A new variant of the coronavirus has scientists worried about the effectiveness of COVID-19 vaccines. In California, Gov. Gavin Newsom has lifted regional stay-at home orders.
But 54 counties in the state are still classified as having “widespread” coronavirus risk. So why did the state loosen the restrictions? And the CDC is reporting the highest number of overdoses in a 12-month period.
Today, the U.S. Senate will receive the article of impeachment against former President Donald Trump for inciting an insurrection. But the actual trial won’t start for another two weeks. Why the delay?
Logistics continue to be a challenge in the fight against the coronavirus. Only about half of the vaccines that have been distributed have been administered. And NPR’s investigations team finds that 135 unarmed Black people were killed by police in the past five years.
President Biden wants 100 million coronavirus vaccinations in his first 100 days. But Pfizer and Moderna have fallen behind in their production. Jobs numbers show another 1.3 million Americans are out of work.
So why are economists optimistic? And about half of the country’s students are attending class remotely. President Biden wants to change that and open more schools.
As new coronavirus variants sweep across the world, scientists are racing to understand how dangerous they could be. WSJ explains. Illustration: Alex Kuzoian/WSJ
Americans love The Cheesecake Factory. The restaurant known for its massive 21-page menu, dozens of dessert options and ancient Egypt-inspired decor was ranked as one of the top casual dining restaurants in the U.S. in 2019. But the eatery popular with everyone from NBA stars to cheesecake aficionados has fallen on hard times as the coronavirus pandemic has wreaked havoc on the restaurant industry. In October, The Cheesecake Factory reported third-quarter sales fell by 12% and same-stores sales were down 23% from a year earlier. So after 40 years in business will The Cheesecake Factory be able to regain its momentum and will the chain’s takeout and delivery service be enough to offset the decline of the dine-in restaurant experience?
As Covid-19 vaccines roll out in several countries, counterfeits are being marketed online. WSJ explains how phony vaccines end up on the internet and the risks for people who buy them. Illustration: Crystal Tai
How does each of the available Covid-19 vaccines work?
Once the vaccine is injected, the mRNA is taken up by the macrophages near the injection site and instructs those cells to make the spike protein. The spike protein then appears on the surface of the macrophages, inducing an immune response that mimics the way we fight off infections and protects us from natural infection with SARS-CoV-2. Enzymes in the body then degrade and dispose of the mRNA. No live virus is involved, and no genetic material enters the nucleus of the cells.
Although these are the first mRNA vaccines to be broadly tested and used in clinical practice, scientists have been working on mRNA vaccines for years. And despite this wonderful parody piece. opens in new tab saying that the technology is “obvious,” in fact the breakthrough insight that put the mRNA inside a lipid coating to prevent it from degrading is quite brilliant — and yes, this may be the first time the New England Journal of Medicine has referenced a piece in The Onion. (Last reviewed/updated on 11 Jan 2021)
How should early side effects be managed?
Analgesics and antipyretics such as acetaminophen or ibuprofen are effective in managing post-vaccine side effects including injection-site pain, myalgias, and fever. However, the CDC does not recommend prevaccine administration of these drugs, as they could theoretically blunt vaccine-induced antibody responses.
Because of the small risk of anaphylaxis, sites that administer the vaccines must have on hand strategies to evaluate and treat these potentially life-threatening reactions. The CDC has issued recommendations on how sites should prepare. opens in new tab. (Last reviewed/updated on 11 Jan 2021)
How long will the vaccines work? Are booster doses required?
Since the vaccines have been tested only since the summer of 2020, we do not have information about the durability of protection. Data from the phase 1 trial of the Moderna vaccine suggested that neutralizing antibodies persisted for nearly 4 months. opens in new tab, with titers declining slightly over time. Given the absence of information on how long the vaccines will be protective, there is currently no specific recommendation for booster doses. (Last reviewed/updated on 11 Jan 2021)
Do the vaccines prevent transmission of the virus to others?
Many commentaries on the results of the vaccine clinical trials cite a lack of information on asymptomatic infection as a limitation in our knowledge about the vaccines’ effectiveness. Indeed, this is a theoretical concern, since up to 40% of people who get infected with SARS-CoV-2 have no symptoms but may still transmit the virus to others.
Nonetheless, there are several good reasons to be optimistic about the vaccines’ effect on disease transmission. First, in the Moderna trial. opens in new tab, participants underwent nasopharyngeal swab PCR testing at baseline and testing at week 4, when they returned for their second dose. Among those who were negative at baseline and without symptoms, 39 (0.3%) in the placebo group and 15 (0.1%) in the mRNA-1273 group had nasopharyngeal swabs that were positive for SARS-CoV-2 by RT-PCR. These data suggest that even after one dose, the vaccine has a protective effect in preventing asymptomatic infection.
Second, findings from population-based studies now suggest that people without symptoms are less likely to transmit the virus to others. Third, it would be highly unlikely in biological terms for a vaccine to prevent disease and not also prevent infection. If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of one!
Until we know more, however, we should continue to emphasize to our patients that vaccination does not allow us to stop other important measures to prevent the spread of Covid-19. We need to continue social distancing, masking, avoiding crowded indoor settings, and regular hand washing. (Last reviewed/updated on 11 Jan 2021)
A number of start-ups and major tech companies like Microsoft, Ticketmaster, Apple, and Google are interested in vaccine or immunization passports to help reopen the economy. But public health officials are weary, warning the apps are pointless without more knowledge about the efficacy of the vaccines. Watch the video above to learn more about digital vaccine verifications and how you could possibly prove your immunity to coronavirus before attending an event or entering a building.
