Category: Vaccine

Significant changes in the Current Procedural Terminology(CPT) code setfor immunizations reflect the changing nature of how COVID-19 is being addressed as actions transition from a public health emergency response to combatting emerging variants much like the flu.

One significant change involves the consolidationof more than 50 previous codes tostreamline reporting of immunizations for COVID-19. A new vaccine-administration code,90480, was approved for reporting the administration of any COVID-19 vaccine for any patient. This replaces all previously approved, product-specific vaccine-administration codes.

From a public health perspective, there was great initial value in tracking each individual vaccine during the public health emergency, With the end of the public health emergency, there is no longer a need for the coding granularity of individual administration codes for every vaccine product.

Additionally, the Vaccines and Related Biological Products Advisory Committee (VRBPAC), an advisory group of the FDA, recommended that the COVID-19 vaccine for the 20232024 vaccination season be a monovalent vaccine that contains the XBB.1.5 strain, and noted that a number of COVID-19 vaccine products will no longer be recommended for use. The streamlined structure brings greater alignment between CPT and the current COVID-19 vaccine reporting environment.

The new coding system will allow for new vaccines for new variants whenever they come up without having to do a new code, said Samuel Le Church, MD, MPH, a member of the CPT Editorial Panel and vice-chair of its Immunization Coding Caucus.

Dr. Church, president of the Georgia Academy of Family Physicians, spoke at the annual AMA CPT and RBRVS Annual Symposium, held virtually this year.

The CPT Editorial Panel approved five new COVID-19 vaccine product codes and one administration code in August 2023. These new COVID-19 codes replaced all previously approved specific COVID-19 product and administration codes, except for vaccine product code 91304 for the Novavax vaccine.

Specific information to assist with proper code selection of the more than 50 COVID-related vaccine product and administration codes were contained in Appendix Q of the CPT code set. With the removal of those COVID-19 codes, Appendix Q was also deleted in November.

Some vaccine and immune globulin products are assigned a code in anticipation of eventual approval by the Food and Drug Administration. These codes are marked with a lightning bolt symbol in the Category I Immunization code descriptors (PDF).

The new codes added for 2024 include three Pfizer-product codes and reflect vaccine concentrations developed for different age groups:

There are also two new Moderna-product codes:

My hope is that all these changes will dramatically simplify your coding experience when dealing with the COVID-vaccine products, Dr. Church said.

Learn more with the AMA about the most current COVID-19 CPT vaccine and immunization codes.

Typically, vaccine codes are electronically published July 1 and January 1, though some may require expedited release due to public health concerns as was the case with the vaccines for COVID-19 and respiratory syncytial virus (RSV).

After the final approval is done, then that lightning bolt will be taken away, Dr. Church said.

Reflecting all these developments, the CPT vaccine early release schedule will now be known as the immunization early release schedule and will include vaccines/toxoids, immune globulins and serum or recombinant products.

There are a lot of changes that are happening in the world of immunization, so it was a bit restrictive to have it be a vaccine early release policy, so we expanded that, Dr. Church explained.

Weve got a lot going on in the RSV world, he added.

This includes two new seasonal RSV monoclonal antibody immunization pediatric codes for children less than 24 months of age with dosage based on the childs weight, as well as two new administration codes for these products that are differentiated by the inclusion of counseling:

Additionally, three vaccine codes were created and associated with use in the adult population:

These codes were developed to provide better tracking to support data-driven planning and allocation, and to track patient outcomes.

Also new are:

The CPT 2024 Professional Edition and CPT Changes 2024: An Insiders View are available from theAMA Storefronton Amazon.

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Big changes will streamline CPT coding for immunization - American Medical Association

A total of thirty clinically confirmed patients of molluscum were recruited for this trial from April 2022 to November 2022. Participants were recruited randomly from the outpatient clinic of the Dermatology and Venerology department et al.-Azhar University Hospital in New Damietta, Egypt. The study was approved by the Damietta Faculty of Medicine Al-Azhar University's Research Ethics Committee (00012367-21-02-002). All participants or their guardians gave their informed consent to participate in the trial6.

Patients of MC who were immune competent, with history of BCG vaccination, above 3years of age and under no concurrent systemic or topical treatment of MC within the past 6weeks was included. Those with history of asthma, febrile illness, immunosuppressive conditions or allergic skin disorders were not included. Moreover pregnant or lactating females were excluded from the study.

Demographic details including age and sex were recorded. Careful medical history and clinical examination as well as baseline characteristics of molluscum lesions, including number, size, and site involved, and duration were recorded at the start of the study and each follow-up visit. Appropriate digital photographs were taken before the start, at each visit and after completion of treatment.

The patients were divided randomly using sealed envelope method into three groups. In group (A) patients, 0.1ml of the MMR antigen was first injected into the forearm and only positive reactors (showing5mm induration at the injection site within 4872h of testing) were included in the study. Included subjects were then injected with 0.1ml (10IU) of MMR vaccine (Trimovax Merieux-Aventis, 0.5ml) in their biggest lesion using an insulin syringe held parallel to the skin surface, with the bevel facing upward. Group (B) included 15 patients who were injected intralesionally with 0.1ml (10IU) of PPD tuberculin (VACSERA, Egypt 2ml vial) in the largest lesion. Group (C) included 15 patients who were injected intralesionally with 0.1ml of normal saline (Otsuka, Egypt) in the largest lesion. Treatments were carried out every three weeks and for 3 treatments or until full clearance whichever was achieved first. Following each treatment patients were instructed to remain at the clinic for 30min for possible signs of immediate hypersensitivity. Patients were followed up for two months from the last treatment session for any sign of recurrence6.

Complete response was considered if lesions had disappeared completely while partial response was considered if regression in lesion size or of more than 50% and no response was considered if lesions persisted as is during the full treatment period (9weeks). Side effects during the course of treatment as pain, itching erythema, edema, induration, ulceration and general systemic action as flu-like symptoms were recorded.

Data were fed to the computer and analyzed using IBM SPSS Corp. Released 2013. IBM SPSS for Windows version 22.0 Armonk, NY: IBM Corp. Qualitative data were described using number and percent. Quantitative data were described using median (minimum and maximum) and mean, standard deviation for parametric data after testing normality using Kolmogrov-Smirnov test. Significance of the obtained results was judged at the (0.05) level.

To estimate the sample size, we used Open Epi program Version 3 and according to: MC response rate (outcome) with Tuberculin Purified Protein Derivative (PPD) 85%, and to investigate the preference of intralesional immunotherapy injection with Measles, Mumps, and Rubella (MMR) Vaccine over Tuberculin Purified Protein Derivative (PPD) and placebo. Assuming alpha error is 5%, 95% confidence level and the study power is 80%. Sample size was established to be at least 7 patients for each study group. To compensate for possible 25% drop off or failure to follow up 15 subjects were selected for each group.

This study protocol was reviewed and approved by ethics committee on human research by Al Azhar faculty of medicine (IRB 00012367-21-02-002). All methods were performed in accordance with the relevant guidelines and regulations. Written informed consents were received from participants upon explanation of the study. Consent for publication was obtained from the participants for publishing the images in the manuscript.

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Intralesional injection of tuberculin purified protein derivative (PPD) versus measles, mumps, and rubella (MMR ... - Nature.com

Four days after Yemi Adetumobi gave birth to her daughter in June 2022 at Akure in Nigeria, she noticed the child's chest heaving. In panic, she took her to the Ondo State Specialist Hospital, where doctors diagnosed a case of severe pneumonia. "After two days, my daughter got better, and I was happy. But soon, I worried about her, because at times, I saw my daughter gasping, meaning she still had breathing problems," Adetumobi recalled.

But when the little girl turned nine months old, she received a measure of protection: the booster dose of the pneumococcal conjugate accine (PCV). Adetumobi remembers the relief.

Worldwide, 750,000 children died last year from severe pneumonia, brought on in many cases by pneumococcus bacteria. The bacteria can also induce meningitis, sepsis and other serious illnesses. "Thank God for the PCV vaccine," Adetumobi said. "My daughter overcame the pneumonia."

PCV was licensed for use in children aged under five in the year 2000. In December 2014, through the support of Gavi, the Vaccine Alliance, Nigeria joined other nations to launch the PCV vaccine as part of its routine immunisation programme. In 2014, nearly 480 children per 100,000 in Nigeria died of pneumonia or other lower respiratory infections. By 2019, that number had declined to 386 per 100,000.

As of 2022, Nigeria has achieved 60% coverage with the final dose of the PCV vaccine, according to UNICEF and WHO data.

"We found that the proportion of hospitalized pneumonia cases decreased after three years of PCV introduction into the National Immunisation Programme in Nigeria," wrote Dr Jalo Iliya, Chief Paediatrician at the Federal Medical Centre, Gombe, in a research paper published this month in the journal Human Vaccine Immunotherapy. Iliya's findings are consistent with studies, such as various pieces of Gavi-funded research on the impact of 10-valent PCV, including work published in the Lancet in 2022 and 2023. "The death rates during post-PCV introduction decreased at all sites chosen for the study," Iliya said in his study.

Another Nigerian study looked at the population-level effects of rising PCV coverage, by analysing carriage of vaccine-type pneumococcus bacteria, rather than episodes of illness. In that paper, published in Nature Communications in May 2023, the researchers wrote, "We documented carriage prevalence and vaccine coverage in two settings annually between 2016 and 2020, following PCV10 introduction. Among rural participants, VT carriage prevalence fell from 21 to 12 percent as vaccine coverage rose seven to 84 percent. The same trend took place in urban areas. Increasing PCV10 coverage reduced pneumococcal infection at all ages, implying at least a comparable reduction in IPD."

Speaking to VaccinesWork, Dr Francis Akanbiamu, the Permanent Secretary, Ondo State Primary Healthcare Development Agency (OSPHCDA), said that PCV had been extremely effective as a means to protect children from pneumonia.

"There's been pneumonia reduction since 2014 due to [PCV] usage. Mothers have been accepting vaccination for their children, having been aware of its effectiveness. They know it protects children's organs against pneumonia. Findings in other places about reduction of hospitalised cases in relation to pneumonia due to the use of PCVs are in tandem with what is happening in Ondo State," Akanbiamu stated.

Modupe Sipasi, a teacher from Akure in Ondo state, recalls, "It was a terrible time for me, when my second-born son, who came to the world in 2019, started to breathe in a way I didn't understand, as it was not normal.

"I rushed him to Oda Health Centre for a check-up. The nurse there told me to go to the Specialist Hospital in Akure. The doctor discovered that my son had pneumonia and admitted him."

Sipasi is convinced that having received a dose of PCV vaccination reduced the severity of her child's illness. "Only God saved my child from pneumonia through PCV, because the doctor told me he could have died," she says. "I would have had hypertension. The doctor even recommended the use of an inhaler. Thank God there was PCV. It also saved my friend's son from pneumonia. Mothers should listen to nurses and doctors. Children need to get the entire gamut of vaccines, not missing any."

Kemi Olowokere, a health worker in the State Specialist Hospital in Akure, echoes her. She told VaccinesWork, "So many deaths happened before the introduction of PCV. The hearts of many mothers were broken due to pneumonia. But after the introduction of PCV in Ondo State, the cases came down. Hospital admission decreased."

Gavi-funded studies reveal that nations such as Mozambique, Burkina Faso, Gambia and Kenya show the efficacy of PCV in the reduction of hospitalised cases of pneumonia. The trend also extends to Mongolia, Lao People's Democratic Republic, Bangladesh, Nepal and Pakistan.

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Severe pneumonia in decline in Nigeria following pneumococcal vaccine roll-out - Gavi, the Vaccine Alliance

Free vaccine clinics hope to prevent spread of parvovirus at Verona Street shelter following deadly outbreak

by Carleigh Minor

The first of three free parvovirus vaccine clinics was held Friday, Dec. 29, 2023, at the Rochester Community Sports Complex following a deadly parvovirus outbreak at the Verona Street animal shelter. (Photo by Carleigh Minor/WHAM, Dec. 29, 2023)

Rochester, N.Y. (WHAM) Rochester Animal Services (RAS) is taking action to protect pets following a deadly parvovirus outbreak at the Verona Street animal shelter.

Friday, RAS held the first of three free vaccine clinics taking place over the next month at the Rochester Sports Complex, encouraging anyone with a dog to attend.

"It's just like a child," said local animal advocate Suzanne Nugent. "These diseases are contagious very contagious, and distemper and parvo (are) killers."

"Parvo, it can stay our in the environment for up to a year," explained Amy Bianchi, outreach coordinator & assistant supervisor of animal control for Rochester Animal Services.

The virus can be spread easily through direct contact with infected dogs, feces and contaminated surfaces.

"It can be passed very easily, and there's only certain things that will kill it," Bianchi said. "Bleach is one of the things that will kill it."

During the quarantine at Verona, we're told 14 asymptomatic dogs have been fostered in homes, and 29 remain in the shelter.

Vaccination and other measures including good hygiene help dogs avoid a parvovirus infection, according to the American Veterinary Medical Association (AVMA).

"You could be walking in a park not even with your pet, step where there may be parvo, where you wouldn't be able to see it, go home, step on your floor, and your pet steps there and licks its paws. You could catch parvo (that way)," Bianchi explained. "It's pretty easy to catch. It's very hard to kill."

The virus is silent, but can be deadly. The AVMA said most deaths from parvovirus occur within 48 to 72 hours after signs first appear.

"Get here for your free vaccine. That is your number one preventative," Bianchi said. "When you have new puppies, they need a whole series (of vaccines). If they haven't had any of them, don't bring them around other dogs. Don't bring them to parks. Take off your shoes when you come in the house. (Things) like that."

The dog area at the Verona Street shelter is currently closed to the public until Jan. 2 to prevent any further spread.

If you missed Friday's clinic, there's still two more being held Friday, Jan. 5 and Jan. 19 at the Rochester Community Sports Complex on Smith Street.

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Free vaccine clinics hope to prevent spread of parvovirus at Verona Street shelter following deadly outbreak - 13WHAM-TV

WHO has added the R21/Matrix-M malaria vaccine to itslist of prequalified vaccines. In October 2023, WHO recommended its use for the prevention of malaria in children following the advice of the WHO Strategic Advisory Group of Experts (SAGE) on Immunization and the Malaria Policy Advisory Group. The prequalification means larger access to vaccines as a key tool to prevent malaria in children with it being a prerequisite for vaccine procurement by UNICEF and funding support for deployment by Gavi, the Vaccine Alliance.

The R21 vaccine is the second malaria vaccine prequalified by WHO, following the RTS,S/AS01 vaccine which obtained prequalification status in July 2022. Both vaccines are shown to be safe and effective in clinical trials, for preventing malaria in children. When implemented broadly, along with other recommended malaria control interventions, they are expected to have a high public health impact. Malaria, a mosquito-borne disease, places a particularly high burden on children in the African Region, where nearly half a million children die from the disease each year. Globally, in 2022, there were an estimated 249million malaria cases and 608000 malaria deaths across 85countries.

The prequalification of the worlds second malaria vaccine, developed by Oxford University and manufactured by Serum Institute of India, is poised to expand access to malaria prevention through vaccination. Demand for malaria vaccines is high but the supply has thus far been limited. The availability of two WHO recommended and prequalified malaria vaccines is expected to increase supply to meet the high demand from African countries and result in sufficient vaccine doses to benefit all children living in areas where malaria is a significant public health risk.

Dr Rogrio Gaspar, Director of the Department of Regulation and Prequalification at WHO said: "Achieving WHO vaccine prequalification ensures that vaccines used in global immunization programmes are safe and effective within their conditions of use in the targeted health systems. WHO evaluates multiple products for prequalification each year and core to this work is ensuring greater access to safe, effective and quality health products".

Dr Kate OBrien, Director of WHO's Department of Immunization, Vaccines and Biologicals, said: "Today marks a huge stride in global health as we welcome the prequalification of R21/Matrix-M, the second malaria vaccine recommended for children in malaria endemic areas. This achievement underscores our relentless commitment to wiping out malaria which remains a formidable foe causing child suffering and death. This is another step toward ensuring a healthier, more resilient future for those who have lived for too long in fear of what malaria could do to their children. Together with our partners we are united in the pursuit of a malaria-free future, where every life is shielded from the threat of this disease.

As part of the prequalification process, WHO applies international standards to comprehensively evaluate and determine whether vaccines are safe, effective and manufactured to international standards. WHO also ensures the continued safety and efficacy of prequalified vaccines through, for example, regular re-evaluation, site inspection and targeted testing. Prequalification supports the specific needs of national immunization programmes with regards to vaccine characteristics such as potency, thermostability, presentation, labelling and shipping conditions.

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WHO prequalifies a second malaria vaccine, a significant milestone in prevention of the disease - World Health Organization

Lawmakers want military researchers to determine whether the COVID-19 vaccine caused more harm than good for service members.

Included in the annual defense authorization bill passed by Congress earlier this month is language calling for a study to assess and evaluate any health conditions and adverse events arising in service members on active duty one year after receiving the first dose of a COVID-19 vaccine. Researchers will be required to report their findings back to lawmakers in December 2024.

The vaccine has been a target of conservative lawmakers for years. In the fiscal 2023 defense authorization bill, lawmakers repealed the Defense Departments mandate for all troops to receive the vaccine. This years bill also contains a host of provisions related to potential reenlistment of individuals kicked out of the ranks for refusing the shots.

But the research mandate inserted by Republican House members during debate on the legislation takes that further, again calling into question the safety of the vaccine.

The Centers for Disease Control and Prevention have said that serious problems [linked to the vaccine] are rare and long-term side effects unlikely. They have also said that medical research thus far has not shown any increased risk of death associated with receiving the inoculation, while contracting coronavirus does carry an increased risk of death.

But the agency has documented allergic reactions and heart problems in a small percentage of vaccine recipients.

The study will look at any health condition developed after receiving such first dose, regardless of whether the condition is attributable to the receipt of such first dose, and an accounting of adverse events including hyperimmune response linked to the vaccine.

House Republicans had also pushed for language prohibiting military leaders from mandating masks to prevent the spread of future COVID-19 outbreaks, but that language was dropped in final deliberations over the bill.

President Joe Biden is expected to sign the authorization bill into law before the end of the month.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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DOD to study whether COVID-19 vaccine helped or hurt troops - Military Times

Canadians raced to get vaccinated against COVID-19 in the first years of the pandemic, but data suggests there's far less of a rush to get the latest shots available this fall.

Federal figures show only 15 per cent of the population aged five and up had received an updated vaccine by Dec. 3.And while older age groups had higher uptake rates, more than half of higher-risk older adults still hadn't gotten a dose by early December, either.

The shots, tailored to the XBB.1.5 Omicron subvariant, are meant to shore up protection against the SARS-CoV-2 descendants currently circulating.

Medical experts say seniors and other higher-risk individuals could leave themselves more vulnerable to serious illness if they skip these updated shots. Less than a third of Canadians in their 60s have had the newest vaccine, along with roughly 44 per cent of people in their 70s, and 48 per cent of those aged 80 and older.

Pandemic fatigue, muddled messagingand complex vaccination timelines might be dissuading Canadians from getting another round of vaccines, experts note.

"Why that gap exists is both an interesting and difficult question," said Dr. Allison McGeer, an infectious diseases specialist with Sinai Health in Toronto. "I think it's because people just aren't getting the message about how much of a risk COVID is."

Data shows SARS-CoV-2 is still circulating at high levels across much of Canada, sending hundreds of people into hospital with COVID every week.Weekly rates of hospitalizations and intensive care admissions remain highest among the oldest age groups.

The immune systems of various higher-risk groups including seniors, pregnant womenand people with other serious health issues can be weaker than those of most healthy adults, increasing their risk of serious illness of any kind.

At the same time, a growing body of evidence suggests that immunity against this ever-evolving virus fades over time, leaving people susceptible to repeat infections.

Just this week, the World Health Organization (WHO) announced yet another variant of interestknown as JN.1, an Omicron offshoot that's rapidly spreading around the world. (WHO officials said the latest batch of vaccines are expected to maintain protection against serious illness and death from this variant as well.)

That's why updated shots can make a difference, according to Canada's chief public health officer, Dr. Theresa Tam.

Tam told CBC News there's "room for improvement" when it comes to vaccine uptake among older Canadians. "That's the group, of course, that has the highest risk of severe outcomes," she added.

Close to a third of the country's older population doesn't appear to have been infected with this virus yet either, Tam noted.

"They've been protecting themselves. They've been getting vaccinated," she added. "But the vaccine base protection can wane over time even protection against severe outcomes wanes over time."

That message doesn't seem to be reaching the public, warnedMcMasterUniversity immunologist and researcher Dawn Bowdish.

Many Canadians think there's a "magic number" of vaccinedoses that will protect them long-term from COVID, but that's incorrect, Bowdish said.

While the overall risks of SARS-CoV-2 infections may be lower now than during the early days of the pandemic, fresh shots are necessary while this virus is still "rapidly adapting."

COVID shots don't act like many of our childhood vaccines, she explained, since this type of virus operates in a specific way: Much like older coronaviruses known for causing the common cold, SARS-CoV-2 has a "remarkable capacity to cause repeat infections" by evolving to better dodge the frontline defences of the human immune system.

That means vulnerable individuals should treat the latest COVID vaccines like annual flu shots not boosters to ensure their immune system is primed to tackle new variants and avoid serious illness and lingering, life-altering health impacts, she said.

"We know that having COVID increases risks of heart attacks and other complications, especially in older adults," Bowdish added.

"And importantly, if an older adult is hospitalized, it is very rare for them to leave the hospital and have the same level of function as they did before they went in."

WATCH | What seniors need to know about this year's fall vaccines:

While the vaccine guidance for higher-risk groups is fairly straightforward, McGeer, in Toronto, said younger adults in their 20s and 30s may have more to consider as they weigh the risks and benefits.

The mRNA-based vaccines from Pfizer and Moderna have been linked to higher reactogenicity referring to expected post-vaccination reactions caused by someone's immune response, such as a fever or a sore arm which can discourage some people from getting another shot, McGeer said.

Novavax's protein-based, non-mRNA vaccine is now approved as well, and doses have been delivered to the Public Health Agency of Canada for distribution to the provinces, but McGeer said it likely won't be as widely available, making it harder to access for many Canadians who want a more traditional option.

People are also trying to navigate complex vaccination advice on how to time their next shots, she added. Guidance suggests waiting six months or so after your last vaccination or infection before getting another dose, which can complicate efforts to roll out seasonal immunization campaigns, since Canadians are operating on various schedules based on when they were last exposed to the virus.

Then there's the simple fact that so many people are tired of getting shot after shot, four years into the COVID pandemic.

"I think everyone has a little bit of COVID fatigue, including our policymakers," said Bowdish. "And so we haven't been as aggressive."

The medical experts who spoke to CBC News also didn't paint a clear picture of what the future could hold for COVID vaccination efforts.

Tam said the door is still open for another spring vaccination push, though she noted uptake last spring was also relatively low. Bowdish, the immunologist, agreed twice-annual vaccines may be appropriate given how quickly this virus is evolving.

McGeer, however, said over the long term, as more people gain repeat exposure to this virus earlier and earlier in life, the need for COVID vaccines could start to shift. A twice-annual vaccine seems unlikely, "and I'm not sure that we're even settling into an annual vaccine," she said.

But the world won't know for years, perhaps even decades, how this virus will evolve, what seasonal patterns it could settle into, and how those factors might change the risks of acute illness or lasting health impacts.

"How long that trajectory is going to take, and where it's going to stop, [is an] open question," McGeer said.

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Just 15% of Canadians got updated COVID vaccines this fall, new figures show - CBC.ca

A new COVID-19 variant is now estimated to make up about 20% of COVID-19 cases in the United States.

The World Health Organization (WHO) recently named the strain, JN.1, a variant of concern meaning that the global body is monitoring the variant closely but hasnt yet added it to its watchlist of high-risk strains. Still, the WHO warns the fast-spreading variant could lead to an uptick in cases during winter months as people spend more time indoors at family and group gatherings.

In California, the proportion of people testing positive for COVID-19 has been on a steady rise since November, coinciding with flu season.

We recently spoke with three UC San Francisco COVID-19 experts, Vivek Jain, MD, MAS; George Rutherford, MD, and Peter Chin-Hong, MD, to get the rundown on this COVID-19 season and the latest variant.

Chin-Hong: The symptoms of JN.1 are thought to be similar those of other members of the Omicron family of COVID-19 variants: Typically, illness starts with a sore throat, followed by congestion and a dry cough.

People may also experience other symptoms such as a runny nose, fatigue, headache, muscle aches, fever, diarrhea and an altered sense of smell. But probably what is more important than the symptoms is who has it: A patient who is older than 75 or is immunocompromised and who has not been recently vaccinated against COVID-19 may experience more serious symptoms like difficulty breathing. Folks like these can get very ill.

Chin-Hong: There is no evidence that the new variant causes more serious disease, hospitalizations or a higher fatality rate than other Omicron variants.

Chin-Hong: Yes. Although the vaccine was developed against another Omicron strain (XBB.1.5), studies have shown that the new COVID-19 vaccine generates a robust immune response to JN.1. I have full confidence in the new formulation of the COVID-19 vaccine for the variants that are circulating right now.

Chin-Hong: Yes, the current slate of COVID-19 antivirals such as Paxlovid and for hospitalized COVID-19 patients, remdesivir are also very effective against JN.1. Remember, its important to take Paxlovid as soon as possible after showing symptoms of COVID-19, ideally within the first five days. Youll need a prescription for both these medications.

Jain: Broadly, everyone 6 months and older should get the new 2023-2024 COVID-19 vaccine. COVID-19 vaccines are very safe and lower peoples risk of death and hospitalization, especially those who are older or who have medical conditions.

Is it time to start masking again?

More on masks

Jain: Yes, if thats convenient. Its also okay to space them slightly apart.

If youre 60 and over or in weeks 32 to 36 of pregnancy, you may also qualify for the new RSV vaccines.

Jain: Everyone should strongly consider staying up to date with annual COVID-19 vaccines. People should talk with their health care providers and consider factors like age, and medical conditions, including whether they are immunosuppressed, live with other people at high risk for serious COVID-19 and their COVID-19 history.

Rutherford: Yes. COVID-19 was the eighth leading cause of death in the U.S. between 2021 and 2022. Its the number one vaccine-preventable cause of death among children in the U.S.

Jain: Yes, health insurance and pharmacies will cover the cost of the new COVID-19 vaccines. People without insurance or who might face a difficult co-payment should contact their local health department for places to get free COVID-19 vaccinations. You can also check the federal governments Bridge Access Program for free COVID-19 vaccines at thousands of locations nationwide.

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COVID-19 variant JN.1 is on the Rise. Here's What to Know. - UC San Francisco

A United States District Court judge has again denied relief to a collection of Steamship Authority employees that had tried to gain an exemption to ferry lines COVID-19 vaccine mandate.

Eleven plaintiffs were seeking a preliminary injunctive but Judge Richard G. Stearns with the federal district court in Massachusetts denied the motion on Dec. 11, arguing that the Steamship was trying to protect the general public by ordering compliance with its mandate.

Its the judges second time ruling against the 11 employees.

The group of employees first filed a 129-page lawsuit in Barnstable County Superior Court in February 2022, alleging the Steamship was infringing on their First Amendment rights. The case quickly moved to the U.S. District Court. Judge Stearns denied the workers request in March 2022, which was appealed.

In October, a panel of three appellate judges ruled that the lower court partially erred when rejecting the Steamship Authority [SSA] workers claims that their rights were infringed upon; and the judges sent the case back to Stearns.

In last weeks ruling, Stearns laid out several reasons for denying the injunction. The employees had argued that the Steamship granted an exemption to the vaccine to one employee for health reasons; their rights were infringed on when they were not granted a religious exemption. But the judge writes in his filing that the Steamships efforts to protect the public were justified.

Granting eleven indefinite religious exemptions creates a substantially higher risk of infection and transmission than granting one time-limited medical exemption, he writes.

The judge also argues that the Steamship tried other measures to stop the spread of the virus, like extensive cleaning, social distancing, and daily health screenings. But, the judge writes, COVID-19 outbreaks on the Authoritys vessels continued to Occur.

In previous comments to The Times, the plaintiffs attorney, Patrick K. Daubert said they are seeking reinstatement for the workers who were terminated for standing by their religious convictions in declining the vaccines.

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Steamship employees again denied vaccine relief - Martha's Vineyard Times

The Ministry of Health confirmed today that a child died of rabies about a month ago. The Palestinian boy was bitten in the Jordan Valley in early October by a stray dog and was not vaccinated after being bitten. Only after symptoms began to appear and his condition deteriorated was he admitted to the An-Najah hospital in Nablus and died. This week, two cases of rabies were added to the 44 cases currently recorded in Israel, a large increase compared to 2022, in which 29 cases were found.

Rabies is a fatal neurological disease with a virtually 100% mortality rate for both humans and animals if a vaccination is not administered before the onset of symptoms. The first known person to survive the virus without vaccination was treated in 2015 using a method now known as the Milwaukee Protocol, which remains controversial.

The virus affects all mammals and is transmitted in saliva, mainly by biting. The virus is also transmitted to people through scratching or licking mucous membranes.

The disease can be prevented in animals with a vaccine given ahead of time and in humans through a series of vaccination injections that are given after exposure to the virus and protect against the development of rabies.

The last time a person died in Israel from the deadly virus was in 2002. Before that, in 1997, three people died in Israel from rabies, including a soldier. This month, several animals infected with rabies were found in the north of the country. The most recent case was last Wednesday: a rabies-infected bull was found in an almond orchard at Kibbutz Ein Harod in Israels North.

Almost all cases of rabies in Israel are in the North, in the Gilboa area. In the Ministry of Agriculture's veterinary services records, a rabies case will only be recognized after the animal suspected of having the deadly disease is caught, sent for testing at the veterinary institutes rabies laboratory, and confirmed to have been infected with the virus.

Therefore, if the attacking animal, usually a jackal or a dog, has behavior typical of an animal infected with rabies but is not caught, it will not be included in the number of cases. As such, it is certain that the real number of cases is greater than the number reported by the Ministry of Agriculture.

Since the war began, stories have come out about soldiers bringing dogs and cats back to Israel with them from Gaza. In addition, the major damages to the barrier separating Israel and the Gaza Strip could allow stray animals to cross into Israel. It is probably the case that most animals that would enter Israel from Gaza are not vaccinated against rabies.

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Palestinian child dies of rabies - Health Ministry - The Jerusalem Post