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Which Coronavirus Vaccine Will Work in the Youngest Children?

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Which Coronavirus Vaccine Will Work in the Youngest Children?

WASHINGTON — Over the previous 10 months, as tens of hundreds of thousands of kids and youngsters acquired the Pfizer-BioNTech vaccine, the businesses’ foremost rival, Moderna, sat on the sidelines, its shot restricted to adults.

However Moderna might now be poised for a comeback at a important juncture within the nation’s vaccination marketing campaign. The corporate is predicted to ship federal officers preliminary information this week on how properly its coronavirus vaccine works for the nation’s youngest kids.

About 18 million kids beneath the age of 5 are the one Individuals not but eligible for vaccination. And whereas uptake for older kids has been gradual, many mother and father are nonetheless anxiously awaiting the prospect to guard their infants, toddlers and preschoolers.

Moderna goes head-to-head with Pfizer-BioNTech for the chance to vaccinate this group, hoping it has discovered what some scientists are calling the “Goldilocks” dose: sturdy sufficient to supply lasting safety, however not so sturdy that it causes widespread worrisome uncomfortable side effects, resembling excessive fevers.

Moderna has opted for a routine of two doses at 1 / 4 the energy of its grownup dose for kids beneath 6. Pfizer is predicted to hunt authorization subsequent month for a three-shot routine for kids beneath 5, with doses one-tenth as sturdy as these for folks aged 12 and up.

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Moderna can also be anticipated to launch information quickly from its medical trial on the subsequent age group up: kids aged 6 to 11.

Dr. Yvonne Maldonado, a Stanford professor of pediatric infectious ailments and a lead investigator on the Stanford website of Pfizer’s pediatric vaccine trials, stated new information from each Moderna and BioNTech within the coming weeks will supply important perception into the effectiveness of their pediatric pictures. She stated researchers are watching rigorously to see if Moderna’s stronger doses “end in extra strong immune responses” than Pfizer’s pictures have elicited in younger kids.

A collection of latest research elevating questions on how lengthy Pfizer’s decrease doses defend elementary-school-age kids has piqued curiosity amongst federal scientists and vaccine specialists in Moderna’s decisions.

Dr. Ofer Levy, a pediatric professional at Harvard Medical Faculty and a member of the Meals and Drug Administration’s unbiased vaccine advisory committee, stated he thought Pfizer may need chosen too low a dose for 5- to 11-year-olds “within the comprehensible precedence to maximise security.”

To this point, Pfizer has been the one participant in vaccinating youthful Individuals, successful authorization to vaccinate 12- to 15-year-olds final Might, adopted by 5- to 11-year-olds in October. Its authorization for adults additionally covers 16- and 17-year-olds.

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Moderna sought authorization to vaccinate youngsters final June, however the F.D.A. delayed contemplating the request due to considerations concerning the threat of myocarditis, a situation involving irritation of the guts that has been tied to each the Moderna and the Pfizer pictures.

Greater than 22 million folks in the USA beneath 18 are actually totally vaccinated with the Pfizer vaccine, however uptake has been leveling off. Solely roughly one in 4 kids ages 5 to 11 are totally vaccinated, for instance, despite the fact that pictures have been provided to that group for greater than 4 months.

However there’s nonetheless a requirement to guard the youngest kids as extra of the nation unmasks, extra mother and father return to workplaces and the summer season journey season approaches.

In contrast with adults, “there isn’t a query that in kids the advantage of an efficient vaccine is much less, as a result of fewer get actually sick,” stated Dr. Eric Rubin, an infectious illness professional on the Harvard T.H. Chan Faculty of Public Well being and a member of an advisory panel to the Meals and Drug Administration.

“However it should profit some people,” he stated. “It would avoid wasting lives.” In line with the Facilities for Illness Management and Prevention, 336 kids in the USA beneath the age of 5 have died of Covid because the begin of the pandemic.

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Hopes that the youngest kids would quickly be lined surged final month after regulators pressed Pfizer-BioNTech to submit preliminary outcomes from its three-dose trial. The F.D.A. wished to get the vaccination marketing campaign underway with two doses whereas awaiting ultimate outcomes on three.

However that effort collapsed when new information from Pfizer that encompassed extra of the Omicron surge confirmed convincingly that two doses failed to guard adequately in opposition to symptomatic an infection.

Now, extra detailed outcomes from Pfizer’s and Moderna’s trials are materializing at roughly the identical time. And whereas neither firm is aware of but whether or not its vaccines will show efficient sufficient for the youngest age group, however each say their analysis reveals they’re protected.

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“We’ve not seen something untoward proper now, so we really feel assured within the security profile,” Dr. Paul Burton, Moderna’s chief medical officer, stated in an interview.

Amy Rose, Pfizer’s spokeswoman, has stated that after cautious analysis, Pfizer-BioNTech selected the “most secure and most tolerable dose” for younger kids. The businesses have stated they’re hopeful {that a} three-shot routine will present sturdy safety for kids beneath the age of 5. Pfizer is testing a 10-microgram dose for 5- to 11-year-olds, a 3rd of the grownup and teenage dosing; and three micrograms for kids beneath 5.

Moderna is proposing considerably greater dosing than Pfizer in all three pediatric age teams: 100 micrograms, the complete grownup dose, for these ages 12 to 17; 50 micrograms in kids 6 to 11, and 25 micrograms in these beneath 6. Regulators are thought-about prone to overview the agency’s information for all three age teams concurrently.

“We actually stand behind these doses,” Dr. Burton stated. Though federal officers say each Pfizer and Moderna’s vaccines wane in efficiency over time, some research of adults have advised that Moderna’s safety holds up longer. “I feel it comes right down to dose,” Dr. Burton stated.

He stated preliminary outcomes confirmed a 50-microgram Moderna dose prompted a “strong immune response” in kids 6 to 11. Whereas the general variety of infections was small, researchers hope that trial will assist reveal how properly the vaccine prevents sickness, not simply how excessive it boosts antibody ranges.

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Dr. Philip Krause, who lately retired as a senior vaccine regulator on the F.D.A., stated the company spent important time final yr worrying concerning the security of Moderna’s vaccine for these beneath 18, with some research displaying a better threat of myocarditis from the corporate’s shot than from Pfizer’s.

“The query is at all times: What’s the dose that offers rise to an immune response that we expect is prone to be protecting?” he stated. “You couldn’t really take a look at to determine the speed of myocarditis because it’s uncommon, however you might ask, ‘What are we sacrificing in immune response by reducing the dose, and do we expect that’s essential?’”

Partly due to considerations about myocarditis, the C.D.C. lately inspired some folks 12 or older, notably boys and males between 12 and 39, to attend eight weeks between their first and second Pfizer or Moderna pictures. Research have proven that teenage boys and younger males are most liable to growing the aspect impact.

Dr. Burton stated that general the analysis had proved reassuring, together with current British information that confirmed myocarditis was very uncommon and usually gentle in each Pfizer and Moderna recipients.

However Dr. Walid F. Gellad, a drug security professional on the College of Pittsburgh, stated it remained unclear whether or not Moderna’s greater dosing would possibly elevate the danger of myocarditis in younger kids. The corporate’s pediatric research are most probably a lot too small to establish the danger of the aspect impact, he and different specialists stated.

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Moderna’s new push additionally comes after a number of research raised questions concerning the safety that two doses of Pfizer-BioNTech’s vaccine present for kids 5 to 11. Researchers in New York State’s well being division lately discovered that safety in opposition to an infection from two doses pale considerably inside weeks.

C.D.C. researchers individually discovered that throughout the Omicron wave, the effectiveness of two doses of the Pfizer shot in opposition to reasonable types of the illness in kids ages 5 to 11 dropped considerably.

The research have kindled a debate amongst vaccine specialists about whether or not a stronger dose would have been higher or whether or not these kids want third doses. Booster pictures are actually approved for everybody 12 and up. Pfizer expects outcomes from its examine of a three-dose routine for the youthful kids subsequent month.

Dr. Gellad stated it was doable the Pfizer dose for 5- to 11-year-olds might have been too weak, however that scientists couldn’t but be sure. He stated he anticipated regulators could be particularly cautious in contemplating greater doses for younger kids given the comparatively low dangers of them catching Covid now and getting severely sick.

Amid all of the questions, one factor is evident: The forwards and backwards over which vaccine might be higher for younger kids might discourage uptake.

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Alison M. Buttenheim, a behavioral well being professional on the College of Pennsylvania, stated these contemplating vaccination discovered consolation in certainty. In any other case, “that’s simply going to pave the way in which to say, ‘I’m going to carry off,’” she stated. “Lots of people are uncomfortable with evolving science.”

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Russia’s war economy is a house of cards

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Russia’s war economy is a house of cards

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The most important thing Russian President Vladimir Putin tries to impress on Ukraine’s western friends is that he has time on his side, so the only way to end the war is to accommodate his wishes. The apparent resilience of Russia’s economy, and the resulting scepticism in some corners that western sanctions have had an effect, is a central part of this information warfare. 

The reality is that the financial underpinnings of Russia’s war economy increasingly look like a house of cards — so much so that senior members of the governing elite are publicly expressing concern. They include Sergei Chemezov, chief executive of state defence giant Rostec, who warned that expensive credit was killing his weapons export business, and Elvira Nabiullina, head of the central bank. 

This pair know better than many people in the west, who have been taken in by numbers indicating steady growth, low unemployment and rising wages. But any economy on a full mobilisation footing can produce such outcomes: this is basic Keynesianism. The real test is how already employed resources — rather than idle ones — are being shifted away from their previous uses and into the needs of war. 

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A state has three methods to achieve this: borrowing, inflation and expropriation. It must choose the most effective and painless mix. Putin’s conceit — towards both the west and his own public — has been that he can fund this war without financial instability or significant material sacrifices. But this is an illusion. If Chemezov’s and Nabiullina’s frustrations are spilling into public view, it means the illusion is flickering.

A new report by Russia analyst and former banker Craig Kennedy highlights the huge growth in Russian corporate debt. It has soared by 71 per cent since 2022 and dwarfs new household and government borrowing.

Notionally private, this lending is in reality a creature of the state. Putin has commandeered the Russian banking system, with banks required to lend to companies designated by the government at chosen, preferential terms. The result has been a flood of below-market-rate credit to favoured economic actors.

In essence, Russia is engaged in massive money printing, outsourced so that it does not show up on the public balance sheet. Kennedy estimates the total at about 20 per cent of Russia’s 2023 national output, comparable to the cumulative on-budget allocations for the full-scale war.

We can tell from the Kremlin’s actions that it sees two things as anathema: visibly weak public finances and runaway inflation.

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The government eschews a significant budget deficit, despite growing war-related spending. The central bank remains free to raise interest rates, currently at 21 per cent. Not enough to beat down inflation driven by state-decreed subsidised credit, but enough to keep price growth within bounds.

The upshot is that Chemezov’s and Nabiullina’s problems are not an error that can be fixed but inherent to Putin’s choice to flatter public finances and keep a (high) lid on inflation. Something else has to give, and that something else includes businesses that cannot operate profitably when borrowing costs exceed 20 per cent.

Putin’s privatised credit scheme, meanwhile, is storing up a credit crisis as the loans go bad. The state may bail out the banks — if they don’t collapse first. Given Russians’ experience of suddenly worthless deposits, fears of a repeat could easily trigger self-fulfilling runs. That would destroy not just banks’ but the government’s legitimacy.

Putin, in short, does not have time on his side. He sits on a ticking financial time bomb of his own making. The key for Ukraine’s friends is to deny him the one thing that would defuse it: greater access to external funds.

The west has blocked Moscow’s access to some $300bn in reserves, put spanners in the works of its oil trade and hit its ability to import a range of goods. Combined, these prevent Russia from spending all its foreign earnings to relieve resource constraints at home. Intensifying sanctions and finally transferring reserves to Ukraine as a down payment on reparations would intensify those constraints.

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Putin’s obsession is the sudden collapse of power. That, as he must be realising, is the risk his war economics has set in motion. Making it recede, by increasing access to external resources through sanctions relief, will be his goal in any diplomacy. The west must convince him that this will not happen. That, and only that, will force Putin to choose between his assault on Ukraine and his grip on power at home.

martin.sandbu@ft.com

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Crews race to contain LA wildfires as menacing winds may ramp up: Live updates

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Crews race to contain LA wildfires as menacing winds may ramp up: Live updates
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LOS ANGELES − Fire crews on Sunday were racing to gain an upper hand against infernos that have ignited across the Los Angeles area amid ominous new wind warnings as flames threatened additional Southern California communities.

Aircraft unloaded water and fire retardant on hills where the Palisades Fire − the most destructive in the history of Los Angeles − ballooned another 1,000 acres to a total of 23,654, destroying more homes. The expansion of the fire, which was 11% contained, to the north and east spurred officials to issue more mandatory evacuations to the west of the 405 freeway as the blaze put parts of Encino and Brentwood in peril.

Cal Fire official Todd Hopkins said the Palisades Fire had spread into the Mandeville Canyon neighborhood and threatened to jump into the upscale Brentwood community and the San Fernando Valley.

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The Palisades Fire is one of six blazes that have erupted since Tuesday, leaving at least 16 people dead. Four of the six fires remained active on Sunday.

Santa Ana winds that have fueled the blazes for the past week were expected to strengthen Sunday morning in Los Angeles and Ventura counties and again late Monday through Tuesday morning. Sustained winds could reach 30 mph, with gusts up to 70 mph possible , forecasters said.

“Critical fire-weather conditions will unfortunately ramp up again … for southern California and last through at least early next week as periodic enhancements of off-shore winds continue,” the National Weather Service said. “This may lead to the spread of ongoing fires as well as the development of new ones.”

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Developments:

∎ About12,000 structures have been damaged or destroyed from the wildfires, which have consumed about 38,000 acres of land total, according to CalFire.

∎ Evacuation orders throughout the Los Angeles area now cover 153,000 residents. Another 166,000 residents have been warned that they may have to evacuate, Los Angeles County Sheriff Robert Luna, said.

∎ Gov. Gavin Newsom announced an investigation into water supply issues that may have impeded firefighters’ efforts.

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At least 16 people have died between the Eaton and Palisades fires, the Los Angeles County Medical Examiner said Saturday.

The Palisades Fire had at least five deaths, according to medical examiner records, and 11 people have died in the Eaton Fire.

Of the 16 total deaths in both fires, the only victim identified by officials was Victor Shaw, 66, who died Wednesday protecting his home in Altadena. Another victim was man in his 80s, but authorities did not release his name, pending notification of next of kin.

To the northeast, the Eaton Fire stood at 14,117 acres and was 15% contained after ripping through parts of Altadena and Pasadena. More than 7,000 structures were damaged or destroyed,  Fire Chief Anthony Marrone said.

In Altadena, California official Don Fregulia said managing the Eaton Fire and its impact will be a “huge, Herculean task” that he said will take “many weeks of work.”

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Progress was reported Saturday in bringing electrical power back to some Los Angeles neighborhoods.

Southern California Edison CEO Steven Powell said there are now about 48,000 customers without power, “down from over half a million just a couple days ago.”

Yes fire officials warned public safety power shutoffs were again likely to prevent new fires being ignited.

“They help save lives,” Marrone said. “Yes, they’re a challenge to deal with, but it’s certainly better than having another fire start.”

Richard and Cathryn Conn evacuated from the Pacific Palisades neighborhood earlier this week, only to find out that much of their neighborhood had been decimated. But they still aren’t sure about their four-bedroom house where they’d lived for over a quarter-century.

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“You can visualize every room,’’ Richard Conn, 75, said, “and then you know there’s a 50% chance it doesn’t exist anymore.”

“If you have ever wondered what it was like living in Dresden after the World War II firebombing, you should come to the Palisades,” he said.

They also don’t know what’s going to happen next as dangerous weather conditions have made it difficult to contain the fires, and more brush fires seem to keep popping up all over the county.

“I feel like people are panicking,” said Gary Baseman, 64. Read more.

As California fire officials are still getting to the bottom of what sparked the wildfires raging across Los Angeles, and politicians point fingers at one another, climate change is helping drive an increase in large wildfires in the U.S.

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“Climate change is leading to larger and more severe wildfires in the western United States,” the latest National Climate Assessment previously reported. These fires have “significant public health, socioeconomic, and ecological implications for the nation.”

But is climate change the main factor in California? It’s not quite that simple. Reporters from the Arizona Republic, part of the USA TODAY Network, dive into this topic. Read more here

Contributing: Jeanine Santucci, Eduardo Cuevas; Reuters

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Video: Community L.A. Fire Brigade Steps In to Help Evacuate Residents

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Video: Community L.A. Fire Brigade Steps In to Help Evacuate Residents

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Community L.A. Fire Brigade Steps In to Help Evacuate Residents

Deep into the evacuation zone, volunteers are stepping in to evacuate L.A. residents from encroaching wildfires. Armed with radios, hoses and knowledge of the area, this brigade offers help to overextended fire departments as they try to reach people who have yet to flee.

“Top is Yankee.” “Victor’s your side. Yankee is the other side of Topanga, OK?” Community fire brigade volunteers are on the streets of Topanga, California. The Palisades fire was encroaching on this home, and Keegan Gibbs and his team were working to evacuate the owner. “OK, hi. So I gotta do this fast, so.” “I honestly just kind of want you to leave, because it’s getting bad.” “No we’re out of here in five minutes.” The brigade works to back up the fire department when resources are stretched thin. “L.A. County and the other supporting agencies are the best in the world at what they do. Events like this, it’s not enough.” The Palisades fire has now been burning for several days, and has destroyed tens of thousands of acres. “It makes no sense for somebody to try to stay here. It’s so unbelievably dangerous.” “I walked kind of with Keegan a little bit. We were going to stay, probably going to stay for a little while, but we walked the property and it’s just almost like, I just don’t think it’s safe. Can you just open that? I’m want to throw some more stuff in here, and then we’ll be good. Just going to put pictures, important memorabilia.” “There’s a huge denial that people won’t be affected by fire, and we have to be advocates for people to realize and accept that risk.” With firefighters still unable to contain two of the region’s largest fires, more L.A. residents are expected to join the tens of thousands who have already been forced to evacuate. “Our mission is to make sure people are safe, just full stop.”

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