Reactive synovitis of the knee joint after COVID19 vaccination: The first ultrastructural analysis of synovial fluid – Wiley
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In this weeks look around the Air Force, Lt. Gen. B. Chance Saltzman is nominated to be the new chief of space operations, a new COVID-19 vaccine becomes available for service members, and Airmen can provide feedback on armor and other gear through the GearFit application. (Hosted by Tech. Sgt. Britt Crolley)
For previous episodes, click here for the Air Force TV page.
Related links:- Lt. Gen. Chance Saltzman nominated to be next Space Force CSO- Air Force prepares for newly approved COVID-19 vaccine: Novavax provides new option for unvaccinated Airmen, Guardians- GearFit shortens feedback loop
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The vaccine deployment in December 2020 signaled a turning point in the COVID-19 pandemic. By the end of May 2021, 40% of the U.S. population was fully vaccinated. But as vaccination rates lagged over the summer, new surges of COVID-19 came, including Delta in the summer of 2021, and now the Omicron variant, which comprises the majority of cases in the U.S.
The United States as of Aug. 5 reached over 1 million COVID-19-related deaths and 91.9 million COVID-19 cases, according to Johns Hopkins University. Currently, 67.2% of the population is fully vaccinated, and 48.2% of vaccinated people have received booster doses.
Stacker compiled a list of the counties with highest COVID-19 vaccination rates in Michigan using data from the U.S. Department of Health & Human Services and Covid Act Now. Counties are ranked by the highest vaccination rate as of Aug. 4, 2022. Due to inconsistencies in reporting, some counties do not have vaccination data available. Keep reading to see whether your county ranks among the highest COVID-19 vaccination rates in your state.
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Counties with the highest COVID-19 vaccination rate in Michigan - Longview News-Journal
President Joe Biden was officially cleared to emerge from isolation Sunday after a second negative COVID-19 test, his physician announced."This morning, the president's SARS-CoV-2 antigen testing was negative for a second consecutive day," presidential physician Kevin O'Connor wrote in a letter Sunday. "He will safely return to public engagement and presidential travel."Biden tested negative on an antigen test Saturday as well, but remained in isolation until Sunday morning before departing for Rehoboth Beach, Delaware.Departing the White House for Rehoboth Beach, the president told reporters he was "feeling good," saying, "After 18 days, I'm clear!"Biden had not left the White House since initially testing positive for COVID-19 on July 21. After taking a five-day course of Pfizer's antiviral drug, Paxlovid, he tested positive for a rebound case of COVID-19 last Saturday and resumed isolation. There are currently no events on his public schedule for the weekend.During isolation, the president has participated virtually in public events from the White House residence. On two occasions, he delivered socially distanced remarks to a restricted pool from the Blue Room balcony, announcing a successful strike that killed al Qaeda leader Ayman al-Zawahiri Monday and signing two bills cracking down on COVID-19 relief fraud Friday.The president and first lady Jill Biden are scheduled to travel on Monday to visit Kentucky after deadly floods in the eastern part of the state killed dozens of people and devastated the area.According to the U.S. Centers for Disease Control and Prevention, "People with recurrence of COVID-19 symptoms or a new positive viral test after having tested negative should restart isolation and isolate again for at least 5 days."During Biden's first bout with the disease, he experienced mild symptoms, including runny nose, fatigue, high temperature and a cough, according to his doctor. The five-day course of Paxlovid the president completed requires a doctor's prescription and is available via emergency use authorization from the U.S. Food and Drug Administration for treatment of mild-to-moderate COVID-19 in people 12 and older who are at high risk of severe illness.The CDC issued a health alert to doctors on May 24 advising that COVID-19 symptoms sometimes come back, and that may just be how the infection plays out in some people, regardless of whether they're vaccinated or treated with medications such as Paxlovid. The CDC said that most rebound cases involve mild disease and that there have been no reports of serious illness.Biden is fully vaccinated and received two booster shots. He received his first two doses of the Pfizer/BioNTech COVID-19 vaccine ahead of his inauguration in January 2021, his first booster shot in September and his second booster vaccination in March.
President Joe Biden was officially cleared to emerge from isolation Sunday after a second negative COVID-19 test, his physician announced.
"This morning, the president's SARS-CoV-2 antigen testing was negative for a second consecutive day," presidential physician Kevin O'Connor wrote in a letter Sunday. "He will safely return to public engagement and presidential travel."
Biden tested negative on an antigen test Saturday as well, but remained in isolation until Sunday morning before departing for Rehoboth Beach, Delaware.
Departing the White House for Rehoboth Beach, the president told reporters he was "feeling good," saying, "After 18 days, I'm clear!"
Biden had not left the White House since initially testing positive for COVID-19 on July 21. After taking a five-day course of Pfizer's antiviral drug, Paxlovid, he tested positive for a rebound case of COVID-19 last Saturday and resumed isolation. There are currently no events on his public schedule for the weekend.
During isolation, the president has participated virtually in public events from the White House residence. On two occasions, he delivered socially distanced remarks to a restricted pool from the Blue Room balcony, announcing a successful strike that killed al Qaeda leader Ayman al-Zawahiri Monday and signing two bills cracking down on COVID-19 relief fraud Friday.
The president and first lady Jill Biden are scheduled to travel on Monday to visit Kentucky after deadly floods in the eastern part of the state killed dozens of people and devastated the area.
According to the U.S. Centers for Disease Control and Prevention, "People with recurrence of COVID-19 symptoms or a new positive viral test after having tested negative should restart isolation and isolate again for at least 5 days."
During Biden's first bout with the disease, he experienced mild symptoms, including runny nose, fatigue, high temperature and a cough, according to his doctor. The five-day course of Paxlovid the president completed requires a doctor's prescription and is available via emergency use authorization from the U.S. Food and Drug Administration for treatment of mild-to-moderate COVID-19 in people 12 and older who are at high risk of severe illness.
The CDC issued a health alert to doctors on May 24 advising that COVID-19 symptoms sometimes come back, and that may just be how the infection plays out in some people, regardless of whether they're vaccinated or treated with medications such as Paxlovid. The CDC said that most rebound cases involve mild disease and that there have been no reports of serious illness.
Biden is fully vaccinated and received two booster shots. He received his first two doses of the Pfizer/BioNTech COVID-19 vaccine ahead of his inauguration in January 2021, his first booster shot in September and his second booster vaccination in March.
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A study out of the United Kingdom has shown that health care workers who received multiple COVID-19 vaccine boosters after initially being infected with the original virus strain from Wuhan are more prone to chronic reinfection from the Omicron variant.
This may help explain why the people who have received several COVID-19 vaccine boosters are increasingly the ones who end up in the hospital with severe COVID-19 symptoms, sometimes resulting in death, said scientist and physicianDr. Robert Malone.
In a July 21 interview for EpochTVs Crossroads program, Malone, an inventor of mRNA vaccine technology, said this phenomenon is the result of a process called immune imprinting,whereby initial exposure to a virus strain may prevent the body from producing enough neutralizing antibodies against a newer strain.
He added that this process is reinforced by multiple inoculations.
All over the world, we are seeing these datasets that show that,unfortunately, the people that are dyingand being hospitalized are overwhelmingly the highly vaccinated, he said. It is not those that have natural immunity.
The COVID-19 vaccines currently in circulation are based on the Wuhan strain of theCCP (Chinese Communist Party) virus, also known as SARS-CoV-2, which causes the illness now identified as COVID-19.
A number of strains have emerged and become dominant since the Wuhan strain was prevalent, including the currently dominant Omicron variant.
The problem is that COVID-19 vaccines use only one of the components of the whole virus, which is a spike protein, so the immune system of a person who received an mRNA vaccine becomes trained to respond to only that component, Malone explained.
Ifthat antigen has changed slightly, if that virus has changed slightly, [the immune system] still reacts as if its the old one, he said.
The COVID-19 vaccines are based on the spike protein of the original virus identified in Wuhan. That strain of the virus no longer exists and is not circulating in the population anymore, Malone said.
If a vaccine based on a now-defunct viral strain is repeatedly administered, it trains the immune system to focus more and more on the antigen delivered through the vaccine and to disregard anything else thats slightly different, Malone explained, calling this phenomenon immune imprinting.
The literature on immune imprinting is bombproof, Malone said. Paper after paper after paper now, in the top peer-reviewed journals from the top laboratories all across the world, are documenting it.
The phenomenon has long been known in the field of vaccinology, said Malone, but the topic is verboten, and people who work in the field prefer not to discuss it, he said.
Health care workers in the UKmany of whom were infected with the Wuhan variant of the virus and also received three or four COVID-19 vaccine doseshave been developing chronic repeated infections from the Omicron variant, Malone said, citing a paper published in the academic journal Science.
Another paper published in Nature shows that the evolution of the virus is not coming from the general population, but rather from immunocompromised people who have received multiple vaccine doses, Malone said, and about 30 percent of the highly vaccinated population are having repeated infections.
This is contrary to the promoted narrative that the unvaccinated are putting the wider population at risk, Malone noted.
Natural immunity from a COVID-19 infection lasts for at least 14 months, including immunity against the Omicron strains, Malone said, citing a scientific paper from Qatar which has not yet been peer reviewed (pdf).
Vaccine-induced immunity, however, lasts only a couple of months, he added.
When someone gets infected with the original virus, that person will generate an immune response that includes all kinds of proteins from the virus, provided he or she hasnt experienced too much immune imprinting, Malone explained.
The problem with these monovalent vaccines, or the single-antigen vaccines, is theyre driving all your immune response against one thing as opposed to the whole virus. So all the virus has to do is genetically, through evolution, tweak a few knobs to escape that, he said. And that is exactly whats happened with Omicron.
The paradox is that most of the countries with emerging economies and low vaccination rates also have the lowest COVID-19 mortality rates in the world, Malone said.
Its likely that were going to continue to see this trend, he said.
According to Our World in Data, only 1.4 percent of Haitis population has been vaccinated, and the country has recorded 838 COVID-19 deaths, a rate of 73 deaths per 1 million people.
In South Africa,where 32 percent of the population is vaccinated, there have been nearly 102,000 deaths, a rate of 1,717 deaths per 1 million people.
In the UK,75 percent of the population is vaccinated, and more than 184,000 people have died, which is a rate of2,736 deaths per 1 million.
And in the United States, 67 percent of the population is vaccinated, and 1.03 million people have died from the virus, a rate of 3,058 deaths per 1 million people.
Malone pointed out a problem with the current mRNA vaccines.
When a vaccine is injected into a patients arm, the RNA from the vaccine, which is a modified RNA, is supposed to last for only a couple of hours, but a study from Stanford University shows that the RNA sticks around for at least 60 days, Malone said.
However, the government only accounts for vaccine reactions and illnesses that are recorded on the Vaccine Adverse Event Reporting System (VAERS)within the first couple of weeks after vaccination, even though the drug is still in the body two months later, Malone said.
The RNA from the vaccine produces more spike protein than the natural infection does, he said. Now that makes sense about why we see more adverse events with the vaccines than we see with the infection itself, because spike is a toxin.
VAERS was established by the Centers for Disease Control and Prevention and the Food and Drug Administration to collect and analyze data about the adverse effects of vaccination.
The system relies on individuals to send in reports and is not intended to determine if a reported health problem was caused by a vaccine, but it is especially useful for detecting unusual or unexpected patterns of adverse event reporting that might indicate a possible safety problem with a vaccine, according to the Department of Health and Human Services.
Malone, president and co-founder of theInternational Alliance of Physicians and Medical Scientists, said over 17,000 doctors and scientists have signed a declaration statingunequivocallythat genetic vaccines need to be withdrawn.
These genetic vaccines are not working, he said.
Meiling Lee andZachary Stieber contributed to this report.
Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.
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While the vaccines continue to provide critical, evidence-based protection against the coronavirus, rare cases of myocarditis and pericarditis have been reported.
The Moderna mRNA vaccine may be more likely to cause myocarditis in men aged 12 to 29 years than other vaccines, requiring more surveillance of patients following the administration of booster shots.1 In the United States, cases of myocarditis are 1 to 2 per 100,000 people, regardless of age, with COVID-19 vaccinations only causing 0.2 cases per million people and only causing 1.4 cases of pericarditis per million people.1
Jorge Moreno, MD, assistant professor of medicine at the Yale School of Medicine, although not involved in the study, noted in a discussion with Medical News Today that the data show that cases of myocarditis and pericarditis from COVID-19 vaccinations are quite rare.2
COVID-19, the illness, can also [cause] myocarditis, and that is much more likely than the vaccine itself [causing it], said Moreno in the interview.2
Additionally, dosing was relevant to case numbers as well. Following patients receiving 2 doses of the Moderna vaccine, cases for anyone between the age of 12 to 39 dropped if administered 31 days following the second dose .1 For men aged 18 to 29 years, the dosing interval may need to increase to 56 days or later to ensure a decreased risk of these conditions developing.1
Often caused by viral infections such as COVID-19, myocarditis is the inflammation of the heart muscle and pericarditis is the inflammation of the 2 layered sac surrounding the heart.2 Symptoms of both diseases are present as persistent chest pain, shortness of breath, palpitations, or all 3.1 Most people recover from mild cases, but some cases of myocarditis or pericarditis have become dangerous.1
During research assessing the correlation between reported cases of myocarditis and pericarditis and vaccinations, investigators at the University of Alberta went through 46 studies and analyzed 8000 reported cases. Based on their findings, they then narrowed the age range to being between the ages of 0 to 39 years. Subsequently, they observed that cases for males over the age of 40 years were very low to none, according to the data.2
While the study authors noted that the data made clear that the time between dosing of the Moderna mRNA vaccine should be prolonged, they also observed that the data did not make clear if young men should avoid the Moderna vaccine entirely and be advised to get the Pfizer mRNA vaccines.1
The FDA and the CDC here in the US did not find that the difference was substantial enough to make that recommendation [for young men to avoid the Pfizer vaccine], Morena said in the press release.2
The study authors also noted the importance of better communication of the risks and benefits of the vaccine for young men and their families, along with more access to non-mRNA vaccine alternatives.1 Although more research regarding personal risk factors and pre-existing conditions should be done to assess potential risk further, the authors explained that due to the evolving nature of COVID-19, study findings remain limited to the investigators understanding of mechanistic studies and how easily diagnosable the diseases are. Additionally, although pericarditis and myocarditis often coexist, myocarditis is more easily identifiable and diagnosed using imaging and troponin protein level testing.1
The authors also noted that long term follow-up may help investigators further understand the natural history, disease recurrence, and risks of COVID-19 even with its evolving nature. To address this, multicenter prospective studies could guide researchers to understand why the vaccines cause these rare cases of heart inflammation.1
References
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Public Health Officials Announce 30,762 New Cases of Coronavirus Disease Over the Past Week IDPH
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Public Health Officials Announce 30,762 New Cases of Coronavirus Disease Over the Past Week - IDPH
The coronavirus disease 2019 (COVID-19) is an acute respiratory disease that is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As a result of the rapid transmission of SARS-CoV-2 and its high morbidity and mortality rates, COVID-19 remains a significant threat.
Study:Does Influenza vaccination reduce the risk of contracting COVID-19? Image Credit: alessandro guerriero / Shutterstock.com
Initially, the development of herd immunity once the vaccinated population reached 70% was believed to reduce the transmission of SARS-CoV-2.
However, the rate of vaccination in different nations varies depending on their specific economic situation. As a result, developed countries often have a higher vaccination rate as compared to underdeveloped countries. This increases the risk of prolonging the pandemic due to the emergence of mutated strains of SARS-CoV-2.
Several studies have observed that the risk of infection and disease transmission are independent of completing a COVID-19 vaccination regimen. Although the risk of developing a severe infection is lower in vaccinated people, the transmission of SARS-CoV-2 variants between vaccinated and unvaccinated individuals still occurs and can subsequently lead to the emergence of new variants.
Currently, ten SARS-CoV-2 variants are being monitored, two of which are considered variants of concern (VOCs). Thus, there remains an urgent need to better understand the evolution of SARS-CoV-2, as well as develop novel treatments and preventive measures that mitigate its spread and adverse effects on human health.
Previous studies have assessed whether countermeasures used to protect against other types of viruses could reduce the adverse effects of COVID-19. Influenza and COVID-19 are two respiratory viral diseases that have similar modes of transmission, clinical outcomes, hospitalizations, complications, and death rates. Additionally, the transmission of these viruses often peaks during the winter months.
The most effective strategy to prevent and control influenza epidemics is annual influenza vaccination. Similar vaccination campaigns have also been important in controlling the COVID-19 pandemic.
The SARS-CoV-2 Omicron variant, which was first detected in South Africa on November 24, 2021, acquired at least one of its mutations from the common cold virus that was also present in the same infected cell. The symptoms of Omicron infection are also very similar to that of the common cold.
Notably, flu vaccination has previously been found to reduce intensive care unit (ICU) admissions, hospitalizations, and mortality from SARS-CoV-2 infections. However, such findings are contradictory and insufficient. Further research is needed to better understand the protective role of the flu vaccine on COVID-19 infections.
A new Spanish study published on the preprint server medRxiv* describes the association between the risk of contracting COVID-19 and the seasonal flu vaccine in patients for whom the flu vaccine is recommended.
The current study involved patients who were considered high-risk for flu complications and were, as a result, recommended for vaccination. The clinical history of the patients was collected to obtain information on COVID-19 diagnosis and flu vaccination.
Study participants living in nursing homes were studied separately due to different living conditions. Both trivalent and quadrivalent flu vaccines were administered to the study participants.
The Mortality in small Spanish areas and Socioeconomic and Environmental Inequalities (MEDEA) deprivation index was used for the analysis of health inequalities and identification of regions with socioeconomic vulnerability. Information on the gender, age, risk factors for flu vaccination, the incidence of COVID-19, and flu vaccine receipt were also collected.
Out of the 429,537 study participants, about 45% were vaccinated against the flu, while 56.8% were women. Participants over the age of 80 were most likely to be vaccinated. Moreover, about 4% of vaccinated people and 4.44% of unvaccinated people contracted COVID-19.
Patients with risk factors for flu complications, such as those with cardiovascular diseases, lung problems, diabetes mellitus, and kidney problems, who also received the flu vaccine were at a lower risk of contracting COVID-19.
Probability of contracting COVID-19 depending on whether or not the patient had received the flu vaccine.
High MEDEA values were associated with lower vaccination rates and a higher risk of COVID-19. Additionally, at high MEDEA index values, people under 60 years of age were associated with higher COVID-19 incidence rates as compared to those over the age of 60.
The current study demonstrates that the flu vaccine could reduce the risk of COVID-19 among individuals who are at high risk for flu complications. However, continuous and effective immunizations are required to reduce the burden of respiratory diseases, especially during a period in which influenza and COVID-19 overlap.
Further research is needed to develop preventive strategies against both diseases simultaneously, as there is a high probability of living with both viruses for a long time.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
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How does the flu vaccine affect the risk of contracting COVID-19? - News-Medical.Net
The U.S. Department of Health is rolling out its "We Can Do This" COVID-19 education campaign ahead of the schoolyear, hoping to increase the vaccination rate among children by educating parents in trusted spaces, and the library is becoming a critical location in the effort.
Dr. Cameron Webb, a senior advisor on the White Houses COVID-19 team, was a special guest for Thursdays story time at Hyattsville's Library. He shared more than a book with families.
Back-to-school is right around the corner, so we want families, we want everybody to have their best protection, he said.
While vaccination rates for children 6 months to 5 years old are the lowest of any age group with 3% vaccinated, Webb hopes parents will step up before little ones reenter school and day care.
We want to make sure that everybody has that protection against COVID-19, but its coming at a time where a lot of people are processing how they look at the pandemic differently.
In Hyattsville, one of the most diverse communities in Prince George's County, it was clear early on that the approach to accessing the vaccine had to be different.
We were the community that was hardest struck in the region, yet we were the last to receive testing and the last to receive vaccines, Prince Georges County Council member Deni Taveras said.
Washington, D.C., Maryland and Virginia local news, events and information
The county's libraries stepped in to help improve access.
We would receive a phone call, and a customer would say, Im an undocumented immigrant. Im having trouble getting through to the vaccine clinic. Theyre telling me I cant get a vaccine, Prince George's County Memorial Library System acting co-CEO Nicholas A. Brown said. And we would tell them exactly what to say. Get on the phone with the vaccine provider to clarify what the policies are. And it was that level of library-to-family connection that helped people get to these resources really quickly.
Thursdays clinic reminded how libraries have pivoted, becoming more than just a place to check out books.
They have a such a nice space for children, so I think it's really great that they tied those two together to offer the vaccine to the community while having children's events here, mother Jillian Campbell said.
Parents said they are adjusting to the new reality and the back-to-school list is changing.
School is starting September or Aug. 22, and he needs to get vaccinated, so we are really, really glad that its being offered over here, mother Grace Burrell said.
It was only a one-day clinic, but the public library is open to share information on where to find other clinics like it by calling local branches during library business hours.
The American Library Association is working alongside the U.S. Department of Health and Human Services to launch similar campaigns around the country.
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Libraries Help Educate About COVID-19 Vaccination Ahead of Schoolyear - NBC4 Washington
Children are now preparing to head back to school for the third time since the onset of the COVID-19 pandemic. Schools are expected to return in-person this fall, with most experts now agreeing the benefits of in-person learning outweigh the risks of contracting COVID-19 for children. Though children are less likely than adults to develop severe illness, the risk of contracting COVID-19 remains, with some children developing symptoms of long COVID following diagnosis. COVID-19 vaccines provide protection, and all children older than 6 months are now eligible to be vaccinated. However, vaccination rates have stalled and remain low for younger children. At this time, only a few states have vaccine mandates for school staff or students, and no states have school mask mandates, though practices can vary by school district. Emerging COVID-19 variants, like the Omicron subvariant BA.5 that has recently caused a surge in cases, may pose new risks to children and create challenges for the back-to-school season.
Children may also continue to face challenges due to the ongoing health, economic, and social consequences of the pandemic. Children have been uniquely impacted by the pandemic, having experienced this crisis during important periods of physical, social, and emotional development, with some experiencing the loss of loved ones. While many children have gained health coverage due to federal policies passed during the pandemic, public health measures to reduce the spread of the disease also led to disruptions or changes in service utilization and increased mental health challenges for children.
This brief examines how the COVID-19 pandemic continues to affect childrens physical and mental health, considers what the findings mean for the upcoming back-to-school season, and explores recent policy responses. A companion KFF brief explores economic effects of the pandemic and recent rising costs on households with children. We find households with children have been particularly hard hit by loss of income and food and housing insecurity, which all affect childrens health and well-being.
Despite job losses that threatened employer-sponsored insurance coverage early in the pandemic, uninsured rates have declined likely due to federal policies passed during in the pandemic and the safety net Medicaid and CHIP provided. Following growth in the childrens uninsured rate from 2017 to 2019, data from the National Health Interview Survey (NHIS) show that the childrens uninsured rate held steady from 2019 to 2020 and then fell from 5.1% in 2020 to 4.1% in 2021. Just released quarterly NHIS data show the childrens uninsured rate was 3.7% in the first quarter of 2022, which was below the rate in the first quarter of 2021 (4.6%) but a slight uptick from the fourth quarter of 2021 (3.5%), though none of these differences are statistically significant. Administrative data show that childrens enrollment in Medicaid and CHIP increased by 5.2 million enrollees, or 14.7%, between February 2020 and April 2022 (Figure 1). Provisions in the Families First Coronavirus Response Act (FFCRA) require states to providecontinuous coveragefor Medicaid enrollees until the end of the month in which the public health emergency (PHE) ends in order to receive enhanced federal funding.
Children have missed or delayed preventive care during the pandemic, with a third of adults still reporting one or more children missed or delayed a preventative check-up in the past 12 months (Figure 2). However, the share missing or delaying care is slowly declining, with the share from April 27 May 9, 2022 (33%) down 3% from almost a year earlier (July 21 August 2, 2021) according to KFF analysis of theHousehold Pulse Survey. Adults in households with income less than $25,000 were significantly more likely to have a child that missed, delayed, or skipped a preventive appointment in the past 12 months compared to households with income over $50,000. These data are in line with findings from another study that found households reporting financial hardship were significantly more likely to report missing or delaying childrens preventive visits compared to those not reporting hardships. Hispanic households and households of other racial/ethnic groups were also significantly more likely to have a child that missed, delayed, or skipped a preventive appointment in the past 12 months compared to White households (based on race of the adult respondent).
Telehealth helped to provide access to care, but children with special health care needs and those in rural areas continued to face barriers. Overall, telehealth utilization soared early in the pandemic, but has since declined and has not offsetthe decreases in service utilization overall. While preventative care rates have increased since early in the pandemic, many children likely still need to catch up on missed routine medical care. One study found almost a quarter of parents reported not catching-up after missing a routine medical visit during the first year of the pandemic. The pandemic may have also exacerbated existing challenges accessing needed care and services for children with special health care needs, and low-income patients or patients in rural areas may have experienced barriers to accessing health care via telehealth.
The pandemic has also led to declines in childrens routine vaccinations, blood lead screenings, and vision screenings. The CDC reported vaccination coverage of all state-required vaccines declined by 1% in the 2020-2021 school year compared to the previous year, and some public health leaders note COVID-19 vaccine hesitancy may be spilling over to routine child immunizations. TheCDC also reported34% fewer U.S. children had blood lead level testing from January-May 2020 compared to the same period in 2019. Further, data suggest declines in lead screenings during the pandemic may have exacerbated underlying gaps and disparities in early identification and intervention for lower-income households and children of color. Additionally, many children rely on in-school vision screenings to identity vision impairments, and some children went without vision checks while schools managed COVID-19 and turned to remote learning. These screenings are important for children in order to identify problems early; without treatment some conditions can worsen or lead to more serious health complications.
The pandemic has also led to difficulty accessing and disruptions in dental care. Data from the National Survey of Childrens Health (NSCH) show the share of children reporting seeing a dentist or other oral health provider or having a preventive dental visit in the past 12 months declined from 2019 to 2020, the first year of the pandemic (Figure 3). The share of children reporting their teeth are in excellent or very good conditions also declined from 2019 (80%) to 2020 (77%); the share of children reporting no oral health problems also declined but the change was not statistically significant.
Recently released preliminary data for Medicaid/CHIP beneficiaries under age 19 shows steep declines in service utilization early in the pandemic, with utilization then rebounding to a varying degree depending on the service type. Child screening services have rebounded to pre-PHE levels while blood lead screenings and dental services rates remain below per-PHE levels. Telehealth utilization mirrors national trends, increasing rapidly in April 2020 and then beginning to decline in 2021. When comparing the PHE period (March 2020 January 2022) to the pre-PHE period (January 2018 February 2020) overall, the data show child screening services and vaccination rates declined by 5% (Figure 4). Blood lead screening services and dental services saw larger declines when comparing the PHE period to before the PHE, declining by 12% and 18% respectively among Medicaid/CHIP children.
Childrens mental health challenges were on the rise even before the onset of the COVID-19 pandemic. A recent KFF analysis found the share of adolescents experiencing anxiety and/or depression has increased by one-third from 2016 (12%) to 2020 (16%), although rates in 2020 were similar to 2019. Rates of anxiety and/or depression were morepronounced among adolescent females and White and Hispanic adolescents. A separatesurveyof high school students in 2021 found that lesbian, gay, or bisexual (LGB) students were more likely to report persistent feelings of sadness and hopelessness than their heterosexual peers. In the past few years, adolescentshave experienced worsened emotional health, increased stress, and a lack of peer connection along with increasing rates of drug overdose deaths, self-harm, and eating disorders.Prior to the pandemic, there was also an increase in suicidal thoughts from 14% in 2009 to 19% in 2019.
The pandemic may have worsened childrens mental health or exacerbated existing mental health issues among children. The pandemic caused disruptions in routines and social isolation for children, which can beassociated with anxiety and depressionandcan have implicationsfor mental health later in life. A number of studies show an increase in childrens mental health needs following social isolation due to the pandemic, especially among children who experience adverse childhood experiences (ACEs). KFF analysis found the share of parents responding that adolescents were experiencing anxiety and/or depression held relatively steady from 2019 (15%) to 2020 (16%), the first year of the pandemic. However, the KFF COVID-19 Vaccine Monitor on perspectives of the pandemic at two years found six in ten parents say the pandemic has negatively affected their childrens schooling and over half saying the same about their childrens mental health. Researchers also note it is still too early to fully understand the impact of the pandemic on childrens mental health. The past two years have also seen much economic turmoil, andresearchhas shown that as economic conditions worsen, childrens mental health is negatively impacted. Further, gun violence continues to rise and may lead to negative mental health impacts among children and adolescents.Researchsuggeststhat children and adolescents may experience negative mental health impacts, including symptoms of anxiety, in response to school shootings andgun-related deathsin theircommunities.
Access and utilization of mental health care may have alsoworsened during the pandemic. Preliminary data for Medicaid/CHIP beneficiaries under age 19 finds utilization of mental health services during the PHE declined by 23% when compared to prior to the pandemic (Figure 4); utilization of substance use disorder servicesdeclined by 24% for beneficiaries ages 15-18 for the same time period. The data show utilization of mental health services remains below pre-PHE levels and has seen the smallest improvement compared to other services utilized by Medicaid/CHIP children. Telehealth has played a significant role in providing mental health and substance use services to children early in the pandemic, but has started todecline. The pandemic may have widened existing disparities in access to mental health care for children of color and children in low-income households. NSCH data show 20% of children with mental health needs were not receiving needed care in 2020, with the lowest income children less likely to receive needed mental health services when compared to higher income groups (Figure 5).
While less likely than adults to develop severe illness, children can contract and spread COVID-19 andchildren with underlying health conditionsare at an increased risk of developing severe illness.Data through July 28, 2022 show there have been over 14 million child COVID-19 cases, accounting for 19% of all cases. Among Medicaid/CHIP enrollees under age 19, 6.4% have received a COVID-19 diagnosis through January 2022. Pediatric hospitalizations peaked during the Omicron surge in January 2022, and children under age 5, who were not yet eligible for vaccination, were hospitalized for COVID-19 at five times the rate during the Delta surge.
Some children who tested positive for the virus are nowfacing long COVID. A recent meta-analysis found 25% of children and adolescents had ongoing symptoms following COVID-19 infection, and finds the most common symptoms for children were fatigue, shortness of breath, and headaches, with other long COVID symptoms including cognitive difficulties, loss of smell, sore throat, and sore eyes. Another report found a larger share of children with a confirmed COVID-19 case experienced a new or recurring mental health diagnosis compared to children who did not have a confirmed COVID-19 case. However, researchers have noted it can be difficult to distinguish long COVID symptoms to general pandemic-associated symptoms. In addition, a small share of children are experiencing multisystem inflammatory syndrome in children (MIS-C), a serious condition associated with COVID-19 that has impactedalmost 9,000 children. A lot of unknowns still surround long COVID in children; it is unclear how long symptoms will last and what impact they will have on childrens long-term health.
COVID-19 vaccines were recently authorized for children between the ages of 6 months and 5 years, making all children 6 months and older eligible to be vaccinated against COVID-19. Vaccination has already peaked for children under the age of 5, and is far below where 5-11 year-olds were at the same point in their eligibility. As of July 20, approximately 544,000 children under the age of 5 (or approximately 2.8%) had received at least one COVID-19 vaccine dose. Vaccinations for children ages 5-11 have stalled, withjust30.3%have been fully vaccinated as of July 27 compared to60.2% of those ages 12-17. Schools have been important sitesfor providing access as well as information to help expand vaccination take-up among children, though children under 5 are not yet enrolled in school, limiting this option for younger kids. A recent KFF survey finds most parents of young children newly eligible for a COVID-19 vaccine are reluctant to get them vaccinated, including 43% who say they will definitely not do so.
Some children have experienced COVID-19 through the loss of one or more family members due to the virus.Astudyestimates that, as of June 2022, over 200,000 children in the US have lost one or both parents to COVID-19. Another study found children of color were more likely to experience the loss of a parent or grandparent caregiver when compared to non-Hispanic White children. Losing a parent can have long term impacts on a childs health,increasingtheir risk of substance abuse, mental health challenges,poor educational outcomes, andearly death. There have been over 1 million COVID-19 deaths in the US, and estimates indicate a17.5% to 20% increasein bereaved children due to COVID-19, indicating an increased number of grieving children who may need additional supports as they head back to school.
Children will be back in the classroom this fall but may continue to face health risks due to their or their teachers vaccination status and increasing transmission due to COVID-19 variants. New, more transmissible COVID-19 variants continue to emerge, with the most recent Omicron subvariant BA.5 driving a new wave of infections and reinfections among those who have already had COVID-19. This could lead to challenges for the back-to-school season, especially among young children whose vaccination rates have stalled.
Schools, parents, and children will likely continue to catch up on missed services and loss of instructional time in the upcoming school year. Schools are likely still working to address the loss of instructional time and drops in student achievement due to pandemic-related school disruptions. Further, many children with special education plans experienced missed or delayed services and loss of instructional time during the pandemic. Students with special education plans may be entitled to compensatory services to make up for lost skills due to pandemic related service disruptions, and some children, such as those with disabilities related to long COVID, may be newly eligible for special education services.
To address worsening mental health and barriers to care for children, several measures have been taken or proposed at the state and federal level. Many states have recently enacted legislation to strengthen school based mental health systems, including initiatives such as from hiring more school-based providers to allowing students excused absences for mental health reasons. In July 2022, 988 a federally mandated crisis number launched, providing a single three-digit number for individuals in need to access local and state funded crisis centers, and the Biden Administration released a strategy to address the national mental health crisis in May 2022, building on prior actions. Most recently, in response to gun violence, the Bipartisan Safer Communities Act was signed into law and allocates funds towards mental health, including trauma care for school children.
The unwinding of the PHE and expiring federal relief may have implications for childrens health coverage and access to care. TheAmerican Rescue Plan Act (ARPA) extended eligibilityto ACA health insurance subsides for people with incomes over 400% of poverty and increased the amount of assistance for people with lower incomes. However, these subsidies are set to expire at the end of this year without further action from Congress, which would increase premium payments for 13 million Marketplace enrollees. In addition, provisions in the FFCRA providing continuous coverage for Medicaid enrollees will expire with the end of the PHE. Millions of people, including children, could lose coverage when the continuous enrollment requirement ends if they are no longer eligible or face administrative barriers during the process despite remaining eligible. There will likely be variation across states in how many people are able to maintain Medicaid coverage, transition to other coverage, or become uninsured. Lastly, there have also been several policies passed throughout the pandemic to provide financial relief for families with children, but some benefits, like the expanded Child Tax Credit, have expired and the cost of household items is rising, increasing food insecurity and reducing the utility of benefits like SNAP.
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