for corporations, to advance this policy.

As the economy fell apart during the coronavirus pandemic, though, it was clear the government must do something to shore up the tattered social safety net, and even Republicans got on board fast. On March 6, 2020, Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act, allocating $8.3 billion to fund vaccine research and give money to states and local governments to try to stop the spread of the virus. On March 18, he signed the Families First Coronavirus Response Act, which provided food assistance, sick leave, $1 billion in unemployment insurance, and Covid testing. On the same day, the Federal Housing Administration put moratoriums on foreclosure and eviction for people with government-backed loans.

On March 27, Congress passed the Coronavirus Aid, Relief, and Economic Security Act (CARES), which appropriated $2.3 trillion, including $500 billion for companies, $349 billion for small businesses, $175 billion for hospitals, $150 billion to state and local government, $30.75 billion for schools and universities, individual one-time cash payments, and expanded unemployment benefits.

Trump signed another stimulus package on April 24, 2020, which appropriated another $484 billion. And on December 27, 2020, he signed another $900 billion stimulus and relief package.

When he took office, President Joe Biden promised to rebuild the American middle class. He and the Democratic Congress began to shift the government’s investment from shoring up the social safety net to repairing the economy. On March 19, 2021, he signed the American Rescue Plan into law, putting $1.9 trillion behind economic stimulus and relief proposals.

Biden signed the Infrastructure Investment and Jobs Law, also known as the Bipartisan infrastructure Act, on November 15, 2021, putting $1.2 trillion into so-called hard infrastructure projects: roads and bridges and broadband.

On August 9, 2022, he signed the CHIPS and Science Act, putting about $280 billion in new funding behind scientific research and the manufacturing of semiconductors. And days later, on August 16, Biden signed the Inflation Reduction Law, putting billions behind addressing climate change and energy security while also raising money to pay for new policies and to reduce the deficit by raising taxes on corporations and the wealthy, funding the Internal Revenue Service to stop cheating, and permitting Medicare to negotiate with pharmaceutical companies over drug prices.

This dramatic investment in the demand side, rather than the supply side, of the economy helped to spark record inflation, compounded by supply chain issues that created shortages and encouraged price gouging. To combat that inflation, the Federal Reserve has been raising interest rates. Numbers released Friday show that inflation cooled in February, suggesting that the Federal Reserve is seeing the downward trend it has been hoping for, although there is concern that the sudden decision of the Organization of the Petroleum Exporting Countries (OPEC) this weekend to slash production of crude oil might drive the price of oil back up, dragging prices with it.

That investment in the demand side of the economy also meant that the child poverty rate in the U.S. fell almost 30%, while food insufficiency fell by 26% in households that received the expanded child tax credit. The U.S. economy recovered faster than that of any other G7 nation after the worst of the pandemic. Wages for low-paid workers grew at their fastest rate in 40 years, with real income growing by 9%. MIddle-income workers’ wages grew by only between 2.4% and 3.9% after inflation, but that, too, was the biggest jump in 40 years. Unemployment has fallen to its lowest level since 1969, and a record 10 million people have applied to start small businesses.

This public investment in the economy has attracted billions in private-sector investment—chipmakers have planned almost $200 billion of investments in 17 states—while it has also pressured certain companies to act in the public interest: the three major insulin producers in the U.S., making up 90% of the market, have all capped prices at $35 a month.  

As the economy begins to smooth out, Biden and members of his administration are touting the benefits of investing in the economy “from the bottom up and the middle out.” They have emphasized that they are working to support unions and the rights of consumers, taking on “junk fees,” noncompete agreements, and nondisparagement clauses. After the collapse of the Silicon Valley Bank, the administration has suggested that deregulation of banking institutions went too far, and Biden has continued to push increased support for child care and health care.

A recent Associated Press–NORC poll shows that while 60% of Americans say the federal government spends too much money, they actually want increased investment in specific programs: 65% want more on education (12% want less); 63% want more on health care (16% want less); 62% want more on Social Security (7% want less); 58% want more spending on Medicare (10% want less); 53% want more on border security (23% want less); and 35% want more spending on the military (29% want less).

This puts the political parties in an odd spot. A week ago, Biden and members of the administration began barnstorming the country to highlight how their policy of “Investing in America” has been building the economy: “unleashing a manufacturing boom, helping rebuild our infrastructure and bring back supply chains, lowering costs for hardworking families, and creating jobs that don’t require a four-year degree across the country,” as the White House puts it.

Meanwhile,  the Republicans are doubling down on the idea that such investments are a waste of money, and are forcing a fight over the debt ceiling to try to slash the very programs that the administration is celebrating. Ignoring that the 2017 Trump tax cuts and spending under Trump added about 25% to the debt, they are focusing on Biden’s policies and demanding  that the government balance the budget in 10 years without raising taxes and without cutting defense, veterans benefits, Social Security, or Medicare, which would require slashing everything else by an impossible 85%, at least (some estimates say even 100% cuts wouldn’t do it).

As David Firestone put it today in the New York Times: “Cutting spending…might sound attractive to many voters until you explain what you’re actually cutting and what effect it would have.” Republicans cut taxes and then complain about deficits “but don’t want to discuss how many veterans won’t get care or whose damaged homes won’t get rebuilt or which dangerous products won’t get recalled.” Firestone noted that this disconnect is why the House Republicans cannot come up with a budget. “The details of austerity are unpopular,” Firestone notes, “and it’s easier to just issue fiery news releases.”

LETTERS FROM AN AMERICAN

HEATHER COX RICHARDSON

[surpluscornbread]

How some media progressives talk about China is WILD

China’s going through a lot of protests and there’s reasons to criticize the Chinese government. There’s even arguments that the current protests, primarily about Zero COVID policies but also talking about censorship, have decent points at this stage in the pandemic. Those are worth considering and debating. But then you get something like this from a senior editor and “progressive Montanan” Bob Brigham:

This, is insane. On many levels. First, there’s no argument that China’s population numbers would fall significantly due to COVID. Estimates are about 5 million people would’ve died without the lockdowns they’ve done which is less than .4% of their population. Huge human cost! Not much change in population.

Second, as Naomi Wu points out, there’s no argument that China is uniquely overpopulated. Density as a whole is less than a number of European states, though some large provinces in the East like Guangdong are quite dense still in the 700/sq km range putting them at about 40% of Malta’s density (https://www.statista.com/statistics/1183370/china-population-density-by-region-province/). But true, density isn’t the only thing that matters. How about water resources? Well in per capita water renewable resources, China has a similar amount to the UK and about 60% more than Germany according to the World Bank (https://data.worldbank.org/indicator/ER.H2O.INTR.PC). China’s forest coverage as a percent of land area is similar to Belgium (https://www.theglobaleconomy.com/rankings/forest_area/). You could think of other things like per capita emissions and there’s none of that where China is substantially higher than European countries Brigham gives a pass for. Or hell, even some US states!

What this all adds up to is fairly blatant racism because now he’s not complaining about actions of the Chinese government but the existence of Chinese people. Which if anything I’d say China’s earlier one child policy and now more relaxed two child policies deserve critique for being unhelpful interventions when birth rates drop quickly and naturally from just urbanization and women’s education being combined...two things China’s proven quite good at in recent decades! And this is combined with unhinged hatred of lockdowns far in excess of where even the protestors have been at.

Chinese people in general were in favor of lockdowns and some still are (though that number has certainly dropped more recently)! That’s why you didn’t see these protests during the rest of the past two years of them. And the lockdowns were working until fairly recently as clearly shown by China’s extremely low death toll (a death toll that is likely pretty close to accurate or at least no more wrong than anyone else’s simply because hiding millions of deaths isn’t a thing governments have ever been able to do, there are too many different threads of information to control for that).

If you want to make arguments that lockdown policies have stayed in place too long, especially since widespread adoption of vaccines, that’s a point that’s worth considering. That’s what the protestors are arguing. But to say they were always anti-science is some crazy bullshit when it’s not just China that strict border controls and lockdowns worked in for well over a year. You’d also need to throw countries like Vietnam, New Zealand, and even Taiwan under that bus.

Lots of other folks make more reasonable and measured criticisms of China, some that are still OK to argue over and disagree with since even a reasonable take can be wrong, but guys like this are in prominent positions of our media apparatus. Which should probably also give people some pause in just what perspectives they get on China relying on even progressive news sources in the West.

[allthebrazilianpolitics]

After testing times, Brazil is back

Synergy between public health system principles and foreign policy must be resumed

The return of Luís Inácio Lula da Silva as president represents an opportunity for Brazil to rebuild its public health system (SUS) and resume its leadership in global health, relaunching cooperation with the global south. However, President Lula will face even greater challenges than those in his previous presidency (2002-10), considering that Brazilian public health was recently described by experts as “scorched earth.”1

Since 2016, the national health services have experienced relentless cuts in public funding. This has led to substantial decreases in the number of services provided by SUS, an increase in indicators of child malnutrition and maternal deaths, and the downgrading or withdrawal of successful programmes such as people’s pharmacies, community health agents, and the response to HIV/AIDS.2

One of the most disturbing examples of the decay is the Brazilian national immunisation programme.3 After nearly half a century of progress, vaccination coverage of the population, including all World Health Organization recommended vaccines, dropped from 73% in 2019 to 67% in 2020 and 59% in 2021, far from the desirable level of 95%.4 The childhood vaccination rate fell from 93.1% in 2019 to 71.5% in 2021, placing Brazil among the countries with the lowest coverage in the world.5

Another important challenge was the devasting effect of covid-19 in Brazil with nearly 700 000 deaths and more than 36 million reported cases since early 2020.6 The botched federal response included official recommendations of ineffective treatments such as chloroquine and ivermectin, delay in purchasing vaccines, the boycott of public health measures adopted by local governments, and the wide dissemination of fake news by public agencies.7 The previous president, Jair Bolsonaro, even disseminated false associations between covid-19 vaccines and HIV, and between wearing masks and pneumonia.8 In his inauguration speech on 1 January 2023, Lula stated that “the responsibilities for this genocide must be investigated and must not go unpunished” following due process and a broad right of defence. 9

Despite the ministry of health’s historical importance as head of the SUS, controlling resources for more than 5000 municipalities, technical staff were replaced by military personnel, and health policies were guided by ideological and religious principles rather than scientific evidence during the covid pandemic.

Continue reading.

[covid-safer-hotties]

Also preserved on our archive

Vaccine hesitancy driven by covid-19 antivaxxers is also effecting other vaccination, driving down efficacy. Mask up and get vaxed!

By Mary Van Beusekom, MS

The effectiveness of the seasonal flu vaccine against hospitalization among high-risk groups during the 2024 seasonal flu season in five Southern Hemisphere countries was low (35%), down from 50% in 2023 but not outside the expected range, which may portend similar efficacy during the upcoming Northern Hemisphere flu season if similar A(H3N2) viruses predominate, Centers for Disease Control and Prevention (CDC) researchers report.

The interim estimates, published late last week in Morbidity and Mortality Weekly Report (MMWR), come from Argentina, Brazil, Chile, Paraguay, and Uruguay, where an average of only 21.3% of patients hospitalized for flu from March to July 2024 (the Southern Hemisphere flu season) had received the flu vaccine.

"While Southern Hemisphere data cannot predict exactly what will happen in the Northern Hemisphere, what we can say is that if we see similar influenza viruses (strains or clades) circulating this season in the Northern Hemisphere, we can expect similar vaccine effectiveness against influenza-related hospitalizations," lead author Erica Zeno, PhD, epidemic intelligence service officer with the CDC’s Influenza Division, told CIDRAP News in an email.

This flu season, the United States is using trivalent (three-strain) vaccines with the same components as those in Southern Hemisphere vaccines, Zeno said.

On August 29, the CDC forecasted that the upcoming flu season "will be similar to or lower than that of the 2023-2024 season rate of 8.9 weekly laboratory-confirmed hospitalizations per 100,000, with moderate confidence," it wrote. "However, past seasons have varied widely in the number of illnesses, hospitalizations, and deaths, depending on the subtypes circulating, population immunity to different subtypes, and vaccine effectiveness against circulating subtypes."

Campaign targeted high-risk groups The researchers used a test-negative, case-control design to analyze data from a multinational surveillance network to generate estimates of interim vaccine effectiveness (VE) against hospitalization with flu-related severe acute respiratory illness (SARI).

The study population was made up of 11,751 SARI patients from three Pan American Health Organization (PAHO) vaccination target groups: young children (58.3%), older children and people with underlying medical conditions (14.5%), and older adults (27.2%). Case-patients had SARI and tested positive for flu, while control patients had SARI and tested negative for flu and COVID-19.

Data were pooled from 30 hospitals in Argentina, 2,477 in Brazil, 13 in Chile, 5 in Paraguay, and 10 in Uruguay beginning 2 weeks after each country's flu vaccination campaign. Vaccination status was confirmed using national electronic vaccination records.

All countries used World Health Organization (WHO)–recommended egg-based Southern Hemisphere formulations. Argentina, Brazil, Chile, and Uruguay used trivalent (three-strain) vaccines containing antigens from A/Victoria/4897/2022 (H1N1)pdm09–like virus, A/Thailand/8/2022 (H3N2)–like virus, and B/Austria/1359417/2021 (B/Victoria lineage)–like virus, while Paraguay used quadrivalent (four-strain) vaccines that also contained the B/Yamagata lineage–like virus.

Vaccination rate lower than prepandemic norms The five countries reported 11,751 flu-related SARI cases and an average low seasonal flu vaccination rate. "The documented influenza vaccination coverage levels (21.3%) were below pre–COVID-19 norms," the researchers wrote. "This finding is consistent with postpandemic declines in vaccination coverage across the Americas associated with vaccine misinformation, hesitancy, and disruptions in routine immunization services, prevalent during the COVID-19 pandemic."

The adjusted VE was 34.5% against hospitalization, 36.5% against the predominant A(H3N2) influenza substrain, and 37.1% against the A(H1N1)pdm09 substrain. VE was 58.7% among patients with chronic conditions, 39.0% among young children, and 31.2% among older adults.

"The vaccine effectiveness estimated is within the confidence interval of prior H3N2 (34%–53%) and H1N1 (18%–56%) for this Southern Hemisphere network," Zeno said. "It is lower than what was observed in the United States last season, but that was on the high-end of the historic range."

As of July 19, too few influenza B cases were available to estimate VE, the authors said. Adjusted VE against SARI from any flu virus was 42.2% in Argentina, 30.3% in Brazil, 56.9% in Chile, and 61.0% in Uruguay; VE was not calculated for Paraguay because of insufficient data. A sensitivity analysis excluding Brazil estimated an adjusted VE of 56.5%.

In total, 32.7% of SARI patients tested positive for flu, and 98.6% of identified viruses were influenza A. Only 0.7% of patients were infected with influenza B, all of which were of the B/Victoria lineage. Of 61.9% of subtyped influenza A viruses, 68.3% were A(H3N2), and 31.7% were A(H1N1)pdm09. Most (59.2%) of the case-patients were older adults, followed by people with chronic conditions (50.4%), and the lowest proportion of cases (16.0%) occurred among young children.

Vaccination can reduce illness severity, death "While flu vaccine effectiveness can vary from season to season, we know that influenza vaccination can offer significant protection for people who get vaccinated and is the best protection against influenza," Zeno said. "Importantly, influenza vaccination also can reduce severity of illness in people who get vaccinated but still get sick."

Vaccination is one of the most effective interventions to prevent flu-related complications, including death, the authors said. "Annual influenza vaccination should be encouraged for young children, persons with comorbidities, and older adults," the authors wrote. "To enhance this year’s modest influenza vaccine protection against hospitalization, providers should treat patients with suspected or confirmed influenza as soon as possible with antivirals."

"Influenza vaccine postintroduction evaluations and knowledge, attitudes, and practices surveys might identify additional reasons for low coverage and strategies for improved coverage for the next Southern Hemisphere season," they added.

[ajunicetryagain]

If you’re uninsured in the US, you should as well – Biden is set to end the emergency declaration for Covid and that means a LOT of things are about to change.

Free vaccines and boosters? Gone.

Free testing? Gone.

Depending on your coverage (or lack thereof), these things might be free or discounted or expensive or only with a doctor’s request. But millions of people are going to be suddenly without coverage too.

Medicaid will be dis-enrolling people who are no longer eligible. Everyone who went on Medicaid during the pandemic, stayed on during the pandemic – no reporting the first W-2 that put you over the monthly limit, no re-enrolling every single year.

Dis-enrollment will hit especially hard in states like mine where Republicans’ refusal to take the Medicaid expansion means there’s a sizeable gap between who qualifies for Medicaid (<$12k) and who qualifies for subsidies (>$21k).

Hospitals will also be losing a lot of additional funding so expect that to be real fun.

We have more time – not til May 11 – so prepare as much as you can. It’s gonna be a rough ride.

hey UK followers, go get your covid boosters ASAP before these bastards take away yet another covid protection. jfc

[justinspoliticalcorner]

Dylan Scott at Vox:

Former President Donald Trump left the White House amid a public health emergency that his own messaging helped exacerbate. Now, as he campaigns to retake the presidency, he is once again politicizing long-held best practices for stopping infectious diseases. With Covid-19 again on the upswing and amid an ongoing measles outbreak, the former president is taking aim at school vaccine requirements from the campaign stump, promising to defund the districts that mandate students receive certain vaccines. The real danger in Trump’s words is not any actual loss of education funding — that threat is toothless, experts say — but the continued normalizing of anti-vaccine attitudes. People are already losing trust in vaccines: Only 40 percent of Americans believe it is extremely important for parents to get their children vaccinated, down from 64 percent in 2001. It is perhaps the most worrying trend in public health right now. We have the tools to stop many infectious diseases — if we take advantage of them. Trump’s words are making it less likely that people will.

Could Trump really defund schools over vaccines?

Trump had a famously complicated relationship with Covid-19 vaccines during the pandemic. While he officially endorsed them, and his administration played a critical role in their development, he simultaneously indulged vaccine hesitancy on the right, where a tangle of conspiracy theories cast the shots as a part of a sinister public health agenda. Prior to being elected, he entertained theories (advanced by his frenemy in the 2024 presidential race, RFK Jr.) about a link between vaccines and autism. Recently leaked footage suggests he still privately shares those views. Now, Trump is promising to make it a priority to take action against schools with vaccine or mask mandates and those that “teach” critical race theory.

“On day one, I will sign a new executive order to cut federal funding for any school pushing critical race theory, and I will not give one penny to any school that has a vaccine mandate or a mask mandate,” he told the Christian Faith and Freedom Coalition, a conservative Christian group, in July.

[...] And Trump can’t just do whatever he wants with federal education dollars, either. The bulk of federal funding is authorized by the Elementary and Secondary Education Act, the federal law that has set most of federal education policy since the 1960s (with several updates over the decades). That spending has fairly specific strings attached, leaving the federal government with a very limited say over how state and local jurisdictions spend their much larger share of school funding. [...] But Carey worries Trump could still influence local school decisions, especially if he’s elected and even if he can’t actually block funding, because he could still use his bully pulpit to make school administrators fear litigation or more subtle retaliations if they defy the federal government’s wishes.

Trump can shape vaccine attitudes — positively and negatively

That kind of softer influence is where the real risk lies. Trump’s words reach a lot of people. So much so that there is a small library’s worth of research on how Trump affected the Covid-19 information ecosystem and the public’s attitudes toward vaccines. One meta-review of 1 million news articles about the pandemic found that nearly 40 percent of them featured Trump and one of the false claims attributed to him. Coverage of specific subjects, such as miracle cures or the deep state, paralleled whatever fixation Trump had at a given time or the enemies he was railing against. Several studies linked messages that featured Trump’s endorsement of Covid-19 vaccines with an increase in actual vaccinations — another measure of his influence. On the flip side, being a Trump voter was associated with a lower likelihood of getting vaccinated, which reflects festering conspiracy theories and anti-public health sentiments in Trump’s base. One Pew survey found that people who trusted Trump the most for pandemic information were the least likely to be vaccinated. This may help to explain why the Trump-voting parts of the US saw more deaths adjusted for population during the pandemic. When Trump starts to badmouth not just Covid-19 vaccines, but also routine childhood vaccinations that have been around for decades and proven their efficacy in preventing deadly diseases, he is adding fuel to a dangerous fire.

Donald Trump’s promise to block funding for schools that require vaccines with his irresponsible “I will not give one penny to any school that has a vaccine mandate or a mask mandate” pitch is part of the right-wing war on public health measures and vaccines.

[mariacallous]

NSELE, Democratic Republic of the Congo—Nana Ibumbu noticed that 8-year-old Daniel Mwanza was burning up. Ibumbu is the nutritionist at an orphanage on the outskirts of Kinshasa, the capital of the Democratic Republic of the Congo, and oversees all aspects of the children’s health. Last fall, Congo faced a major mpox (previously known as monkeypox) outbreak, as well as a persistent threat from measles. She decided to give Daniel antibiotics, hoping his fever would die down. But then the vomiting started, and soon afterward blotchy rashes appeared on Daniel’s skin.

Days later, two younger children, Chris Matondo and Benicielle Tshitenge, showed the same symptoms. Ibumbu thought they all might have measles; few of the 35 kids living in the orphanage were vaccinated. She took the three to a nearby health clinic, where Dr. Tresor Gulefwa had another theory: mpox. To be sure, he had to send samples to the National Institute of Biomedical Research (INRB), located in central Kinshasa, about 18 miles away—the only lab able to test for infectious diseases in either Congo or the neighboring Republic of the Congo.

Congo struggles with a string of annual epidemics: Measles, polio, cholera, plague, malaria, Ebola, and mpox are just some of the diseases that have threatened children, many of whom are unvaccinated. In Congo, only 35 percent of children are fully vaccinated before their second birthday. This follows an unfortunate trend: Before the COVID-19 pandemic, global immunization rates were slowly increasing, but in 2021 almost 25 million children around the world missed their routine vaccinations, the largest backslide in more than three decades.

Congo has long been a ground zero for infectious diseases. Low vaccination coverage—as well as reduced trust in vaccines—and poor sanitation put the country at risk of exporting viruses across its borders. During a 2018 Ebola outbreak, which became the world’s second-largest, related cases were reported in Uganda. Although Congo’s government has taken steps to improve immunization rates, the country’s large size and limited financial resources make controlling nationwide outbreaks difficult. Without comprehensive vaccination campaigns, diseases can spread and adapt undetected and threaten the rest of the world, too.

Days after returning from the health clinic, 1-year-old Chris’s fever remained high. All the orphanage staff could do was wait. Without the test results, they wouldn’t quarantine the children, as a mpox quarantine would be much stricter than one for measles, given the 3 percent to 6 percent mortality rate for mpox. As they waited for the results, the children in the orphanage mingled and spread the disease to at least two others. Even months later, Gulefwa never received the test results from the INRB.

But whether the children at the orphanage had measles or mpox still mattered: Although a more effective mpox vaccine, Jynneos, was approved by the FDA in 2019, it is not yet publicly available in Congo. When the virus reached Europe and the United States last year, causing short-lived but sizable outbreaks, they received the available vaccines. But Congo is among the countries most affected by both viruses. Between 2020 and 2022, the World Health Organization recorded more than 10,000 cases of mpox in Congo, with more than 360 deaths. Congo also experienced its worst-ever measles epidemic between 2018 and 2020, with more than 460,000 cases. The true figures are likely much higher.

Given Congo’s history with the disease, just one case of mpox is enough to declare an epidemic, according to Gulefwa. Last year, 22 of the country’s 26 provinces experienced mpox epidemics. But the lack of capacity for rapid testing in Congo often renders test results useless, as the orphanage staff learned. “The biggest challenge is the time between when we receive the samples and when we find the results,” Placide Mbala, INRB’s lab manager, said.

Congo struggles to immunize millions of children under ordinary circumstances. A lack of infrastructure, fuel shortages, and the centralization of vaccines in the capital have contributed to the problem. Keeping the vaccines at the necessary temperature in the tropical climate is the biggest challenge, said Devos Kabemba, the head of the Nsele health zone. He added that the Nsele health zone doesn’t receive enough annual funding to develop adequate vaccination campaigns—only $3 per child, when it really needs $15. Support from international partners isn’t enough to cover it.

The government has focused on education. At the Mervedi medical center in Nsele, mothers stood in line with their newborns waiting for them to be vaccinated. Many women said they have no access to clean, running water—another factor exacerbating epidemics in the country. Outside the clinic, Ortane Manligo, a community volunteer, spoke to people about vaccines. Her work is key, as rampant disinformation following the COVID-19 pandemic has made people wary of vaccination.

Community volunteers “were doing well with convincing parents to vaccinate children against polio and other diseases,” Manligo said. “But when COVID came, disinformation spread on WhatsApp.” A study by the government and international partners showed that 45 percent of disinformation about COVID-19 is transmitted by word of mouth and 20 percent through social media; while the government has involved community leaders in its fight against disinformation, rumors remain hard to control. COVID-19 made it harder to convince citizens to get vaccinated, undermining preparedness for future pandemics.

Another major barrier to immunization efforts is low-level corruption. Many health workers responsible for vaccinating children around the country say they have not been paid for years. Jacques Belly, a health worker in Kinshasa who administers vaccines, said he has not been paid beyond his $75 monthly risk bonus since 2008, adding that the situation in the Nsele health zone resembles that of most of his colleagues. “We are Congolese, and we care about our children. We continue to work, and we continue to ask the government to pay us through strikes and protests,” Belly said.

Most funding for vaccines and medical utilities comes from partners like UNICEF, the World Health Organization, and the Gates Foundation, but health workers’ salaries are the responsibility of the state. Veronique Kilumba Nkulu, Congo’s deputy health minister, said the issue stems from a lack of digital payment infrastructure that could allow the money to reach health workers in remote areas. She said in an interview with Foreign Policy that they are trying to introduce more mobile payments, but the situation on the ground shows that even in Kinshasa, health workers aren’t receiving their salaries.

This precarity has led some local health workers to extort the population by asking parents for money in exchange for vaccines. Kamy Musene, a former program field manager for the University of California, Los Angeles, infectious disease program in Congo, monitored the government’s efforts between 2018 and 2022. He found that some mothers were collecting sugar cane to pay for vaccination cards for their children. “We heard in some villages that mothers had to buy vaccination cards for their babies, which can cost almost $1,” he said. Some mothers said their children still did not receive vaccines, and in some cases not even their cards.

“The problem is they know what is happening, but they are not reacting to what we are telling them. Nothing is changing,” Musene said.

The children at the orphanage in Nsele eventually recovered, according to Ibumbu, but the test results never came back. While the outbreak—which she still suspects to be measles—would have been a good opportunity to immunize all children at the orphanage, Gulefwa never received the supplies to do so, leaving the orphanage vulnerable to outbreaks. For Ibumbu and the children at the orphanage, the lack of food and beds is a much more immediate threat. “We don’t have enough means to protect and support these children,” she said. “But we’re trying to do it; it’s our duty.”

Although the COVID-19 pandemic laid bare the importance of global health security, the inequity and disinformation that followed have affected the ability of some governments in the global south to immunize children against other threats. As new diseases emerge, countries like Congo remain on the front line of eradication—and without the appropriate resources, they risk fueling other outbreaks and other pandemics.

[health-views-updates]

Ethical Sourcing in the Vaccine Industry: Building a Sustainable Future

The global vaccine market is expected to experience significant growth in the coming years, driven by continuous innovations, government initiatives, and rising awareness about the importance of immunization. According to a recent report vaccine market revenue is poised to expand at a remarkable pace, supported by increasing demand for preventive healthcare measures and the growing prevalence of infectious diseases worldwide.

Rising Incidences of Infectious Diseases Boost Vaccine Demand

In recent years, the world has witnessed a surge in the prevalence of infectious diseases such as COVID-19, influenza, and measles, which has highlighted the urgent need for effective vaccines. Governments and healthcare organizations across the globe are ramping up their efforts to ensure mass immunization, thereby propelling the vaccine market forward. Initiatives such as the World Health Organization's (WHO) Expanded Programme on Immunization (EPI) have been instrumental in increasing vaccine coverage, especially in developing nations.

Get Free Sample Report@ https://www.snsinsider.com/sample-request/2903 

Technological Innovations Enhance Vaccine Development

Technological advancements in vaccine development are another major factor driving the growth of the market. Innovations such as mRNA vaccines, viral vector-based vaccines, and recombinant subunit vaccines have opened new avenues for the development of safe and effective vaccines. The success of mRNA vaccines during the COVID-19 pandemic has showcased the potential of these new technologies, leading to increased investments in research and development. Companies are now focusing on developing vaccines for a wide range of diseases, including cancer, Alzheimer’s, and HIV, beyond the traditional infectious diseases.

Increased Government Funding and Public-Private Partnerships

Governments across various countries are taking active measures to ensure the availability and accessibility of vaccines. Increased funding, subsidies, and favorable regulatory policies are encouraging pharmaceutical companies to invest in vaccine research. Public-private partnerships have also played a crucial role in accelerating vaccine development, manufacturing, and distribution. For example, initiatives like Gavi, the Vaccine Alliance, and COVAX have helped streamline the process of vaccine distribution to low- and middle-income countries, ensuring equitable access to life-saving vaccines.

Expanding Scope of Vaccines: From Prevention to Therapeutics

Traditionally, vaccines have been associated primarily with the prevention of infectious diseases. However, recent developments indicate a shift toward therapeutic vaccines, which are designed to treat existing conditions. Therapeutic vaccines are gaining traction for their potential to treat chronic diseases such as cancer, allergies, and autoimmune disorders. This expansion in the scope of vaccines is expected to further drive the growth of the market, offering new opportunities for pharmaceutical companies to explore.

North America Leads the Market, Asia-Pacific Emerges as a Key Growth Region

Geographically, North America holds a dominant position in the global vaccine market, attributed to the presence of leading pharmaceutical companies, robust healthcare infrastructure, and high awareness about immunization. The United States, in particular, has been at the forefront of vaccine research and development, with companies like Pfizer, Moderna, and Johnson & Johnson leading the way.

Meanwhile, the Asia-Pacific region is anticipated to witness substantial growth over the forecast period, fueled by rising healthcare expenditure, expanding population, and increasing government initiatives to promote immunization programs. Countries like China, India, and Japan are investing heavily in vaccine development and are emerging as key players in the global market.

Key Players in the Vaccine Market

The vaccine market is characterized by the presence of several established players, including GlaxoSmithKline, Pfizer, Sanofi, Merck & Co., and Moderna. These companies are continuously engaging in strategic collaborations, mergers, and acquisitions to expand their product portfolio and strengthen their market position. The competitive landscape of the vaccine market is dynamic, with companies focusing on innovations to develop vaccines that are not only effective but also easy to manufacture and distribute on a global scale.

Challenges and Future Outlook

Despite the promising growth, the vaccine market faces challenges such as regulatory hurdles, high development costs, and the need for extensive clinical trials to ensure safety and efficacy. Moreover, vaccine hesitancy remains a significant barrier to achieving high immunization coverage rates worldwide. However, ongoing awareness campaigns, coupled with advancements in vaccine technologies, are expected to address these challenges over time.

The future of the vaccine market looks promising, with continuous innovations and strategic partnerships paving the way for the development of vaccines against emerging infectious diseases and chronic conditions. As the world continues to recover from the impact of the COVID-19 pandemic, the importance of vaccines in safeguarding global health has never been more evident.

About Us

SNS Insider is one of the leading market research and consulting agencies that dominates the market research industry globally. Our company's aim is to give clients the knowledge they require in order to function in changing circumstances. In order to give you current, accurate market data, consumer insights, and opinions so that you can make decisions with confidence, we employ a variety of techniques, including surveys, video talks, and focus groups around the world.

Contact Us Akash Anand – Head of Business Development & Strategy info@snsinsider.com Phone: +1-415-230-0044 (US) | +91-7798602273 (IND)

Other Trending Reports

Patient Flow Management Solutions Market Growth

Medical Device Reprocessing Market Growth

Burn Care Market Growth

Pharmaceutical Filtration Market Growth