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Who needs COVID boosters? Experts must decide with incomplete data

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Who needs COVID boosters? Experts must decide with incomplete data

COVID-19 vaccine holdouts don’t have any monopoly on doubt. Even scientists who fervently imagine the photographs are the way in which out of the pandemic usually want they’d a bit extra proof.

Proof of when the vaccines begin to defend, and of how lengthy they accomplish that. Proof that a person could be higher off with a booster dose. Proof, even, that one vaccine would possibly work higher than one other.

However all of these issues require one thing that has not but been established: a typical forex by which individuals’s ranges of safety might be reliably measured, valued and in contrast. If it rises, which means an individual’s defenses are stronger; if it falls, they’ve turn into extra susceptible.

Within the language of vaccines, that measure known as a “correlate of immunity.” It’s not proof itself, however a Rosetta Stone that guides the seek for proof.

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The absence of those immune correlates is “one of many struggles we’re all having,” stated Dr. Hayley Gans, a pediatric infectious illness specialist at Stanford College and member of an knowledgeable panel that advises the Meals and Drug Administration on COVID-19 vaccines.

After any new vaccine is rolled out, it may possibly take a long time for scientists to agree upon an ordinary method to measure its safety, stated Dr. Joel I. Ward, a retired professor of immunology at UCLA. Typically they simply surrender.

That was the case when a vaccine for whooping cough, additionally referred to as pertussis, was launched within the early Nineteen Fifties. Over the following 30 years, infants stopped dying of whooping cough, and regardless of the absence of a correlate of immunity, scientists declared victory. Then within the early Nineteen Nineties, when docs started to detect pertussis infections in adolescents and adults who had been vaccinated, scientists shrugged and beneficial boosters.

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The earliest COVID-19 vaccines started rolling out lower than a yr in the past, so it’s no shock that scientists have but to seek out and agree on a typical measure of immunity, Ward stated.

This would possibly look like an arcane debate, however having a method to measure a vaccine’s safety may assist scientists convey the pandemic beneath management.

Amongst different issues, it might enable docs to evaluate whose immunity to COVID-19 is slipping and determine those that may benefit from a booster.

An excellent correlate of immunity could be simple to measure with a reasonable but dependable industrial take a look at. If scientists are fortunate, they could discover one which instantly captures the immunological response that’s defending an individual: that might have the additional advantage of serving to to clarify simply how the vaccine works.

Extra seemingly, although, scientists should accept a surrogate measure — some course of or protein (presumably even a waste product) that’s associated to immunity.

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What makes this all so troublesome is the complexity of the human immune system. It’s multilayered, with divisions of labor that aren’t all the time clearly distinct. Its extensive solid of characters — lymph nodes, white blood cells, 5 totally different courses of antibodies, and quite a lot of B cells and T cells — work together with each other in many various methods over totally different intervals of time. On prime of that, a few of these actors look the identical initially, however tackle new roles as they mature.

For those who may watch the immune system’s response to a viral invader — and the virus’ efforts to evade its grasp — it’d resemble a struggle. First encounters differ, skirmishes are received and misplaced, reinforcements arrive, and battle traces shift. Typically the struggle is received in mucus membranes, the place respiratory viruses first get in. Typically the coup de grace is delivered within the bloodstream, after the invader has breached the gates.

Taking a snapshot throughout that ongoing drama could give a deceptive image of the place the struggle is being waged, the way it will finish, or whether or not the truce that ends hostilities will maintain.

Discovering a single metric that captures all this dynamic complexity is a tall order, stated Dr. Archana Chatterjee, a pediatric infectious illness knowledgeable on the College of Chicago who serves on the FDA advisory board.

“This isn’t easy arithmetic … it’s calculus,” she stated. Add the unknowns in regards to the coronavirus and people’ unpredictable behavioral responses to the pandemic, she added, and “it’s three-dimensional chess.”

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Many researchers imagine antibodies that focus on the coronavirus’ telltale spikes and one other function referred to as the receptor binding area could possibly be a good correlate of immunity. Proponents of that concept embody Dr. Anthony Fauci, who directs the Nationwide Institute of Allergy and Infectious Illnesses.

Some antibodies are skilled by a vaccine or an infection to acknowledge a pathogen and neutralize it. Within the instant aftermath of publicity, their numbers sometimes soar, and they are often readily detected within the bloodstream.

However like all proteins, antibodies decay over time. At that time, the duty of ordering replacements will get handed off to a fancy of B cells and T cells wherein immune reminiscence resides. (A few of these T cells additionally goal and kill contaminated cells.) One preliminary examine that discovered that vaccinated individuals with no detectable antibodies to COVID-19 of their blood had been nonetheless about 50% much less seemingly than unvaccinated adults to turn into severely sick.

Counting on these neutralizing antibodies as the one measure of immunity could be a mistake, stated Dr. Paul Offit, a vaccine knowledgeable at Youngsters’s Hospital of Philadelphia who serves on the FDA panel. Antibodies will decay, and failing to credit score the immune system’s different technique of safety will lock us into persevering with cycles of vaccination, he stated.

“Do we actually need a yearly vaccine? Is that what we’re going for?” Offit stated. “I hope not.”

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A single measure of immunity would provide one other profit too: a method to gauge the worth of somebody’s “pure immunity” after recovering from an an infection and examine it with the safety afforded by a vaccine. Medical doctors would possibly discover that some individuals can safely skip a vaccine; alternatively, COVID-19 survivors would possibly notice they nonetheless want a dose or two of vaccine for his or her safety.

The suitable correlate of immunity may additionally enable docs to determine a threshold beneath which an individual (or a bunch of individuals, like these over 65) turns into susceptible to extreme sickness. That may alert the affected person to take additional precautions, both by avoiding contaminated individuals or getting a booster.

Medical doctors, sufferers and public well being officers may additionally use a dependable correlate of immunity to make higher boosters. If a take a look at confirmed that individuals experiencing breakthrough infections nonetheless had robust immunity, it might be a robust signal that the coronavirus had advanced to evade the vaccine’s defenses. Boosters could should be tweaked accordingly.

If a take a look at revealed {that a} vaccine didn’t immediate robust immune reminiscence, maybe the booster dose ought to improve, or the interval between photographs needs to be stretched out a bit. Vaccine specialists say both may elicit stronger and extra sturdy immune responses.

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Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County

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Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County

A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.

The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.

The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.

Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.

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The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.

After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.

As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.

Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.

The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.

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Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.

Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.

The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.

Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.

While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.

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Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.

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Political stress: Can you stay engaged without sacrificing your mental health?

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Political stress: Can you stay engaged without sacrificing your mental health?

It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.

“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”

Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.

Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.

The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.

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That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.

In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.

“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”

Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).

The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.

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For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.

Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.

“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.

Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.

There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.

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“Politics is many forms of stress all rolled into one,” Ford said.

Weinschenk observed this firsthand the day after the election.

“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”

That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.

Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.

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“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”

Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.

“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”

On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”

“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.

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Genessa Krasnow has been seeing a lot of that since the election.

The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.

“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.

“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”

That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.

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“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.

Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.

“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”

Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.

“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.

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The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”

“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”

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Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight

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Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight

President-elect Donald Trump joined Elon Musk in Texas and watched the launch from a nearby location on Tuesday. While the Starship’s giant booster stage was unable to repeat a “chopsticks” landing, the vehicle’s upper stage successfully splashed down in the Indian Ocean.

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