Why Does the AstraZeneca COVID-19 Vaccine’s Efficacy Vary?

AstraZeneca’s COVID-19 vaccine is up to 90% effective, the company said Monday in a press release, making it the third pharmaceutical firm to report promising vaccine news, following Pfizer and Moderna. AstraZeneca, which partnered with University of Oxford researchers to develop its two-dose vaccine, reported efficacy from two different dosing regimens; one led to 62% efficacy and another to 90%, with an average, the company says, of 70%.

The company’s vaccine was initially developed by Oxford scientists, who started with a disabled cold virus that commonly infects chimpanzees. It’s a more traditional approach than the strategy used by Moderna and Pfizer, both of which relied on the genetic mRNA code from SARS-CoV-2, the virus that causes COVID-19. The Oxford team used the cold virus as a molecular Trojan horse (technically known as a “vector”) to disguise the true payload: material from SARS-CoV-2, which triggers the human immune system into action. The chimp virus helps to deliver the coronavirus more efficiently without causing actual COVID-19.

Among people who received a half dose of the AstraZeneca vaccine, and then a full dose about a month later, about 90% were protected from symptomatic COVID-19 illness. Among those getting two full doses of vaccine a month apart, 62% were protected from getting sick. None of the people receiving either regimen were hospitalized or became severely ill.

The data, part of a scheduled efficacy review, are based on 131 cases of COVID-19 among both the vaccinated and placebo groups. But because the full set of data has not been published, vaccine experts—including regulators—are still trying to figure out why the different regimens led to different results. “The different levels of efficacy with two different dosing regimens is scientifically intriguing,” says Dr. Jessica Justman, associate professor of medicine in epidemiology at Columbia Mailman School of Public Health and senior technical director of ICAP at Columbia, a global public health services group.

One possible explanation relates to the vaccine’s design. Because it relies on a weakened cold virus to deliver the COVID-19 viral material, recipients’ immune systems may actually be mounting a response to the cold virus rather than the coronavirus. Halving the first dose helps to dampen this immune response to the cold virus, possibly increasing the response to the coronavirus.

“We know with other [cold] virus vectors you do get immunity to the vector,” says Dr. Anna Durbin, professor of international health at Johns Hopkins University and an investigator running one of the U.S. COVID-19 vaccine trials. “It may be that the higher [first] dose induced more immunity against the vector so when the second dose came in, it didn’t express the [SARS-CoV-2] protein as well. But we don’t know that yet.”

It’s also possible that the discordant results have something to do with the way the trials were conducted. Testing of the half dose+full dose regimen, which was done in the U.K., began after the company’s combined U.K.-Brazil trials had started and many participants already received the originally planned two full doses. Fewer people received the former combination—nearly 9,000 people received two full doses, while only 2,700 received the half dose+full dose regimen. Those in the latter group have been followed for a shorter period of time, and simply may not have had enough time to develop COVID-19.

In the U.S. trials, however, all participants are still receiving two full doses of vaccine. Results from those tests could help to explain some of the discrepancy. “I will be very interested to see if we are going to see the same results or different results from the [U.S.] trial,” Durbin says. She also notes that it would be challenging to change the U.S. trials at this point to include a half-dose+full dose regimen—the vaccine trial design was vetted and approved before they began, and modifying them would potentially compromise the data, as scientists would no longer be comparing similar groups of people across different sites.

The U.K. and Brazil data also suggest that the AstraZeneca vaccine may be helping to prevent transmission of the virus. If true, that would be an “added bonus,” says Durbin. However, the company did not say how many of the 131 confirmed COVID-19 cases among trial participants tested positive but experienced no symptoms. In the U.K. and Brazil studies, the researchers tested volunteers weekly, so they could understand how many people developed asymptomatic disease, and study them for their response to the vaccine. In the U.S. study, people are only tested if they develop COVID-19 symptoms, meaning that among those who are positive, researchers are comparing how sick the vaccinated people get to how ill those receiving placebo get.

All of which means that the AstraZeneca results, while encouraging, leave a lot of unanswered questions. It’s not clear how the U.S. Food and Drug Administration (FDA) will interpret the data, and whether it will recommend the half dose+full dose regimen, or require more data to be collected about that approach.

One factor that may play a role: with infections continuing to rise around the world, it’s becoming critical to vaccinate as many people as possible, as quickly as possible. And if the half dose+full dose regimen proves more effective when the final data are revealed, then it also has the advantage of immunizing more people with the same amount of vaccine. “It’s a win-win,” says Justman. “You get better protection and provide it to more people.”

But it’s still too early to tell whether that’s the case, and also too early to start making decisions about which vaccine you might choose if given the option. “The advice I would give today, on Nov. 23, is to sit back and wait and see what additional information comes out,” says Justman. “As much as we want all the information right now, I think we need to just be patient and let things play out through proper scientific and regulatory channels.”

Contact us at letters@time.com.

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Snapshots of Daily Life in a Remote Region of Portugal

At the onset of the coronavirus pandemic, with travel restrictions in place worldwide, we launched a new series — The World Through a Lens — in which photojournalists help transport you, virtually, to some of our planet’s most beautiful and intriguing places. This week, André Vieira shares a collection of images from Portugal.

The Barroso, in northern Portugal, is part of the historical province of Trás os Montes — “behind the hills,” in Old Portuguese. It’s one of the nation’s most isolated areas, known for its harsh climate, rough terrain and stunning beauty. Its residents are sometimes dismissively (and wrongly) portrayed as simple and unsophisticated. The truth is that their profound attachment to their land and traditions make Trás os Montes one of the most culturally unique parts of the country.

Isolation has made the traditions here particularly rich and diverse. Ancient Catholic rites have combined with the cultural vestiges from the many other peoples who, over several centuries, have found their way to the region: Visigoths, Celts, Romans, the soldiers of Napoleon’s army.

To survive the unforgiving geography, residents of the Barroso have, over time, developed a complex farming system that relies on the collective management of the water, forests and pastures used by their animals. This method has helped keep the soil fertile, the rivers and springs clean, and the landscape unblemished.

It is a system based on self-sufficiency, where residents eat what they grow, bake their own bread (often in their village’s ancient community oven), step on grapes from their orchards to make wine, and slaughter hogs to make sausages and ham — which they smoke above their kitchen’s fireplace.

In 2018, the United Nations’s Food and Agriculture Organization included the distinctive region on its list of “Globally Important Agricultural Heritage Systems.” It was among the first European sites to receive such designation. The title was a morale booster for residents, who benefited from the new status by highlighting the environmentally friendly way in which their products are made and promoting the region as a prime location for ecotourism.

I come from Brazil, but my great-grandfather grew up in a village in Trás os Montes before migrating to South America. Portugal, once the seat of one of the richest empires in the world, has been beset in recent history by deep poverty, especially in the countryside. In search of a better life, millions of Portuguese emigrated to the country’s former colonies and richer countries in Europe. Many of those migrants were from Trás os Montes.

In late 2017, tired of living in post-Olympic Rio de Janeiro, I decided to move to Portugal, where photography became my way of getting to know a country which, despite my family origins, I knew only superficially. When I read about the region’s U.N. designation, I realized there was something special about my family’s roots that I wasn’t aware of, a perspective that my work as a photographer could give me the privilege of exploring in depth — which I did over many trips until the coronavirus pandemic hit.

My first stop was at the village of Vilarinho Seco, considered one of the best-preserved examples of the traditional architecture of the Barroso, with houses made of rustic stone, often with a shed for the animals on the ground floor, ornate granite granaries next to them, and public water fountains lining the streets every few hundred yards. Vilarinho is in one of the highest parts of the Barroso, at about 3,300 feet above sea level, in the middle of a windswept plateau.

A cold and wet fog covered the landscape on my first visit, limiting visibility. I roamed the streets of the village without meeting a soul, until I heard the faint and approaching sound of jingling bells. Soon, small groups of cows emerged from the mist, orderly marching in single file to their sheds to spend the night. Soon the village was full of life, with neighbors greeting each other in their muddy boots and wet clothes, taking time for a chat before heading home to sit around the fire, have dinner and end another hard day of work.

My first acquaintance in town was Elias Coelho, the patriarch of one of the oldest families in the village. He seemed to have something to discuss with everyone who walked by. It didn’t take long for him to invite me to his home, with a blazing fireplace in the kitchen and rows of sausages and smoked ham hanging from the ceiling above it.

“Here we make everything at home,” he proudly explained, pouring wine into my glass.

Clinging to his arm like a koala was Beatriz, his two-year-old granddaughter, the youngest resident of Vilarinho Seco. Her seven-year-old sister, Bruna, is the second youngest. There are no other children close to their age for them to play with, but most grown-ups seem to take the responsibility of looking after them as they freely roam around the village.

“Life here was very hard. Many people have left,” he said, lamenting the potential loss of the village and its traditions. “The young don’t want the heavy work in the fields anymore.”

Covas do Barroso, some 15 minutes south of Vilarinho by car, sits at around 2,000 feet above sea level. Its architecture is similar to that of Vilarinho Seco, but the landscape here is very different. The village lies on the edge of a valley, surrounded by forests of pine and oak. A pristine stream courses through it, and seemingly every house has an orchard full of grapevines and persimmon trees.

The coronavirus pandemic has largely spared the Barroso, which has benefited from its isolation. Montalegre, one of the region’s two municipalities, had fewer than 200 cases and one death since March. Boticas, the other municipality, managed to make it into November without a single infection. It’s now dealing with an outbreak of around 30 cases.

But the large Barroso diaspora, which returns each summer from all over the globe to the place they still call home, was also affected. Many still came, though they were largely denied the celebrations that make up a big part of the experience: the shared wine and food, the village festivals, the traditional games, songs and dances.

The region faces other threats, too. In 2019, residents of Covas were surprised by the news that a mining company was awarded a permit, given by the Portuguese government, to extract lithium in the mountains surrounding the village. Another company won the rights to mine near the village of Morgade, some 40 minutes away.

The news brought about fierce opposition from residents. Eventually, the companies were forced to delay their plans and produce a detailed environmental impact report for their projects.

“The government is always complaining that the interior of the country keeps losing population. Well, we are the ones who chose to stay and raise our families here. We are here out of choice, not because of a lack of options. And now they come to threaten our way of life,” said Nelson Gomes, one of the leaders of the resistance movement in Covas do Barroso. “They talk about the jobs that will be created, but they don’t realize that those are much less than the livelihoods that will be destroyed.”

Mr. Gomes’s close friend Paulo Pires would be among those most affected if the mining plans proceed, since its processing site would be built a little more than a quarter mile from his property.

Mr. Pires is one of the few residents of Covas who raises sheep instead of cattle. Most of the pastures where they graze are either collectively owned by the village or located on the area’s wild mountainsides, much of which, he said, might be affected — or destroyed — by the mine.

One day, we discussed the mine while returning his flock to its shed. Waiting for them inside were the baby lambs, a crowd of jumping cotton balls. Mr. Pires spread fresh dry hay on the ground. Outside the sky was turning purple, the sun setting behind the mountains on the opposite end of the valley — the mountains that contain the main vein of lithium crossing the region. After he let the mothers in, we went outside to stare at the landscape as the evening set in.

“The mining company offered a ridiculously low amount as compensation for my property. But even if it was good, what would I do with it?” he said. “Why would I want to leave a place like this?”

André Vieira is a photographer based in Portugal. You can follow his work on Instagram.

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Treating the pain of endometriosis

Many women suffer through years of painful menstrual periods before they are able to get an answer about what’s causing them: a common and often undiagnosed condition called endometriosis.

What is endometriosis?

Endometriosis is a condition that occurs when tissue much like the tissue that lines a woman’s uterus — called the endometrium — starts to grow in other places inside the body. Most commonly, these growths are within the pelvis, such as on the ovaries, the fallopian tubes, the outer surface of the uterus, or the bladder.

During the menstrual cycle each month, the tissue lining the uterus grows thicker, then breaks down as blood that exits through the vagina. The wayward tissue growths of endometriosis respond to the same hormones as the uterine lining. But instead of draining through the vagina as a menstrual period, blood from tissue growth elsewhere in the body has nowhere to go. It pools around nearby organs and tissues, irritating and inflaming them, and sometimes causing scarring. In addition to pain, endometriosis can cause other symptoms, such as bowel- and bladder-related problems, heavy periods, sexual discomfort, and infertility.

Diagnosing endometriosis may take time

In some cases, diagnosis of endometriosis is delayed because teenagers and adult women assume that their symptoms are a normal part of menstruation. Those who do seek help are sometimes dismissed as overreacting to normal menstrual symptoms. In other cases, the condition may be mistaken for other disorders, such as pelvic inflammatory disease or irritable bowel syndrome.

A study by the World Endometriosis Research Foundation found that among women ages 18 to 45, there was an average delay of seven years between the first symptoms and the time of diagnosis. Most cases are diagnosed when women are in their 30s or 40s. The problem of getting an accurate diagnosis and treatment is worse for some minority groups, including people of color and indigenous people, according to the Endometriosis Foundation of America.

Getting relief from endometriosis

While there is no known cure for endometriosis, the good news is that medications, surgery, and lifestyle changes can help you find relief and manage the condition.

Your doctor might recommend one or more treatments to help relieve pain and other symptoms. These include:

  • Nonsteroidal anti-inflammatory (NSAID) medications. These may be either prescription or over-the-counter formulations, including ibuprofen (Advil, Motrin) and naproxen (Aleve), which are used to relieve pain.
  • Hormone therapies. Because endometriosis is driven by hormones, adjusting the hormone levels in your body can sometimes help to reduce pain. Hormone medications are prescribed in different forms, from pills, vaginal rings, and intrauterine devices to injections and nasal sprays. The goal is to modify or halt the monthly egg-releasing cycle that generates much of the pain and other symptoms linked with endometriosis.
  • Acupuncture. This is an alternative medicine treatment, which uses small needles applied at specific sites on the body to relieve chronic pain.
  • Pelvic floor physical therapy. This practice addresses problems with the pelvic floor, a bowl-shaped group of muscles inside the pelvis that supports the bladder, bowel, rectum, and uterus. Pelvic pain sometimes occurs when muscles of the pelvic floor are too tight, causing muscle irritation and muscular pain, known as myofascial pain. To treat myofascial pain, a specially trained physical therapist uses her hands to perform external and internal manipulations of the pelvic floor muscles. Relaxing contracted and shortened muscles can help alleviate pain in the pelvic floor, just as it would in other muscles in the body.
  • Cognitive behavioral therapy. Another option to help manage pain is cognitive behavioral therapy (CBT). Although few studies have looked at the effects of CBT on endometriosis symptoms, it has been used to successfully manage other conditions that cause chronic pain. CBT is based on the idea that healthier thought patterns can help reduce pain and disability, and help people cope with pain more effectively.
  • Stress management. Experiencing chronic pain can cause stress, which may heighten sensitivity to pain, creating a vicious cycle. Because stress can make pain worse, stress management is an important component of endometriosis management.
  • Lifestyle improvements. Maintaining a regular exercise program, a healthy sleep schedule, and a healthful, balanced diet can help you better cope with and manage stress related to your endometriosis.
  • Surgery. Your doctor may recommend surgery to remove or destroy abnormal tissue growth, to help improve your quality of life or your chances of getting pregnant. Some studies have shown that removing growths of abnormal tissue and scar tissue caused by mild to moderate endometriosis can increase the likelihood of getting pregnant.

Ultimately, it may take time to find the right combination of treatments to ease pain and manage this condition. But working closely with your doctor makes it more likely that you will be able to do so.

The post Treating the pain of endometriosis appeared first on Harvard Health Blog.

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FDA Authorizes Arthritis Drug Combo for COVID-19

Nov. 19, 2020 — The FDA on Thursday granted emergency use authorization for the arthritis drug baricitinib to be used in combination with remdesivir to treat hospitalized adults and children with suspected or confirmed COVID-19.

The combination is meant for patients who need supplemental oxygen or mechanical ventilation.

Baricitinib plus remdesivir was shown in a clinical trial to reduce recovery time within 29 days of starting the treatment, compared with a control group who received placebo plus remdesivir, according to the FDA press release.

The median time to recovery from COVID-19 was 7 days for the combination group vs. 8 days for those in the placebo plus remdesivir group. Recovery was defined as either discharge from the hospital or “being hospitalized but not requiring supplemental oxygen and no longer requiring ongoing medical care,” the agency said.

The odds of a patient dying or needing a ventilator at day 29 was lower in the combination group compared with those taking placebo and remdesivir, although no specific data was provided. “For all of these endpoints, the effects were statistically significant,” the agency stated.

Emergency use authorization allows doctors to use the drugs during a health crisis. Full approval takes much longer, and the research continues.

“The FDA’s emergency authorization of this combination therapy represents an incremental step forward in the treatment of COVID-19 in hospitalized patients, and FDA’s first authorization of a drug that acts on the inflammation pathway,” said Patrizia Cavazzoni, MD, acting director of the FDA’s Center for Drug Evaluation and Research.

“Despite advances in the management of COVID-19 infection since the onset of the pandemic, we need more therapies to accelerate recovery and additional clinical research will be essential to identifying therapies that slow disease progression and lower mortality in the sicker patients,” she said.

The data supporting the authorization requrest is based on a randomized, double-blind, placebo-controlled clinical trial conducted by the National Institute of Allergy and Infectious Diseases.

The trial followed patients for 29 days and included 1,033 patients with moderate to severe COVID-19. In the study, 515 patients received baricitinib plus remdesivir, and 518 patients received placebo plus remdesivir.

In reviewing the combination, the FDA “determined that it is reasonable to believe that baricitinib, in combination with remdesivir, may be effective in treating COVID-19 for the authorized population” and the known benefits outweigh the known and potential risks. Additionally, there are no adequate, approved, and available alternatives for the treatment population.

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Stacey Abrams drops into historic Verzuz rap battle to encourage Georgians to vote in critical Senate runoff races: ‘Let’s get it done’

To kick off a Thursday night matchup described as “the battle to end all battles” between two Atlanta hip-hop legends, Jeezy and Gucci Mane, former Georgia gubernatorial candidate Stacey Abrams had an important message for residents of the state leading up to the Jan. 5 Senate runoff races: “Vote.”

“We [need to] at least make sure that everyone shows up to vote so we have two senators to make sure we have COVID response and we’ve got stimulus money coming back to Georgia,” Abrams said, while remotely opening up the event for the two rappers at the famed Magic City strip club in Atlanta.

Verzuz, the brainchild of producers Timbaland and Swizz Beatz, is a virtual series of music battles between popular artists streamed on Instagram and Apple Music that sprang up in response to the COVID-19 pandemic as a way to keep people entertained at home.

On Thursday, Abrams thanked Jeezy and Gucci, former friends turned foes who are now back on good terms, for mobilizing formerly incarcerated people throughout the state to vote. She joked that the appearance earned her some “street cred” with her nieces and nephews.

Former Georgia gubernatorial candidate Stacey Abrams. (Staff photo by Ben McCanna/Staff Photographer)

“I just wanted to say thank you to both of you, especially for the work you’ve done to encourage folks who are coming back, returning citizens, to know that they have the right to vote,” Abrams said. “I’ve got a younger brother who’s been in and out of the system and I know that redemption is real and I know that the voices that these men and women can bring to our state matter.”

The live-streamed event had more than 5.5 million total viewers on Instagram and millions more through Apple Music.

Abrams shared a screenshot of her appearance on Twitter with the caption “Let’s get it done,” alongside a link for Georgians to request absentee ballots.

Both Democratic Senate candidates also gave shout-outs to Abrams. Jon Ossoff, who’s going up against incumbent Republican Sen. David Perdue, tweeted, “Go Stacey!”

And the Rev. Raphael Warnock, who’s going up against GOP Sen. Kelly Loeffler, tweeted, “Thanks Stacey Abrams. … Let’s win this.”

Democratic U.S. Senate candidates Raphael Warnock and Jon Ossoff are seen at a campaign event on November 19, 2020 in Jonesboro, Georgia. (Photo by Elijah Nouvelage/Getty Images)
Democratic U.S. Senate candidates Jon Ossoff and Raphael Warnock are seen at a campaign event on Thursday in Jonesboro, Ga. (Photo by Elijah Nouvelage/Getty Images)

Abrams narrowly lost to Republican Gov. Brian Kemp in a controversial race in 2018 and has since dedicated her efforts to mobilizing Georgia voters through her Fair Fight national voting rights organization, which has been widely credited as a huge force behind President-elect Joe Biden’s winning Georgia in the 2020 general election.

In a fun exchange at the top of the Verzuz conversation, rapper Gucci Mane asked Abrams, “Can you wipe my record clean?”

“That’s a job that the governor could do,” responded Abrams, who came close to winning that position in 2018, and is rumored to be considering another run in 2022. “You know, we’ll have to think about that later.”

Below are key dates for Georgians to remember ahead of the state’s Senate runoff elections on Jan. 5, 2021:

Cover thumbnail photo illustration: Yahoo News; Photos: Prince Williams/Wireimage via Getty (2), Melina Mara/The Washington Post via Getty Images


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December vaccine rollout possible, BioNTech CEO says

BioNTech chief executive says the vaccine developed with Pfizer may start deliver in December

BioNTech co-founder Ugur Sahin said on Thursday the frontrunner COVID-19 vaccine his German firm is developing with Pfizer could be rolled out before the year is over in the United States or Europe.

“We are working at full speed,” he told AFP in a Zoom interview, confirming that the companies planned to apply for emergency use authorisation of their jab in the US on Friday, while European regulators will receive another batch of data “next week”.

“There is a chance that we can receive approval from the US or Europe or both regions this year still,” said Sahin, 55, who is also BioNTech’s chief executive.

“We may even start delivering the vaccine in December,” he added, “if everyone works together very closely”.

The BioNTech/Pfizer shot and another one being developed by US firm Moderna have taken the lead in the global chase for a vaccine, after large-scale trial data this month showed that their jabs were around 95 percent effective against COVID-19.

The twin breakthroughs have lifted hopes for an end to a pandemic that has infected more than 56 million people and caused more than 1.3 million deaths worldwide since the virus first emerged in China late last year.

The US, the European Union and a slew of other nations have already placed orders for hundreds of millions of doses of the top vaccine candidates in development.

Health workers, carers and people considered at high risk for severe COVID-19 are set to be first in line for the jabs.

‘A normal winter’

Speaking from the western German city of Mainz, Sahin said if all the players involved—governments, pharma companies and vaccine logistics firms—”do a really good job”, then “we can succeed in vaccinating 60 to 70 percent of the population by the autumn of 2021.”

“And when we’ve accomplished that then we could have a normal winter. Without another shutdown.”

Ugur Sahin, scientist CEO and co-founder of BioNTech, said there is a chance of US and European approval for the vaccine this ye
Ugur Sahin, scientist CEO and co-founder of BioNTech, said there is a chance of US and European approval for the vaccine this year

Beyond the US and EU, more than 30 countries are at different stages of negotiations to secure the BioNTech/Pfizer vaccine, Sahin said.

With concerns growing that poor nations could be left behind in the scramble, Sahin said BioNTech was talking to organisations like the World Health Organization and the Bill and Melinda Gates Foundation on distributing the vaccine “worldwide”, and finding ways to reduce its cost.

The price of the BioNTech/Pfizer vaccine is expected to be around $20 (17 euros) per dose, with a booster shot to be taken 28 days after the first.

Experimental tech

Sahin and his wife Ozlem Tureci, both children of Turkish immigrants to Germany, founded BioNTech in Mainz in 2008.

They set out to fight cancer using an experimental technology known as “mRNA”, before the pandemic shifted their focus.

No mRNA vaccine has ever been approved but both the BioNTech/Pfizer and the Moderna efforts are based on it.

The technology uses synthetic versions of molecules called “messenger RNA” to hack into human cells, and effectively turn them into vaccine-making factories.

Other contenders in late-stage testing like AstraZeneca/Oxford University and Johnson & Johnson are using the traditional approach of injecting people with modified viruses to trigger an immune response.

Sahin said he was “very confident” his vaccine was safe, a day after Pfizer and BioNTech announced that a completed study of their trial—involving some 43,000 volunteers, more than 21,000 of whom received the jab—showed no serious side effects.

German Chancellor Angela Merkel, a former scientist who has been praised for her handling of the coronavirus crisis so far, on Thursday said “we don’t want to take any risks” on a vaccine, and that the latest news was encouraging.

Sahin predicts many more mRNA-based vaccines and drugs to come, potentially transforming cancer treatments.

Vaccine effectiveness
Comparison of the effectiveness of conventional vaccines and three vaccines in clinical trials against Covid-19

‘Second generation’

Sahin said he and his wife planned “of course” to get their jabs as soon as possible.

In a nod to vaccine sceptics, he said the only option was to keep providing “answers, information and transparency”.

He predicts that many people will want to be innoculated once a vaccine becomes available, numbers that would only grow when those people shared their positive experiences.

One big question that remains unanswered is how long the vaccine’s protection lasts.

Sahin estimates it could be “at least a year, if not longer” but he stressed that more data was needed to reach a final conclusion.

A key challenge with BioNTech/Pfizer vaccine lies in the distribution, since it needs to be stored at minus 70 degrees Celsius (- 94 degrees Fahrenheit).

Sahin said Pfizer and BioNTech would use special cool boxes to store and transport the vaccine in the first few months.

But they are already developing a “second generation” of the vaccine that could stand warmer temperatures, he said.

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Could Night Shifts Raise Asthma Risk?

TUESDAY, Nov. 17, 2020 (HealthDay News)

Night-shift workers are about one-third more likely to develop moderate to severe asthma compared to folks working daylight hours, a new study finds.

Researchers in Britain explained that working a night shift can play havoc with the body’s internal clock, and has been tied to an increased risk for various metabolic disorders, cardiovascular disease and cancer. So, in the new study, they collected data on nearly 287,000 people listed in the U.K. Biobank between 2007 and 2010.

Compared with people who worked regular office hours, shift workers were more likely to be men, smokers, and live in urban areas and poorer neighborhoods. They also drank less alcohol, slept fewer hours and worked longer hours.

About 5% of all the participants had asthma and nearly 2% had symptoms that were moderate to severe, said researchers led by Dr. Hannah Durrington of the University of Manchester, in England.

After accounting for age, sex and a range of other risk factors, night-shift workers had a 36% rise in the odds of having moderate to severe asthma, compared with those working normal office hours, the researchers found.

Also, the odds of “wheeze” or airway whistling were 11% to 18% higher among night-shift workers, and the odds of poorer lung function were about 20% higher in people working permanent night shifts.

Durrington’s group stressed that the study can’t establish cause and effect, and only points to an association.

“However, it is plausible that circadian misalignment leads to asthma development,” the authors theorized. “The public health implications of our findings are potentially far-reaching, since both shift work and asthma are common in the industrialized world.”

The report was published online Nov. 16 in the journal Thorax.

About one in five people in the developed world work either permanent or rotating night shifts, most often in service industries or factories, the study authors noted in a journal news release.

Dr. Len Horovitz is a pulmonary specialist at Lenox Hill Hospital in New York City. He wasn’t involved in the study, but said its findings were “confounded by the fact that there were many smokers in this group,” and smoking can greatly raise the risk for asthma.


More information

For more on asthma, head to the U.S. National Heart, Lung, and Blood Institute.

SOURCE: BMJ, news release, Nov. 16, 2020

Steven Reinberg

Copyright © 2020 HealthDay. All rights reserved.


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How to help siblings get along better

“It’s been part of our culture, at least in the US, to think that siblings fight. That there’s going to be lots of times they don’t get along. That’s what they do,” said Laurie Kramer, a professor of applied psychology at Northeastern University in Boston.

“When social lives are so restricted, families really see the value of encouraging their kids to be friends, in some respects, to be companions and playmates.”

Unlike many of our relationships, we don’t choose our siblings, and this makes for a unique dynamic. Brothers and sisters can withstand far more negativity and behavior that simply wouldn’t fly among friends, Kramer said.

That’s one reason why sibling interactions are developmentally so important. These relationships allow children to try out new social and emotional behavior, particularly when it comes to conflict, helping them learn ways to manage emotions and develop awareness of other people’s thoughts and feelings.

“It’s helpful for children to have experiences in a very safe relationship with a brother or sister where they can work through (conflict) and learn conflict management skills that they will be able to use in other relationships in their life,” Kramer said.

“Conflict can be very constructive and helpful. It helps children get a sense of who they are and their own identity.”

It’s worth parents spending some time to help their children get along since these are typically the longest-lasting of our close relationships. That shared history can be really important in a crisis.

So what steps should you take to help feuding siblings get along? Here are some ideas.

One-on-one time

It may sound counterintuitive, but scheduling regular one-on-one time with your children is a good first move.

It's time to give up perfectionist parenting — forever. Here's how

“When you have one on one time there is no competition for your attention. There are no perceived winners and losers in this regard,” said family therapist Jonathan Caspi, a professor in the department of family science and human development at Montclair State University in New Jersey.

“There is the ability to praise and correct without the audience (and it having any meaning) for the other children. It’s a freer relationship and one in which bonding and closeness can be developed without interference,” he said via email.

Another tip: While it’s tempting to seize the moments they do get along to get things done, it’s important to take a moment and praise siblings when they are cooperating and playing nicely — parent the good behavior as well as the bad.

Intervene or ignore?

Tougher to deal with are the fights and knowing when to intervene or not. As a rule, Caspi said, it’s better to ignore simple bickering.

However, he stressed that physical violence and the name calling that often precedes it should be policed.

“Since violence escalates incrementally in its severity, it is important that parents stop verbal violence before it becomes physical. Name calling is violence and opens the door for escalation into more severe violence.”

“Do not allow your children to call each other curse words or negative terms like ‘fat,’ ‘stupid,’ ‘icky,’ etc. While physical wounds heal, verbal ones can last a lifetime.”

Children under the age of 8 don’t usually have the skills to manage conflict, said Kramer, who encouraged parents to act as mediators or coaches to facilitate solving the problem at hand rather than serving as a referee.

So your kid has a Covid-19 symptom. What do you do now?

“What happens when parents do nothing and don’t intervene is that children can get the message that parents think what you’re doing is OK. That it’s all right to keep on at one another,” she said.

“We encourage parents to intervene to help children manage conflict on their own.”

For example, Kramer suggested saying something along the following line: “I’m hearing some scuffling. I’m hearing some conflict. I’d like for the two of you to work this out together. If you need some help, I’m down the hall but let’s see what you can do on your own.”

It was once thought that girls used more verbal aggression than boys, Caspi said, but research is suggesting that sisters are just as apt to use physical violence as much as brothers.

“The difference may be how severe the physical violence gets. Boys tend to do more damage, particularly when older,” he said via email. “It was also assumed that girls relied more on relational aggression (e.g., strategies to socially humiliate, isolating, injure reputation) than boys. However, there is evidence that brothers use this approach about the same too.”

Parents should step in when fights turn physical.

What not to do

The danger with intervening or involving yourself in children’s disagreements is that it can backfire and fuel the fighting.

Parents tend to intervene on behalf of the younger child, which builds more resentment in the older and empowers the younger to challenge the older more frequently, Caspi said. Avoid phrases like “You’re bigger, be nice!” “Be a good role model,” or “She’s little, let her have the toy.”

Getting kids to connect across racial — and geographic — lines

“Another reason for bickering is parents who make lots of comparisons. Parents should avoid comparing their children. Children hear the comparisons and it creates more competition and fighting,” he said.

It’s also important to take complaints seriously. For example, if a child consistently complains, “It’s not fair” — something I find particularly challenging in dealing with my own daughters.

“When children complain about fairness, parents often dismiss it … which only confirms the sense that they are on the outside in the parent-children relationship. Acknowledge the feelings and openly discuss it,” Caspi said.

“Parents should observe how they intervene in sibling conflicts. Are you taking one’s side more than the other’s? If so, change it up,” he said.

Lastly, and perhaps most crucially, both Caspi and Kramer said that it’s important for parents to cut themselves some slack and take care of their own mental health. Kids can pick up on stress and tension, and this may lead to more fights.

“Parents are stretched in so many different ways right now,” Kramer said.

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10 Best Foods to Control Blood Sugar

One of the biggest concerns of people with diabetes is learning to control their blood sugar. Food plays a huge part of doing so. Certain foods can help keep your blood sugar at consistent levels, while others can cause it to drop or skyrocket.

When you’re living with diabetes, knowing which foods to include in your diet can help keep blood sugar under better control. But with so much misinformation out there, it can be tricky to know what’s fact and what’s fiction.

Here’s a list of the top 10 foods to control blood sugar.

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