Category: Covid-19 Vaccine

Page 351«..1020..350351352353..360370..»

Do COVID-19 vaccines work in people who are being treated for MS? – Medical News Today

September 23, 2021

MS is a chronic autoimmune disease that affects the central nervous systems ability to communicate efficiently. According to the National Multiple Sclerosis Society (NMSS), about one million people in the United States are living with the disease.

Health experts consider MS to be an inflammatory disease. It affects the myelin sheath, a fatty insulating layer surrounding the nerve cells that helps them transmit electrical impulses rapidly.

It is unclear why, but in people with MS, the B cells of their immune system attack the myelin sheath. This gradually erodes nerve impulse transmission. Individuals with this progressive disease experience debilitating symptoms such as numbness, tremor, fatigue, or blurred vision.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

Many people with MS have experienced significant relief from the progression of their disease by using modern drugs called anti-CD20 monoclonal antibodies. Specifically, these drugs target B cells, limiting their ability to attack the myelin sheath to slow or even halt the progression of MS.

Because they work by limiting the activity of the immune system, health experts consider people taking anti-CD20 drugs as immunocompromised.

The immune system is complex, featuring multiple cell types. A recent study in Nature Medicine investigated whether the immune systems of MS patients on anti-CD20 therapy would respond to vaccination with a COVID-19 mRNA vaccine such as Pfizer or Moderna.

Vaccines work by provoking immune system responses among B cells and T cells. Since many people are dependent on anti-B cell therapy to control the progression of their condition, it was unclear if the COVID-19 vaccine would provoke an appropriate immune response among MS patients.

Amit Bar-Or, M.D., a Penn Medicine physician, served as lead investigator. In this study, we looked at antibody and cellular responses, said Dr. Bar-Or. Even among people with decreased [B cell-mediated] antibody levels, we saw robust T cell responses, in some cases even stronger [than among people not on anti-CD20 therapy].

In other words, while not an optimal response, involving both B cells and T cells, the response is adequate.

While the study was small, with just 20 MS patients, an ongoing investigation involving 600 participants will assess the effectiveness of administering additional vaccine doses to MS patients.

Dr. Bar-Or noted that his teams study was inspired, in part, by emerging research among patients receiving immunotherapy to treat cancer. Despite being immunocompromised, theyre getting robust T cell responses [] [The COVID-19 vaccine] is indeed protective among these patients, he said.

Although MS patients made fewer antibodies to the virus compared to people not on immune-suppressing drugs, their T cell responses were markedly robust. This shows that vaccination is likely to provide ample protection against SARS-CoV-2 infection.

According to the NMSS, people on anti-CD20 drug therapy should get vaccinated, as they may expect at least some immunity.

While this is good news for cancer patients and clinicians, it is also of academic interest to researchers who study the immune system. This teaches us about human immune responses, Dr. Bar-Or noted.

The present study is already having an impact on guidance for immunocompromised patients, said Dr. Bar-Or, citing recent changes adopted by the NMSS.

The study sheds light on the fundamental mechanisms underlying the development of multiple sclerosis, said Dr. Bruce Bebo, Executive Vice President, Research, for the NMSS. This kind of research is helping NMSS focus research investments, he added.

Were getting closer to cures and treatments for MS. We have good treatments for the relapsing or remitting form of MS, but we dont have them for the hard-to-treat progressive form.

Part of the reason for that has been a lack of understanding of the fundamental mechanisms driving the more aggressive, progressive form of MS. The fundamental biology [behind these two forms of MS] is related, Dr. Bebo said, but distinct.

Thanks to the present study and related research, theres a tremendous amount of excitement in the research community [] Were getting closer to cures and treatments for MS.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

Continued here:

Do COVID-19 vaccines work in people who are being treated for MS? - Medical News Today

Firefly Music Festival Kicks Off Thursday, COVID-19 Vaccination Or Negative Test Needed To Attend – CBS Philly

September 23, 2021

DOVER, Del. (CBS) Firefly Music Festival kicks off Thursday in Delaware, and organizers are trying to prevent the spread of COVID-19. Firefly ticketholders must show proof that theyve been fully vaccinated or show a negative COVID-19 test taken no earlier than 72 hours prior to entry.

The website says you must bring a government-issued photo ID that matches their proof of vaccine.

The festival kicks off Thursday at the Woodlands of Dover International Speedway with headliner Billie Eilish.

More:

Firefly Music Festival Kicks Off Thursday, COVID-19 Vaccination Or Negative Test Needed To Attend - CBS Philly

iPhone users will soon be able to add COVID-19 vaccination card to Apple Wallet – FOX 7 Austin

September 23, 2021

Biden meets with business leaders on COVID-19 vaccine mandates

President Joe Biden invited CEOs and business leaders to the White House on Sept. 15, 2021, to discuss COVID-19 mandates.

LOS ANGELES - iPhone owners will soon be able to add a digital copy of their COVID-19 vaccination card to their Apple Wallet, thanks to an upcoming software update.

A spokesperson for Apple confirmed that while the feature to add a COVID-19 vaccination card specifically to Apple Wallet is not available just yet, it will be in an upcoming update.

For now, the most recent iOS 15 update released on Sept. 20 allows users to add their vaccination status to their health app where other health information including medications and health status can already be documented.

According to an Apple developer blog post published Tuesday, iPhone users can download and store verifiable health records, including COVID-19 vaccinations and test results in the phones health app.

"Users can choose to share verifiable health records stored in the Health app with approved third-party apps requesting this information, like airlines, event venues, and other businesses that facilitate in-person interactions," the developer blog reads.

Apple to soon allow iPhone users to add their COVID-19 vaccine cards to their Apple Wallet's.

The new update comes as a rapidly growing number of cities across the U.S. are requiring people to show proof they have been inoculated against COVID-19 to teach school, work at a hospital, see a concert or eat inside a restaurant.

New York City, New Orleans, San Francisco and Los Angeles were among some of the first cities to impose such rules at many businesses last month.

The measures are an attempt to stem the rising tide of COVID-19 cases that has pushed hospitals to the breaking point.

When New Orleans imposed its vaccination mandate in August, Mayor LaToya Cantrell called proof of vaccination the best way to protect businesses. She said she is not imposing capacity limits or contemplating a shutdown similar to the one that devastated businesses in 2020.

"Unlike this time last year, we have a tool that we did not have," she said, referring to vaccines.

Last month, Louisiana set daily records for the number of people hospitalized with COVID-19, reaching 2,907 patients on Aug. 13. Ninety-one percent of those hospitalized were unvaccinated, according to state data.

Meanwhile across the nation, more Americans have now died from COVID-19 than did in the 1918-19 Spanish flu pandemic approximately 675,000.

This grim statistic is prompting health and state officials to sound the alarm on the need for more Americans to get vaccinated.

The U.S. population a century ago was just one-third of what it is today, meaning the flu cut a much bigger, more lethal swath through the country. But the COVID-19 crisis is by any measure a colossal tragedy in its own right, especially given the incredible advances in scientific knowledge since then and the failure to take maximum advantage of the vaccines available this time.

Just under 64% of the U.S. population has received as least one dose of the vaccine, with state rates ranging from a high of approximately 77% in Vermont and Massachusetts to lows around 46% to 49% in Idaho, Wyoming, West Virginia and Mississippi.

RELATED: COVID-19 has killed about as many Americans as the 1918-19 flu

Globally, about 43% of the population has received at least one dose, according to Our World in Data, with some African countries just beginning to give their first shots.

"We know that all pandemics come to an end," said Dr. Jeremy Brown, director of emergency care research at the National Institutes of Health, who wrote a book on influenza. "They can do terrible things while theyre raging."

COVID-19 could have been far less lethal in the U.S. if more people had gotten vaccinated faster, "and we still have an opportunity to turn it around," Brown said. "We often lose sight of how lucky we are to take these things for granted."

The current vaccines work extremely well in preventing severe disease and death from the variants of the virus that have emerged so far.

The Associated Press contributed to this story.

Excerpt from:

iPhone users will soon be able to add COVID-19 vaccination card to Apple Wallet - FOX 7 Austin

Michael Flynn Wonders Out Loud Whether There’s COVID-19 Vaccine in His Salad Dressing – The Daily Beast

September 23, 2021

Michael Flynnthe man Donald Trump once selected as the standout candidate to become his National Security Adviserhas shared his apparently genuine concern that there might be COVID-19 vaccine in his salad dressing. Since he was pardoned by Trump for lying to the FBI last November, Flynn has gone full QAnon and went as far as to call for a military coup earlier this year. But his descent into quackery went further this week when he fell for an absolutely ridiculous conspiracy theory about vinaigrette. Somebody sent me a thing this morning where theyre talking about putting the vaccine into salad dressing, or salads, said the ex-Trump official. Im thinking to myself, this is the Bizarro World, right?Snopes appears to have found the source of Flynns concerns, reporting that there is research being done to see if mRNA vaccines could be grown in edible plants like lettuce in the future, but no one has yet proposed putting the COVID-19 vaccine into Flynns or anyone elses salad.

Here is the original post:

Michael Flynn Wonders Out Loud Whether There's COVID-19 Vaccine in His Salad Dressing - The Daily Beast

Only immunocompromised individuals need additional COVID-19 vaccine doses at this time – The Baylor Lariat

September 22, 2021

By Emily Cousins | Staff Writer

Additional shots for the Moderna and Pfizer vaccines have been approved for emergency use by the U.S. Food & Drug Administration, but they have only been recommended for immunocompromised people.

In a news release, the FDA said people who are not immunocompromised do not need to worry about additional doses yet, but anyone who is in close contact with an immunocompromised person should get vaccinated according to their health status.

Todays action allows doctors to boost immunity in certain immunocompromised individuals who need extra protection from COVID-19, FDA commissioner Dr. Janet Woodcock said. As weve previously stated, other individuals who are fully vaccinated are adequately protected and do not need an additional dose of COVID-19 vaccine at this time. The FDA is actively engaged in a science-based, rigorous process with our federal partners to consider whether an additional dose may be needed in the future.

The ever-changing state of COVID-19 makes it difficult to predict if booster shots will be needed for the general public, Vahedi Shah lead epidemiologist for the Waco-McLennan County Public Health District said via email.

The CDC and FDA are looking at the data available from other countries as well as studies by Pfizer to make the determination, Shah said. We will follow the recommendations made by these organizations.

Baylor medical director Sharon Stern said via email that doctors are learning more daily about the immune response and how long it lasts.

If you look at current immunizations, you will find tetanus booster every 10 years, influenza every year and some shots like MMR and varicella that do not require boosters after the initial series, Stern said. We had years and years of data to figure out which schedule to put those on.

Stern said the Centers for Disease Control and Prevention has not recommended a booster shot for the Johnson & Johnson vaccine, and she would suggest following what the CDC has advised.

Shah said doctors are still researching the combination of the Johnson & Johnson vaccine and mRNA vaccines.

At present, any student who would like to get an mRNA vaccine after a J&J should consult with their healthcare provider, Shah said.

Shah said the FDA and CDC have decades of experience working to curb the spread of diseases, and people should follow the guidance of these experts.

The more the virus circulates in the population, the higher the chances for mutations, Shah said. If a higher proportion of the population is not vaccinated, there is a strong possibility that the vaccines may be less effective against new mutations.

Stern said at this time, all the vaccines are effective against known variants.

Chances are, the brilliant vaccine scientists will be able to tweak the current vaccines if we have a variant that the vaccine does not protect against, Stern said.

View original post here:

Only immunocompromised individuals need additional COVID-19 vaccine doses at this time - The Baylor Lariat

COVID-19 vaccines work, even if they aren’t 100% effective – PolitiFact

September 22, 2021

Reports of vaccinated Americans catching COVID-19 have invigorated vaccine skeptics, but such breakthrough infections are expected, and no vaccine is 100% effective. And thats not unique to COVID-19 vaccines.

Still, some Facebook posts have suggested otherwise.

"First in history, a vax that does not prevent catching or spreading a virus, and only lasts for months," one post says. "Mind boggling!"

This post was flagged as part of Facebooks efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)

"Vaccines are the best defense we have against infectious disease," the Centers for Disease Control and Prevention says on its website, "but no vaccine is actually 100% safe or effective for everyone because each persons body reacts to vaccines differently."

This is as true for the flu vaccine as it is for COVID-19 vaccines.

"Some fully vaccinated people will get sick, and some will even be hospitalized or die from COVID-19," the CDC says. Vaccinated people with breakthrough infections can also spread the disease.

But most people who get COVID-19 are unvaccinated, and fully vaccinated people who are infected are less likely to suffer a serious illness. Studies show that vaccinated people are eight times less likely to be infected and 25 times less likely to be hospitalized or die from COVID-19 than unvaccinated people, according to the CDC.

"Vaccines remain effective in protecting most people from COVID-19 infection and its complications," the agency says.

All COVID-19 vaccines approved by the World Health Organization for emergency use are required to have an efficacy rate of 50% or greater.

As for how long the COVID-19 vaccines provide protection against the disease, if and when everyone will need a booster shot is still being debated. In August, the Food and Drug Administration authorized Pfizer and Moderna to give a third dose of their vaccines to certain immunocompromised people because it could increase protection for people such as organ transplant recipients, Yale Medicine recently noted. In September, an FDA advisory committee recommended booster shots of the Pfizer vaccine for people who receive their second shot at least six months prior and who are 65 and older or have a high risk of a severe case of COVID-19.

But, again, plenty of other vaccines have boosters. The flu vaccine, of course, is annual, and vaccines against Hepatitis B, whooping cough, chicken pox and measles, among other diseases, require multiple shots.

We rate this post False.

Go here to read the rest:

COVID-19 vaccines work, even if they aren't 100% effective - PolitiFact

City Of Boulder Continues Free COVID-19 Vaccine Clinics And Testing – City of Boulder

September 22, 2021

The City of Boulder, in partnership with the states COVID-19 vaccination program, will continue to offer free weekly vaccine clinics through Oct. 10, with the potential for future dates to be announced. Clinics will be held on Sundays from noon to 5 p.m. at the Boulder Public Library Main Branch, 1001 Arapahoe Ave., in the Canyon Theater. Those attending the clinics should enter the north side of the building near Canyon Boulevard. Spanish language interpreters will be available at each clinic.

Vaccinations are critical to curbing the spread of COVID-19 and help protect people from serious illness, said Housing and Human Services Department Manager Elizabeth Crowe. As the Delta variant continues to impact the Boulder community, the city remains committed to making the vaccine easily accessible for community members.

All community members are invited to the clinics, including families with children ages 12+. COVID-19 vaccines are safe, effective and help protect against the Delta variant. The clinics are 100% free and no insurance, ID or pre-registration is required, however those that prefer to schedule a time can reserve one in advance.

The one-dose Johnson & Johnson vaccine and the two-dose Pfizer and Moderna vaccines will be available. Those who have already received their first Pfizer or Moderna dose should be aware of the recommended window of time between the first and second doses and should bring their vaccination card with them to the clinic. The Centers for Disease Control and Prevention advises that both doses of the vaccine series be completed with the same product. Additional shots will be available for people whose immune systems are compromised.

In addition to vaccinations, testing is an important component of the citys pandemic response. COVID-19 testing is available at Stazio Ball Fields, located at 2445 Stazio Dr. in Boulder, seven days a week from 8 a.m. to 6 p.m. As cases of the highly contagious Delta variant continue to impact our community, testing remains vital to stopping the spread of COVID-19.

For more information about testing, vaccines and clinics, visit Boulder Countys website.

Excerpt from:

City Of Boulder Continues Free COVID-19 Vaccine Clinics And Testing - City of Boulder

COVID-19 Vaccine Incentive Program to Launch September 23 – City of Milwaukee

September 22, 2021

FOR IMMEDIATE RELEASE: September 21, 2021

MILWAUKEE Mayor Tom Barrett and Health Commissioner Kirsten Johnson have announced a new COVID-19 vaccine incentive program for City of Milwaukee residents. Beginning Thursday, September 23, any City of Milwaukee resident over the age of 12 who receive their first dose of the COVID-19 vaccine at the Northwest Health Center (7630 W. Mill Rd.) or Southside Health Center (1639 S. 23rd St.) will also receive one $100 U.S. Bank gift card on site, while supplies last.

Every vaccine brings us one step closer to the other side of this pandemic, said Health Commissioner Kirsten Johnson. We are hopeful that this incentive program will encourage Milwaukee residents to prioritize getting their COVID-19 vaccine.

Everyone who is eligible to receive the free COVID-19 vaccine is eligible to receive this gift card, regardless of insurance, ID, or citizenship. The Milwaukee Health Department vaccination sites have the Pfizer COVID-19 vaccine available for anyone 12 years of age and older or the Johnson & Johnson COVID-19 available for anyone 18 years of age and older. Individuals under the age of 18 will need to have a parent or guardian present to receive their vaccine and incentive.

Currently, 53.6% of Milwaukee residents 12 years of age and older are fully vaccinated, with 59.5% having received their first dose. Information about this incentive program can be found at milwaukee.gov/COVIDvax. Any questions regarding this program can be directed to the COVID-19 Hotline at 414-286-6800.

###

Go here to see the original:

COVID-19 Vaccine Incentive Program to Launch September 23 - City of Milwaukee

COVID-19 vaccine: If there are no side effects, does it work? – Medical News Today

September 22, 2021

Many people assume that when a person experiences side effects after COVID-19 vaccination, it is a sign that the vaccine is working.

This may leave people without such symptoms wondering whether their vaccinations have been successful. According to a new research letter from scientists at Johns Hopkins Medicine, this is not a valid concern.

The Johns Hopkins research confirmed that the Pfizer-BioNTech and Moderna vaccines are exceedingly effective at generating a strong antibody response regardless of whether a person develops side effects or not.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

The letters senior author Dr. Aaron Milstone, associate hospital epidemiologist at Johns Hopkins Hospital, explains,

It wasnt known if a lack of symptoms following vaccination or prior SARS-CoV-2 infection would indicate a less-than-adequate antibody response in people who received either the [Pfizer-BioNTech] or Moderna vaccines, so we studied an available group of staff from our hospital to see if there were any connections.

There were none. In the study, 99.9% of all the participants successfully developed the antibodies the vaccines are designed to promote.

The research letter appears in the journal JAMA Internal Medicine.

The surface of the SARS-CoV-2 virus is covered in spikes that latch on to healthy cells, allowing the virus to enter and infect. Both of the vaccines tested the Pfizer-BioNTech and Moderna vaccines deliver to the body a set of instructions, or mRNA, to make the spike protein.

In response, the bodys immune system begins producing immunoglobulin G (IgG) antibodies as a defense against the spike protein. The IgG antibodies destroy and eliminate the spike protein from the body.

Should the immune system encounter SARS-CoV-2, the spikes of the virus trigger the release of these antibodies, which neutralize the virus or limit the severity of any disease it causes.

It is of note that none of the available COVID-19 vaccines contain any living or dead SARS-CoV-2.

In total, 954 healthcare workers at Johns Hopkins Medical took part in the research. All of them had received either the Pfizer or Moderna vaccine, and some had previously had a SARS-CoV-2 infection.

What indicated an infection was either having a positive SARS-CoV-2 PCR test within 14 days of the second vaccine dose or having an elevated IgG antibody count before receiving the vaccine.

The researchers asked the participants to report their reactions to their first and second inoculations. They could report none, mild including injection site pain, headache, and mild fatigue or clinically significant symptoms, such as fever, chills, and fatigue.

Just 5% of the participants reported side effects after their first inoculation, although 43% said that they experienced side effects after the second one.

People who took the Moderna vaccine were more likely to have clinically significant symptoms after either dose, and those who had previous SARS-CoV-2 infection were more likely to experience them after the first shot but not the second.

Whether individuals experienced side effects or not, almost all 953 out of 954 developed IgG antibodies 14 days after their last vaccine dose.

The lone exception was an individual taking immunosuppressant medication.

Some people had especially high IgG levels, which the researchers link to a few possible factors. These include reporting clinically significant symptoms, being female, being under the age of 60 years, having received the Moderna vaccine, and having had earlier SARS-CoV-2 exposure.

Lead author Dr. Amanda Debes, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, tells HUB, the news center for Johns Hopkins:

The findings suggest that either spike mRNA vaccine will work well against SARS-CoV-2, even if a person doesnt experience symptoms after vaccination or if they had a prior infection by the virus. This should help reduce anxieties that the vaccines will be less effective in either situation.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

Original post:

COVID-19 vaccine: If there are no side effects, does it work? - Medical News Today

Johnson & Johnson Says Its Booster Shot Provides Increased Protection From COVID-19 – NPR

September 22, 2021

Johnson & Johnson shared data from the Phase 3 trial of its booster shot on Tuesday indicating a booster shot at six months provided a 12-fold increase in antibodies. Eva Marie Uzctegui/Bloomberg via Getty Images hide caption

Johnson & Johnson shared data from the Phase 3 trial of its booster shot on Tuesday indicating a booster shot at six months provided a 12-fold increase in antibodies.

People who receive a Johnson & Johnson COVID-19 vaccine booster shot are better protected against the coronavirus for a longer period of time, according to the pharmaceutical company's latest trial results.

The one-dose Johnson & Johnson vaccine has been found to be 66% protective against moderate and severe disease overall worldwide and 72% protective against such cases in the U.S. But when a person receives a booster shot two months after getting the pharmaceutical company's one-dose vaccine, the protection against COVID-19 increased to 94%.

A booster shot at six months provided a 12-fold increase in antibodies.

The company had previously shared earlier evidence from this trial that people who received its one-shot COVID-19 vaccine could benefit from a booster shot after six months. The information shared Tuesday was part of the company's Phase 3 trial.

"Our large real-world-evidence and Phase 3 studies confirm that the single-shot Johnson & Johnson vaccine provides strong and long-lasting protection against COVID-19-related hospitalizations. Additionally, our Phase 3 trial data further confirms protection against COVID-19 related death," said Mathai Mammen, global head of Janssen research and development for Johnson & Johnson, in a statement.

Experts have said coronavirus boosters will be needed down the road because the efficacy of these vaccines, including the two-dose Pfizer and Moderna shots, wanes over time. Johnson & Johnson's trial data provides further support that a COVID-19 booster shot could go a long way in providing continued protection from the virus.

"Our single-shot vaccine generates strong immune responses and long-lasting immune memory. And, when a booster of the Johnson & Johnson COVID-19 vaccine is given, the strength of protection against COVID-19 further increases," Mammen said.

Pfizer's own data indicates booster shots can restore its vaccine's efficacy to 95%. A third dose of the Moderna vaccine, given six months after the initial two doses, also significantly boosts immunity, according to the company's data.

Despite President Biden's earlier announcement that the U.S. plans to get booster shots in the arms of already-vaccinated Americans, it's unclear when health officials would approve such a move for the general public.

Health officials have already recommended a third shot of the Pfizer or Moderna vaccine for a more limited population people who are moderately to severely immunocompromised. But last week, the Food and Drug Administration recommended against approval of a booster dose of the Pfizer-BioNTech COVID-19 vaccine for people 16 years and older.

That ruling didn't weigh in on a Johnson & Johnson booster shot, however.

The company says it has provided available data to the FDA and plans to submit the data to other regulators, the World Health Organization and National Immunization Technical Advisory Groups worldwide to inform decision-making on vaccine administration strategies.

Data from Johnson & Johnson's booster trial showed strong protection against severe COVID-19 infections soon after the second-dose was administered.

At least 28 days after a patient received the second Johnson & Johnson shot, data showed at least 75% overall efficacy against severe or critical COVID-19 infections, across all age cohorts and all countries included in the study.

Doses of the Johnson & Johnson Janssen COVID-19 vaccine. Elijah Nouvelage/Bloomberg via Getty Images hide caption

Doses of the Johnson & Johnson Janssen COVID-19 vaccine.

Specifically for the U.S., the company reported a 74% efficacy against critical COVID-19 infections. The booster also provided 89% efficacy against hospitalization and 83% against COVID-19-related death.

A booster shot after two months provided 94% efficacy against COVID-19 in the U.S. According to the company, as early as two weeks after the booster shot was administered data showed 100% efficacy against critical COVID-19 infections.

When a booster of the Johnson & Johnson COVID-19 vaccine was given six months after the single-shot dose, antibody levels increased nine-fold one week after the booster and continued to climb to 12-fold higher four weeks after the booster.

See the original post here:

Johnson & Johnson Says Its Booster Shot Provides Increased Protection From COVID-19 - NPR

Page 351«..1020..350351352353..360370..»