Category: Flu Vaccine

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Why avian flu vaccine rollout would cost 1.5k/shed a month – FarmersWeekly

November 29, 2023

Vaccinating UK poultry flocks for avian influenza has been described as cost prohibitive because an EU surveillance requirement for swabbing and testing would set producers back 1,000-1,500/month for every shed housing immunised birds.

The true cost of vaccination was revealed for the first time at the British Free Range Egg Producers Associations (BFREPA) 2023 National Free Range Show in Telford.

See also:Livestock disease insurance what to look for in policies

Although the cost of the vaccine itself and its administration are unlikely to be high, the EU has set a high bar for its trading partners on testing flocks to ensure there are no silent infections circulating in vaccinated flocks.

Gordon Hickman, head of exotic disease control at Defra, says surveillance is the real killer in relation to the cost benefit of vaccination.

If we follow the requirements the EU has set out for intra- and third-country trading, it is very, very prohibitive in terms of cost, he says.

It would demand monthly visits from a vet to take 60 samples from every shed because each is classed as a separate epidemiological unit; these samples would be tested at a government-approved laboratory.

In addition, producers would have to have their first five or 10 dead birds tested weekly, for the lifetime of the vaccinated flock.

In your longer-lived production situations, that is every week from the point that you vaccinate, Gordon explains.

Although Defra supports vaccination provided it is properly managed, properly administered, we have a good surveillance strategy and our trading partners agree that it is the right thing to do, he says the department is not yet able to recommend it.

It is likely that producers would pick up the tab for vaccination unless the virus became a threat to human health.

Although 91% of eggs produced in the UK supply the domestic market, the UK has important overseas markets for the sale of primary breeder chicks, hatching eggs and meat and egg products.

This means the needs of trading partners would have to be met before a significant vaccine programme could be rolled out.

If that does happen, vaccines are likely to be given to day-old chicks in the hatchery.

Two doses may be needed in long-lived birds such as layers, ducks and turkeys, with the second dose given at transfer.

The biggest challenge with developing a vaccine for avian influenza is that the virus is constantly mutating.

This means vaccines developed now may not be effective against future strains.

This could cause problems in multi-age sites, because birds may not be vaccinated for the most current strain.

However, vet Ian Lowery, a partner of Crowshall Veterinary Services and consultant vet to the British Egg Industry Council, says some vaccines being used by other countries are proving effective.

There is no perfect vaccine, no vaccine that ticks all those boxes for us, but there are vaccines that we can work with, [and] relatively quickly if we need to.

How the cost would be shared within the industry would also need to be addressed.

If a layer farm vaccinated, some significant benefit would be realised by the broiler or duck farm down the road, but that is quite hard to rationalise.

How do we cost-share that between the various sectors that may not choose to vaccinate, but will fundamentally benefit on the back of it?

There is also a risk that if the government sanctions vaccination, insurers are likely to demand that their policyholders vaccinate.

A poll of poultry producers at the conference reflected current opinion on vaccination.

Before producers were advised of the cost and other considerations, a show of hands confirmed about 90% would consider vaccinating their own flocks; when they were later polled, not a single producer appeared to support it.

A Scottish egg producer whose entire flock of 192,000 layers was culled after birds tested positive for avian flu recommends that every farm should have a disease contingency plan.

James Baxter, who farms with his wife, Margaret, and sons, Andrew, Jonathan and David, near Stranraer, says their professionally designed plan was vital in securing an early payout from the Scottish governments compensation scheme.

It is an invaluable resource in a time of crisis, James says. It makes you think about disease during peacetime, when your head is clear.

It makes business sense; it keeps you up to date with current practice too.

The Baxters have 12 sheds on their farm and believe the infection was introduced by pigeons roosting on the chimney of one shed topped with solar panels.

It had snowed seven days before the first cases appeared, creating a viral soup around the chimney when the snow melted.

We believe thats how avian flu got into our farm, says James.

The disease was detected in only one of the sheds, where a mortality rate of 3.3% was experienced, but it required every bird on the farm to be culled.

In just two weeks, we went from flat out to nothing. All we had was two pieces of paperwork and an IOU from the Scottish government, he says.

At day 20, the business received full compensation from the Scottish government.

He advises other producers to have contingency planning in place.

For us, it meant we got sound advice on day one on how this situation would progress, so we knew what was coming.

He diverted egg collection lorries and a 54t feed delivery.

We would have had 28 pallets of eggs if the collection lorries had come, only for them to be destroyed, whereas we were compensated for them through our insurance scheme, probably saving us 30,000.

It also speeded up the paperwork trail, which advanced the valuation process by a day.

You dont get compensated for dead hens, but by moving the valuation forward more quickly, I would say that we saved 4,000-5,000 hens that we would not have been valued on.

James admits that the shock of becoming an infected premises was overwhelming.

Planning is essential for your mental wellbeing and the eventual recovery of your business, he suggests.

He also urges producers to notify their insurer every time there is a change in the egg price.

If the egg price goes up, get straight onto your insurance company if you are insured for loss of income.

There is a vague mention of price trends in insurance policies like mine, but there is a lot of wriggle room in that, and insurance companies do like a bit of wiggle room. That probably cost me 500,000.

He accepted a settlement offer from his insurer after 240 days.

The Baxters will be back in production on 8 February 2024, having opted to not restock for 12 months.

In the meantime, they are fitting spikes onto shed roofs to deter pigeons and other birds from future perching.

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Why avian flu vaccine rollout would cost 1.5k/shed a month - FarmersWeekly

COVID variants, free at-home test kits and China respiratory issues … – American Medical Association

November 29, 2023

AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts inmedicineon COVID-19, medical education, advocacy issues, burnout, vaccines and more.

Featured topic and speakers

AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, shares the latest on China's pneumonia outbreak and mysterious wave of respiratory infections. Also covering updates for flu season, COVID trends and RSV surges. AMA Chief Experience Officer Todd Unger hosts.

Unger: Hello and welcome to the AMA Update video and podcast. Today we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia in Chicago. I'm Todd Unger, AMA's chief experience officer, also in Chicago.

Welcome back, Andrea.

Garcia: Hi, Todd. It's good to see you. Thanks for having me back.

Unger: It is good to be back from our holidays. The last time we talked, just before Thanksgiving, we were starting to see some surges in respiratory illnesses. Andrea, where do we stand right now after the holiday?

Garcia: Well, we know data reporting will lag a bit after the holiday, but most experts are expecting a post-Thanksgiving spike in illnesses as respiratory virus season picks up and we know fewer people are taking precautions. And that really goes for all three respiratory viruses we've been talking about, RSV, COVID and flu.

As you mentioned, before the holiday, we were already starting to see signs of surges. And according to CDC data, in the weeks leading up to the holiday, there was a sharp rise in RSV cases. And if we look at the CDC's most recent FluView report, the same can be said for flu most notably in the South Central, Southeast, Mountain and West Coast regions.

These increases are really expected to continue in the coming weeks. And we know possibly flu season can last into the spring of next year. Outpatient respiratory illnesses in general, which is a fever plus cough or sore throat, is above the baseline nationally for the third week in a row. And the number of weekly flu hospital admissions is also increasing.

Unger: Andrea, what about COVID?

Garcia: Well, prior to the holiday, the highest rates of positive COVID tests were seen right here in the Midwest, as well as in the Western states. And nationwide, COVID hospitalizations were up but still far below those pandemic levels.

According to the latest CDC data, COVID hospitalizations and deaths rose by about 9% during that week ending November 11. Overall, that's still low for this time of year when we compare that to previous years.

Earlier this week, though, CDC did release an update on BA.2.86, which is a COVID variant that we first saw the agency reference back in August. That variant is projected to now compromise about 8.8% of circulating variants, and that's nearly triple the estimated prevalence of two weeks ago.

At this time, the CDC says the expected public health risk of this variant, including its offshoot, JN.1, which we talked about last time, is low. But the agency will continue to track it as it steadily increases. And as we talked about in previous updates, tests and treatments are expected to be effective against this variant, including JN.1.

And at this time, it's not possible to know whether BA.2.86 produces different symptoms from other variants. But generally, we've seen similar symptoms across variants. And we know that in general, symptoms and how severe they are generally depend in part on a person's individual immunity.

Unger: Well, Andrea, given that information, would you say that it's time to worry?

Garcia: I think the problem right now is the lagging vaccination rates for all three respiratory viruses. And we know that health officials and clinicians continue to urge vaccinations to head off another severe respiratory virus season like we experienced last year.

But so far, those vaccination rates are not promising. Whether it's vaccine fatigue, misinformation, barriers to access, people are just not getting vaccinated in the numbers that we would have hoped for. And that, we know, could lead to crowded emergency departments and hospitals later this winter.

Unger: Well, let's talk a little bit more about vaccination rates. Where are we at this point?

Garcia: Well, CDC is actually making it easier to answer that question. And they recently created a weekly COVID-19 vaccine dashboard and a weekly RSV vaccination dashboard that helps ensure we're getting that accurate and timely information about vaccination against respiratory viruses.

The dashboards complement that existing CDC weekly flu vaccine dashboard. So all three of those dashboards are now available under the new RespVaxView page. And that'll allow people to monitor vaccination trends more easily. We're going to put a link to that page in the description of this episode.

So far, the data on that dashboard really reveals persistent disparities in vaccination coverage. That's based on race and ethnicity and geography. And it shows that COVID and flu vaccination remains low among children and pregnant people, which is concerning. So CDC is continuing to call on physicians to help improve those numbers, urge their patients to take advantage of the safe and effective immunizations as soon as possible.

Unger: Absolutely. And, Andrea, with COVID in particular, people can also test, of course, to reduce spread. And you mentioned earlier that the tests we have remain effective at detecting the new variants. However, for a lot of people, home test prices have become a problem, and in fact prohibitive once insurance stopped covering them. Do we have any options here?

Garcia: Yeah, the good news is the federal government is now offering a new batch of free COVID tests. So each household can order four more free COVID tests to be sent out by the federal government starting this week. As with those previous five rounds of government-issued COVID tests, orders can be placed online at covid.gov.

People who didn't take advantage of the last offer, which was back in September, can still order the four rapid tests made available then for a total of eight tests. It's really easy to order them. The only information you need is your name and an address to send them to. No health insurance information is needed.

I think it's also important to note that although some of these tests might arrive with expiration dates that have passed, the FDA has extended the dates for most approved tests. So users can check that true expiration date of the COVID test on the FDA's regularly updated site. And many of the reasons why testing is helpful are that it can narrow down which virus you have, which we know can help inform available treatment options.

Unger: Well, that's good news. And everybody order those free COVID tests, covid.gov, find out more information. Andrea, to your point about testing, we know that catching these viruses early is really important. Over the weekend, we also saw multiple headlines about an outbreak in China. It feels a little bit like deja vu to many of us. What's going on there and do we need to be concerned?

Garcia: Those headlines were triggered by a reported surge in respiratory illnesses in children in recent weeks. And news reports and social media posts really caught the attention of the WHO and members of ProMED, which is a disease tracking site run by the International Society for Infectious Diseases that health officials monitor for early warnings of potential emerging diseases.

Those reports did prompt the WHO to formally request that China provide information about the potentially worrying spike in respiratory illnesses and clusters of pneumonia in children. The WHO said that Chinese health officials provided the data it requested last Thursday during a teleconference. And that showed the increase in hospital admissions of children were due to diseases, including bacterial infections, RSV, influenza and the common cold virus since October.

On Sunday, the country's health ministry confirmed this data, saying that the surge in illnesses were caused by flu and other known pathogens, not by a novel virus.

Unger: Well, I guess that's good news. It sounds a lot like the mix of things going on here. So I'm just going to summarize. Does that mean we don't have something to worry about at this point?

Garcia: Well, based on what's being reported, it seems we don't need to be concerned about a novel pathogen at this time. I think that concern was not necessarily unwarranted because we know the emergence of new flu strains or other viruses capable of triggering pandemics typically start with these undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia.

China lifted their COVID restrictions much later than most other countries. This is technically their first full winter since they removed those restrictions. Other countries, like here in the U.S., we saw that increase in respiratory diseases such as RSV when our pandemic precautions ended. The acting director of the WHO's department of epidemic and pandemic preparedness and prevention said these increases appear to be driven by the rise in the number of children contracting pathogens that they had avoided during the two years of COVID restrictions.

Unger: Well, we're going to certainly continue to keep an eye on that. Andrea, thanks so much for joining us and sharing these updates. That wraps up today's episode.

If you enjoyed this discussion, you can support more programming like it by becoming an AMA member at ama-assn.org/join.

We'll be back soon with another AMA Update. In the meantime, you can subscribe to catch all our new episodes and find videos and podcasts at ama-assn.org/podcasts. Thanks for joining us. Please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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COVID variants, free at-home test kits and China respiratory issues ... - American Medical Association

Three Weeks Left: Boost Your Immunity and Your Wallet! Get a Free … – University of Arkansas Newswire

November 29, 2023

Photo Submitted

Participants are needed for a study examining the effects of the immune system on social perception in the workplace. People's immune system is activated when they are sick or experiencing a stressor, and recent research suggests that it affects people's social behavior as well.

Because people often have to make important decisions about hiring and promotions while they are sick or stressed, it is important to examine how the immune system affects people's thought processes about others. In this study, researchers are seeking participants who will be given the flu vaccine to temporarily activate their immune system.

Participants will attend two lab sessions at the UAMS-NorthWest Campus in Fayetteville. Sessions will be one to one and a halfhours long and will take place on two consecutive weekdays at approximately the same time each day. During the first session, half of the participants will get the flu shot and half will get a shot with salt water but no vaccine or medicine (these participants will get the actual flu shot at the end of the second session). Participants will also get their blood drawn, provide a saliva sample and complete tasks and questionnaires about social perception the way people view other people. Participants will also be asked to give their impression of different social interactions. At the second session, participants will again get their blood drawn, provide a saliva sample and complete tasks and questionnaires about social perception.

Eligibility:

Adults ages 18 to 40

Have not gotten the flu vaccine since August 2023

No history of allergic reactions to vaccines

People who have diagnosed illnesses that suppress their immune system should not participate in the study

All potential participants will go through a phone screening to check eligibility

If you are interested and would like more information, pleasefill out an interest formorvisitsparklab.uark.edu/flushotstudy.

EmailIDMstudy@uark.eduif you have questions.

Excerpt from:

Three Weeks Left: Boost Your Immunity and Your Wallet! Get a Free ... - University of Arkansas Newswire

Graceful Health: The fall immunization trio RSV, COVID-19, and Flu – Brattleboro Reformer

November 29, 2023

Fall and winter months typically usher in waves of infections, with RSV (Respiratory Syncytial Virus), COVID-19, and flu (influenza) posing significant health risks. Health experts are concerned these viruses may circulate simultaneously this year, creating a "tripledemic," straining healthcare systems and access to care.

Immunizations are the best defense for you and those you care about against serious illness from these diseases. This is particularly important for those with certain risk factors.

Vaccines are an important way to gain immunity. Immunity to a disease is achieved when disease-specific immune cells and antibodies are present in your body, as these can neutralize toxins or disease-carrying organisms, preventing serious illness or death.

Immunization can be either active or passive.

Active immunity results from exposure to a disease organism or its components. This triggers the immune system to produce antibodies and immune cells.

You can gain active immunity either by becoming infected with the actual disease (natural immunity), or through a vaccine. The obvious disadvantage of the natural method is that severe illness or death can occur. Either way, if an immune person encounters that disease in the future, their immune system will recognize it and rapidly produce the defenses needed to fight it. Active immunity is usually long-lasting.

Passive immunity occurs when a person is given the antibodies directly, rather than producing them through their own immune system. For example, a newborn acquires passive immunity from its mother through the placenta. People can also get passive immunity through products such as monoclonal antibodies. The major advantage to passive immunity is that protection is immediate, whereas active immunity takes time (usually several weeks) to develop. However, passive immunity lasts only for a few weeks or months.

RSV, an important cause of the common cold, can sometimes cause respiratory distress, especially in infants, older adults, and individuals with underlying health conditions. It is highly contagious and tends to peak from fall through spring.

RSV is the leading cause of hospitalization for infants under the age of one year in the U.S. Until this year, the only available protection from RSV was a very expensive monthly antibody shot used only in highly susceptible infants. However, this year, new RSV vaccines and a longer-lasting antibody product for infants were approved, marking a turning point in the ability to combat this virus safely and effectively.

RSV immunization treatments are recommended for several high-risk groups:

All infants under eight months old, born during or entering their first RSV season (fall through spring) should receive nirsevimab, the new RSV monoclonal antibody shot.

Children aged 8 to 19 months who have risk factors for severe RSV illness, such as premature birth or chronic lung disease, should receive nirsevimab. Consult with your child's healthcare provider for guidance.

All pregnant women at 32-36 weeks gestation should receive the vaccine Abrysvo to protect their babies from severe RSV. Please note: the adult RSV vaccine, Arexvy, is not approved for use during pregnancy.

Adults aged 60+ years, especially those with chronic lung issues, are also eligible for the new RSV vaccines, either Arexvy or Abrysvo. Speak with your healthcare provider to determine if RSV vaccination is appropriate for you.

The rapid development and deployment of COVID-19 vaccines have been nothing short of miraculous. Vaccination has been instrumental in reducing COVID-19 cases, hospitalizations, and fatalities, as well as preventing long-COVID. The CDC recommends that everyone aged 6 months and older get vaccinated against the latest COVID-19 variants with the updated vaccine released this fall. Specific groups may require additional doses to maintain protection.

Because flu viruses mutate so quickly, last year's vaccine may not completely protect you from this year's viruses. New flu vaccines are released every year to keep up with these changes. It is especially important for those at higher risk of complications. Even for those without risk factors, receiving the flu vaccine is crucial, as it helps prevent the spread of the virus to more vulnerable individuals.

The CDC advises that it is safe to get the RSV, COVID-19, and flu shots all at the same time. These immunizations are available at many pharmacies, doctors' offices, and health clinics. Many workplaces and schools also offer vaccination clinics.

Don't wait to protect yourself and your loved ones this fall. Get immunized against the flu, RSV, and COVID-19.

For more information, visit: https://www.cdc.gov/respiratory-viruses.

George Terwilliger, MD, is Grace Cottage Family Health & Hospitals Chief Medical Officer. Board Certified in family medicine, he is a graduate of the University of Vermont College of Medicine and completed his residency in family medicine at the University of Massachusetts Medical Center in Worcester, Mass.

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Graceful Health: The fall immunization trio RSV, COVID-19, and Flu - Brattleboro Reformer

COVID-19 vaccinations trending down nationally and in Yellowstone … – Q2 News

November 29, 2023

BILLINGS Interest in the COVID-19 vaccine has been dropping ever since the first shot, and its apparent in Yellowstone County. Since September, RiverStone Health workers have administered 1,145 COVID-19 shots throughout the county, a lot less than the nearly 1,900 flu vaccinations that have been doled out.

At Pharm406 on Billings West End, people are still coming in for vaccinations against multiples diseases, but more people are unsure whether they'll get the COVID-19 shot this season.

Trying to stay up on our immunizations so we come here to 406 and got our shingles shot today, said Candy Alberi, who drove to Pharm406 from Red Lodge Tuesday.

The decision wasnt so easy for Alberi when it came to the new COVID-19 vaccine that rolled out in September.

Alina Hauter/MTN News

Im not sure if we are. I know as we grow older its more important as we age. Fortunately, my husband and I are healthy so that makes it easier to make that decision," said Alberi, who got her COVID-19 vaccine shots last year.

Alberis not alone.

Weve learned to live with COVID. Human race has come around, theyre not afraid of COVID. If they get COVID, they stay home for three to five days and they dont really see the benefit of getting vaccinated anymore, said Kyle Austin, owner of Pharm406.

Austin sees it all when it comes to reactions to the COVID vaccine. While only 14% of American adults have received this years COVID vaccine, 28% have gotten their flu shot.

Are they as effective as the flu shot? I would say theyre more effective because the technology out there is more advanced than flu shot technology, Austin said.

He believes theres no specific reason that interest in the COVID vaccine has waned. COVID shots are now more expensive for the uninsured since theyre no longer subsidized by the government.

Alina Hauter/MTN News

If youre an individual thats uninsured, youre going to be flipping a bill for $150 for a COVID shot this year, said Austin.

Some might be nervous about the side effects they felt with the first COVID-19 vaccines.

What the manufacturers did this year was they went back to a monovalent COVID vaccine and people are seeing very side effects with it, Austin said.

He said the politicization of the pandemic also didnt help vaccination hesitancy.

Thats when we saw a huge hesitancy. Im not going to get it or Im going to get it. And there was a very fine line on there, said Austin.

A vaccine thats still divisive, but for 65-year-old Kelly LeSueur, its an easy decision.

Ive just seen what people can go through and the hardships and stuff by having the COVID and stuff so I made sure to get those and the boosters and everything just to be sure, cover all the bases, LeSueur said at Pharm406.

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COVID-19 vaccinations trending down nationally and in Yellowstone ... - Q2 News

We weren’t that great at treating fluit should not be our model for … – The BMJ

November 29, 2023

Former US covid-19 response coordinator Ashish Jha tells The BMJ about antivirals, long covid, his worries for the winter seasonand why the partisanisation of vaccination worries him

Taking office in November 2021, US President Joe Biden was immediately confronted by the chaotic nature of his countrys reaction to covid-19. One of his first actions was to appoint a covid-19 tsarsomeone who would oversee the response in a joined up manner, from testing and surveillance to access to vaccines and treatments to on-the-ground responses from doctors.

Jeff Zients was first appointed and when he moved to become Bidens chief of staff the president chose Ashish Jha, a long time public health expert and one of the loudest voices during the pandemic, to fill the role.

Jha was in the post for 15 months, until the duties were absorbed into other parts of government. His tenure saw the US exit the state of emergency for covid-19 and face an mpox epidemic that has affected over 30000 Americans to date, as well as the crucial organisation of medium and long term plans for the US to continue living with covid.

Ashish K Jha is adjunct professor of global health at Harvard TH Chan School of Public Health. He is a practising general internist and a professor of medicine at Harvard Medical School.

Jha received his MD from Harvard Medical School and then trained in internal medicine at the University of California, San Francisco. He completed his general medicine fellowship at Brigham & Womens Hospital at Harvard Medical School and received his masters from Harvard TH Chan School of Public Health.

In March 2022, Jha was appointed White House covid-19 response coordinator by President Joe Biden, a position he held until June 2023.

I didnt really know what the job would entail. People can have misconceptions about what the White House can and cannot do. They often describe [the role] as a tsarI think of tsars as having immense amounts of power, and this was not a job that came with a whole lot of power.

People think that you can just make things happen. But in our form of government in the US, Congress has a lot to say about what will and will not get done. They can certainly decide whats going to get funded and whats not. Then you have our courts, which are also independent. And there are policies put in by the administration that the court basically blocked. So its not like youre at the head of government and all the branches are aligned. Not at all. So much is about navigating and then figuring out where you can really drive policy, and how you drive it in a way that brings a lot of people along.

Its obviously very political in every country, but covid-19 has become strangely partisan in the US. The partisanisation of vaccines, for instance, was very harmfulwhat began as partisan views of covid vaccines I worried would spill over into partisan views of every other vaccine. One of my goals has been to try to de-partisanise or make vaccines and treatments much more bipartisan, something that didnt feel like it had a political angle to it. And while I certainly trieddoing a lot of work in the background, meeting with groups, meeting with political leaders from across the political spectrum, for instanceI dont feel like I made as much progress as I wanted. I have real regrets about that because if vaccines become something that gets tied to political identity, thats very harmful for public health. And I worry a lot about that for our country.

I think its reasonable to think about covid vaccines the way we think about flu vaccines. Obviously, the virus, SARS-CoV-2, is evolving much more rapidly than flu and its not quite as seasonal as flu. But the new XBB variant targeted monovalent vaccine thats now available clearly gives a big bump in antibodies that helps reduce infections for a period. Thats not a very long lasting protection and its not perfect protection, but it does reduce your risk of getting infected. And for a lot of peopleparticularly people at high riskavoiding infection is a really good idea. If youre 75 and have chronic lung disease, getting vaccinated may make the difference between life and death.

Does a 20 year old need an annual booster? My view is no. But are they better off getting it? I believe they are, because if you get vaccinated, youre going to have a period of time when youre less likely to be infected. Thats good. Youre less likely to disrupt your work, youre going to have lower levels of transmission even if you do get infected, youre less likely to get long covid.

For me, the critical thing is that people over 65, people over 70, people over 60, really, really need to get that vaccine because those are people who are going to benefit in a much more meaningful way.

As a physician, whenever I ask myself if I should prescribe treatment X, I have two sets of questions. One is, what do I understand about this disease where I think this treatment should be helpful? Whats the clinical evidence? And then what are the costs of these treatments? And I dont just mean a financial cost, there are also side effectswhats the harm of giving somebody a treatment?

So lets take a look at antivirals for covid. These tend to be short courses, 5-10 days, there are some drug-drug interactions, which are very manageable. But no one I know says that these drugs are incredibly toxic and somehow will cause long term damage. They will not. We have a lot of experience with drugs like this. We use them for long periods of time for people with HIV and literally tens of millions of people around the world, certainly many millions of people in the US. And we have good evidence that theyre a very safe drug for people to take for a short period of time.

Whats the benefit? Well, we have some really good clinical data and some decent clinical data. I remember [former CDC director] Antony Fauci1 saying to me, If you have an antiretroviral thats effective, why would you not use it? The less virus you have the less likely it is to do damage.

Now we can talk about whether its financially worth it. How strong is the clinical data? It is good but not great. We have some randomised trial data, but a lot of observational data. I put the whole package together and I think some of the observational data suggest it might reduce risk of long covid. Theres a theoretical basis for that.

The data are not overwhelming, but if you start with deep scepticism of treatments then, yes, you may not be persuaded. I look at it as a risk-benefit and I think the risk of using antivirals is relatively low and I think the benefit is clear for some people and likely for a lot more. And thats why I tend to lean towards doing it, because the risk of these treatments is so incredibly low because theyre short courses.

There are other things that are in the works: phase 3 trials of oral antivirals are happening. And other treatments outside of antivirals. One of the treatments that was used early in the pandemic, before they stopped working, was monoclonal antibodies.2 I have pushed for more investment in developing monoclonals. For two reasonsfirstly there is a proportion of people who just cant get oral antivirals and for them it remains an important option. More broadly, our national ability to build monoclonals against viruses is a really important capability against future viruses and against future pandemics.

There are several factors underlying covid that we need to separate.

Firstly, there is clearly a percentage of the population that is suffering from long covid. And what they need is two sets of things. One, they need a system that is supportive of their challenges: we need to make sure that our disability systems and our healthcare systems are designed to take care of those people. Two, they need research for new therapeutics and new approaches to treating covid and long covid. That part weve made some progress with, but it's not gone as fast as we need to.

But there is a second wider matter: what is the risk of developing long covid today? If you do not have long covid right now, if you feel well and then you go out and you get covid tomorrow, what is the risk that you can develop long covid? And how do we minimise that risk?

I often talk about how I think the risk of long covid now is relatively low and people say youre minimising the experience of people who have long covid. No, no, no, no. Those are separate things. There are people with long covidwe have got to take care of them. But the risk of developing new long covid at this moment is reasonably low and weve got to figure out how to continue to drive that risk lower.

There are three sets of things that I wanted to disentangle. Firstly, there is passive surveillance through things like wastewater surveillance, which I feel reasonably good about because it doesnt require behaviour change, it doesnt require any kind of new investment. Its a steady state investment that lets us track covid and thats where weve used it. But I would like it to be expanded to other types of infections.

Secondly, there is the question of testing surveillance of a population through regular mass samplingsending kits to peoples homes, getting them to swab and send it backthe kind of things that the UK did that the US actually never did. I think theres a lot of value in that, because while wastewater surveillance tells you at a community level how much infection there is, it doesn't tell you anything about whos getting infected, whos not, whos being most affected. Having a baseline level of surveillance that lets you understand which communities, which populations, is valuable. And my sense is most countries are pulling back from that and not doing that.

That gets us to the third part, which is just general availability of testing for people who have respiratory symptoms. There are a lot of people who say, well, why even bother? Whats the point, we never used to test for flu before. Well, for one thing, we have treatments. So if you get flu, especially if youre a high risk, you can get treated for it if you get tested early. Certainly that is true for covid. So there is a good reason to test. Another thing is if you have the flu and you have symptoms, you should probably stay home for a bit. We could talk about how long, but even if you just stayed home during your most symptomatic period, it would dramatically reduce the amount of spread that happens in a population.

We werent that great at treating flu. I dont think that should be our model. We have a lot of fluin the US some 10% of the population gets infected with flu every year, 30 000-40000 people die every year. Now, that number is hard for people to wrap their brains around. I remind people that 30 000-40000 deaths means 30 000-40000 families that will not have a grandparent around. Why do we think thats okay, especially when the interventions are things that we can do to dramatically cut that down and are not super expensive?

Now often this gets framed as, Well, we didnt lockdown society for flu. No ones talking about locking down societies or shutting down schools. Thats a very high level thing that you do under very rare circumstances. But making sure that everybody whos at elevated risk is up to date on their vaccines, that feels like something we should invest in. Making treatments widely availableit could be expensive, some of these treatments can be expensive, but for lots of other diseases when we have an effective treatment, we try to make it as available as possible. We should absolutely do that. And weve already talked about testing and making testing more widely available and trying to reduce spread.

I went into medicine for, in some ways, all the wrong reasons, which is because my parents really wanted me to become a doctorand Im now old enough to just admit it.

I got to medical school very unsure but just fell in love with it. The demystification of disease, of the human body and how it works: I thought it was all super fascinating and then pretty quickly came to realise I love practising, I love taking care of people, I love being a witness to people and in very difficult moments in their lives.

Sometimes in medicine you can help people get better, sometimes you cant. But even when you cant, you can play a really critical role in helping them navigate difficult moments. And I still practise largely for that privilege.

Commissioned, not externally peer reviewed.

Competing interests: None.

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We weren't that great at treating fluit should not be our model for ... - The BMJ

Flu and Covid-19: Time running out to get protected before … – Swindon Link

November 29, 2023

BySwindon Link- 29 November 2023

The UK Health Security Agency (UKHSA) South West is calling on everyone who is eligible to book their flu and COVID-19 vaccinations ahead of Christmas and other upcoming celebrations.

This will help them get winter strong and have safe and healthy celebrations. As the vaccines take up to two weeks to provide maximum protection, getting vaccinated soon will help reduce the risk of severe disease in time for upcoming celebrations.

So far this winter in the South West:

Flu and COVID-19 spread more when we spend more time indoors. If you are in one of the groups who is eligible for vaccination against flu and COVID-19 and are yet to take up the vaccines, ensure you get them as soon as possible. This will help your celebrations stay on track, whether thats putting up decorations, attending work parties, feasting with friends, taking children to festive events, or attending worship or carol services.

Everyone aged 65 and over, pregnant women, and individuals with certain long-term health conditions like diabetes or cardiovascular disease, are eligible for free flu and COVID-19 vaccines. These vaccines offer the best defence against becoming severely unwell, hospitalisation and death from COVID-19 and flu.

Most children are eligible for thechildren's flu vaccine. This includes pre-schoolers who were aged 2 or 3 years on 31 August 2023, school-aged children (Reception to Year 11) and children with certain health conditions. Each winter, thousands of children need to go to hospital for treatment (10,000 children were hospitalised with flu last season), including intensive care, with children under the age of 5 years having one of the highest rates of hospital admissions due to flu compared to other age groups. By getting vaccinated, your child not only protects themselves, but also those around them, including babies, grandparents, and people with weak immune systems.

Parents of school-aged children who havent yet been offered the vaccine at school are urged to ensure their childrens school vaccination consent forms are completed. They are being offered the free nasal spray flu vaccine, delivered in schools by immunisation teams up and down the country. If your child missed out on the vaccination session at school, ask the immunisation team about their catch-up sessions.

Pre-schoolers are eligible for the free nasal spray via their GP practice. And any child aged between 6 months and 2 years who has a health condition that puts them at increased risk from flu will be offered a flu vaccine injection instead of the nasal spray. This is because the nasal spray is not licensed for children under 2 years old. School-aged children who cant have the nasal spray for medical or faith reasons will be offered an injected flu vaccine instead. These appointments can be booked via your GP.

Pregnancy changes how the body responds to infections like flu and COVID-19 and puts them, and their babies, at higher risk of complications requiring hospitalization than non-pregnant women. The flu and COVID-19 vaccines are the best defence we have against serious infections. Vaccinated women have a lower risk of severe disease requiring hospital treatment and it reduces the risk to their unborn child of stillbirth and prematurity.

Professor Dominic Mellon, Deputy Regional Director for UKHSA South West said:

The Christmas season is special to a lot of people as families and friends gather to celebrate. However, it also coincides with when respiratory virus activity typically rises. In amongst getting presents sorted and planning whats on the festive menu, make time to prioritise your health by getting vaccinated to ensure you stay Winter Strong and keep your plans on track.

In the South West, theres still a lot of eligible people who have yet to get their winter vaccines, putting them at risk of complications and even hospitalisation from catching flu or COVID-19.

As well as protecting yourself, ensure your children are vaccinated too against flu. Each winter thousands of children require treatment in hospital for flu or its complications. Many of these episodes can be prevented by a simple vaccine. On top of helping to keep your child healthy, the flu vaccine also helps stop the spread of flu in the family and wider community helping to protect those who are more vulnerable and the elderly such as grandparents.

Dr Matthew Dominey, Consultant in Public Health and Screening and Immunisation Lead for NHS England South West said:

Just like the weather, it can be difficult to predict whats coming in the future, which is why its important to get protected now, while you still can. We know that both the COVID-19 and flu vaccines really increase peoples immunity and are highly effective at reducing the risk of severe infection and hospitalisations.

"To be ready for the festive season, I would really encourage anyone who qualifies and has not yet had their COVID-19 or flu vaccinations to book an appointment in the next couple of weeks and make the most of the offer available. The national booking system will stop taking bookings on 15 December so booking now is vital.

To book Covid and flu vaccines, you can either download the NHS App, visit http://www.nhs.uk/book-covid or call 119 for free if you cant get online.

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Flu and Covid-19: Time running out to get protected before ... - Swindon Link

Preparing for winter: Help us care for you – Medway NHS Foundation Trust

November 29, 2023

This winter we will be ready to help patients across Medway and Swale requiring care, but there are important things we should all do to take care of ourselves and stay well, particularly as we continue to live with the ongoing presence of COVID-19.

As a member of our community, you can help us, while we care for you. We know that:

If you get flu and COVID-19 at the same time, research shows youre more likely to be seriously ill

Getting vaccinated against flu and COVID-19 will provide protection for you and those around you for both these serious illnesses.

Millions of eligible people in England can book their life-saving autumn COVID-19 vaccine online now, after the NHS recently stepped up its winter vaccination programmes in response to the risk of a new Covid variant. Anyone eligible can book their Covid vaccinations via the NHS website, by downloading the NHS App, or by calling 119 for free if they cant get online.

If youre 65 or over, youre at increased risk of getting seriously ill if you catch flu or COVID-19. Protect yourself and those around you. Book your vaccinations now by visiting theNHS website.

Meanwhile the flu vaccine is safe and effective and is offered every year on the NHS to help protect people at risk of getting seriously ill. The best time to have the flu vaccine is in the autumn or early winter before flu starts spreading, but you can get the vaccine later. If you've had COVID-19, it's safe to have the flu vaccine. It will still be effective at helping to prevent flu.Find out more on the NHS website.

During winter and periods of cold weather its important to look after yourself if you start to feel unwell. You shouldnt wait until it gets more serious; instead seek advice from your pharmacist as early as possible. Pharmacists can give you advice about winter illnesses, including which medicines to take.

Finally, we would like to remind you about the current visiting measures in place at Medway Maritime Hospital which ensure the protection of patients and staff. These include washing your hands regularly, or using hand gel and not entering the hospital if you have COVID-19 symptoms, unless you require urgent medical care. Thank you for your cooperation and for helping us care for you this winter.

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Preparing for winter: Help us care for you - Medway NHS Foundation Trust

City of Toronto to close its 4 vaccine clinics after provincial funding … – CityNews Toronto

November 29, 2023

Its been more than two years since the City of Toronto widely opened its COVID-19 vaccine clinics for bookings, but the municipalitys four remaining facilities are set to close.

Toronto Public Health officials announced its four clinics (Scarborough Town Centre, North York Civic Centre, Cloverdale Mall and Metro Hall) will be closing on Dec. 13. They said its being done because operational funding from the Ontario government as part of its COVID-19 response is expiring at the end of the year.

The move comes amid a recent, increased push to get COVID-19 boosters and influenza vaccines.

The response has been tremendous and certainly our clinics have been fully booked for many, many weeks, and have had a steady flow of people, Dr. Vinita Dubey, Toronto Public Healths associate medical officer of health, told CityNews.

She noted the clinics in more recent months have expanded to provide a number of other shots, including ones students need at school such as HPV, hepatitis B and meningococcal vaccines.

Dubey said public health staff are trying to catch up on youth vaccinations not administered because they were redirected for COVID-19 response and during pandemic-related school closures.

We know that about 250,000 students so thats almost 70 per cent of students according to Toronto Public Health records are missing one or more doses of vaccine, she said, noting various vaccines can fight against measles, mumps, rubella, diphtheria, tetanus, polio, whooping cough and chickenpox.

Now that may be because they didnt get the vaccine because of the pandemic or maybe they got it but they didnt report it to us so we want to be able to catch up on all of those.

We know that some of the risk for some of these diseases continues. We know that measles is still spreading. Weve actually had cases of measles come to Toronto that come through travel. But we want to make sure that it doesnt spread same with polio so thats why we have to restart vaccinating.

Dubey said Toronto Public Health staff are looking for $3.8 million from the provincial government over and above base funding to address gaps when it comes to youth vaccinations.

Well continue to provide catch-up opportunities, notifications to parents as we can with some of that base funding, but because we are in a bigger deficit than in usual years we just want to be able to address that as well, she said.

Ontario NDP MPP and health critic France Glinas called for more public health funding, saying clinics are vital for families and can better help address issues people may have versus private-sector pharmacies.

A lot of people trust public health. They will go to a public health clinic and talk to the public health nurse and ask their questions, and make sure that they feel confident that they are making the right decisions for themselves, for their children, for their babies, for their family members, she told CityNews on Tuesday.

They have a lot of catching up to do with the school-aged children but they dont have the resources to do it, so they are asking for a few million dollars so that they can make sure that school-age kids get the vaccinations they need so that we build herd immunity and protect the weaker, more frail children.

CityNews contacted Ontario Health Minister Sylvia Jones office for comment about the end of funding for Torontos clinics when the facilities are still being used. A spokesperson didnt directly answer the question. Instead, they pointed to past funding for Toronto Public Health programs and one-time grants to help deal with COVID-19.

Our government will restore funding to the level previously provided under the 2020 cost-share formula and is providing a one-per-cent increase in base funding per year for three years beginning in 2024, Hannah Jensen said in an email statement.

This increase in permanent funding each year is in direct response to the asks of public health units, including Toronto Public Health, to the province to provide stabilized funding.

Jensen said there will also be discussions with public health units in Ontario to clarify roles and responsibilities to build a stronger, better connected public health system, but its unclear how that might impact the delivery of vaccines.

Meanwhile, Dubey said she and her staff are hopeful extra money will come and emphasized the provincially funded clinics were helpful.

We do have to recognize that there were some trade-offs in public health and health care (during the COVID-19 pandemic) and so we do actually need to be able to address those as well, she said.

For those who want to book a vaccine appointment at one of the City of Torontos clinics, click here. COVID-19 boosters and flu shots can also be obtained at certain pharmacies.

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City of Toronto to close its 4 vaccine clinics after provincial funding ... - CityNews Toronto

Should you get the COVID-19 and flu vaccines at the same time? Here’s what to know – WXYZ 7 Action News Detroit

November 27, 2023

(WXYZ) The arrival of snow and cold weather often brings an increase in colds and other illnesses. Protecting yourself and your loved ones by keeping your vaccines up to date is important. But how safe is it to get both the flu and the COVID vaccine at the same time?

I often get asked that same question by my patients. Especially since a recent study found that older people getting the flu and COVID-19 shots together might face a small increase in stroke risk.

Here's what I can tell you: the study analyzed Medicare claims and found only three cases of strokes per 100,000 doses administered. These cases occurred in adults aged 85 and older who received a high-dose flu shot at the same time as a bivalent COVID booster. So, based on that research, the risk is very rare. Plus, its also worth noting that the updated COVID-19 vaccines now focus on fighting just one virus type, unlike last year's bi-valent shot.

Furthermore, there have been other studies that have not found the same stroke risk. Overall, research from the past three years shows that getting a flu shot and a COVID-19 vaccine at the same appointment is safe. This is why the CDC and the FDA have not changed their vaccine advice.

A recent small study presented at a vaccine conference made an interesting discovery. It found that healthcare workers who received both their flu and bivalent COVID-19 shots on the same day had stronger antibody responses. These stronger responses were observed right after vaccination and continued for up to six months, compared to those who received their shots on different days.

However, it's not all straightforward. Other studies have come to different conclusions, some even showing a slight decrease or no difference at all in antibody levels.

So, what does this mean for protection? Well, a recent large study by Pfizer looked into the health outcomes of people who received flu and COVID-19 vaccines together or separately. The results showed little difference. Both groups had similar rates of hospitalization, emergency room visits, and doctor's appointments. Interestingly, the group that received both shots at the same time tended to seek medical care for COVID-19 a bit more, but they were less likely to need medical attention for the flu.

Ultimately, the choice of how to get your vaccines largely depends on personal preference. What's most important is getting vaccinated now, especially with rising respiratory illnesses. While receiving both flu and COVID shots on the same day is safe, it's a good idea to consult with your healthcare provider to determine what's best for your health.

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Should you get the COVID-19 and flu vaccines at the same time? Here's what to know - WXYZ 7 Action News Detroit

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