How to Hire With a Vaccine Mandate in Place

Asking prospective employees about their vaccination status can be awkward–and possibly lead to legally sticky situations. Some prospective employees will appreciate it if your company is mandating Covid-19 vaccinations. While surgical-grade facemasks have proven somewhat effective at preventing the spread of Covid-19, a vaccine is currently the only true way to protect yourself and others from getting sick.

Others are less convinced. And if your company is in a hiring bind, as many are these days, you might need to codify and justify your safety policies. Here’s a primer on how to hire with a vaccine mandate in place.

Be transparent.

Nicolas Holand–founder of GooseSmurfs, a gaming company based in Indianapolis–has needed to hire nine new workers since July, when he added the vaccine to his company’s job requirements. He wants to avoid compromising the safety of his existing 46 employees.

“We also emphasize that this is a good thing for the candidates who may soon work in the workplace,” says Holand, noting that employees who are vaccinated are at a lower risk of contracting Covid-19 than those who remain unvaccinated. “They are more protected and resistant to any potential infection of Covid and therefore their workdays won’t be affected,” he adds.

While Holand says that so far, all of the candidates he’s hired has agreed to GooseSmurfs’s vaccination policy and most of them already had their full dose. The founder suspects he’s had a smoother time with the process because the company has been transparent and direct with its requirements on the job post itself. He says most candidates who were hesitant about the mandate likely didn’t apply. “Overall, being straightforward about the policy made the hiring process easier and seamless,” he says.

Make the vaccine a condition of employment.

When people take a job, they do so with an understanding of a job’s requirements. As an employer, you don’t want to violate that contractual agreement because it could lead to turnover. That’s why it’s crucial to outline any vaccine policies with candidates before they accept the position, says John Hooker, professor of business ethics and social responsibility at Carnegie Mellon University.

Additionally, if you have a policy in which some workers are required to be vaccinated, such as those in the office, and others are not, that rationale should be clear upfront. “It’s critical to have these kind of [policies] run across the entire company, as opposed to allowing them for some people and not for others,” says Hooker.

And if you do require a vaccine for some and not others, Hooker suggests making your reasoning known: “There must be a reason for that distinction and it shouldn’t be arbitrary.” Employees are less likely to push back on policies when they understand the rationale behind them, he says.

Don’t ask about a prospective worker’s vaccination status.

If you have a mandate in place, you likely want to know whether you will have to accommodate a new employee who isn’t vaccinated. While it’s fine to ask about a person’s vaccination status, you can’t make your hiring decision based on that person’s status alone. If a candidate is turned down for a job, and is told it is because he or she won’t receive the vaccine, they can file a discrimination lawsuit.

It is illegal both under federal and state laws to discriminate against an employee based on his or her medical condition with regard to employment decisions. It is, however, difficult for applicants to prove that a company didn’t hire them because of a health condition, says Jared Pope, HR law specialist CEO of Work Shield, a Dallas-based HR software company.

If you do decide to pass on candidates after having a conversation about their vaccination status, be cordial. Thank them for applying and let them know that you’ll keep them in mind should a position open up that would be a better fit.

An even better idea? Don’t ask at all. Talk about the company’s policy regarding vaccines during the interview process. Let the candidate know if any exceptions can be made if they choose to move forward. “Questions about the workplace can be asked and answered in an interview, and are not discriminatory or illegal in nature,” says Pope. Down the line, you can require proof of vaccination, he adds.

By Brit Morse, Assistant editor, Inc.@britnmorse

Source: https://www.inc.com/

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Should Businesses Force Employees to Get Covid Vaccine? Advice From a Lawyer

With the Covid-19 vaccine rollout steadily gathering steam, and an overwhelming desire to get back to business, companies face a difficult choice: should they force employees to get vaccinated? And if not, how can they encourage workers to roll up their sleeves? Bloomberg Businessweek spoke to Kevin Troutman, a Houston-based lawyer who co-chairs the national healthcare practice of the law firm Fisher Phillips. This interview has been condensed.

Could an employer face some liability if its workers arent vaccinated?

Workers comp laws are the exclusive remedy for illnesses and injuries contracted in the workplace. But employers also have to be concerned about following OSHA guidance, and we expect that OSHA is going to be issuing some COVID-specific standards. They’re going to at least say, I think, make the vaccines available to your employees, and it will be a violation if then you fail to do it. You could be fined and penalized and, you know, OSHA can hand out some substantial fines. So it can be it can be pretty significant.

What should employers do then to encourage employees to take the vaccine?

One thing that is really important is to share reliable objective information with employees, to try to dispel any misunderstandings or misconceptions that are out there. Ideally, the information should come from local healthcare providers — maybe arrange for a doctor in the community to just come out and maybe talk to their employees, answer some questions and help employees to understand the issues better.

If leaders of the organization believe that vaccinations are the right thing to do, and they are out there explaining it, and providing reliable information, and even setting an example and saying, “Hey, I’m getting vaccinated,” I think those things will help get employees more comfortable with taking the vaccine.

What about offering incentives for getting vaccinated?

A lot of employers think, “Well, I’ll just offer some money and, and get people to take the vaccination, and it’s as simple as that.” Unfortunately, it’s not as simple as that. All medical information is supposed to be treated as confidential — you’re not supposed to get that information and then use disability-related information to discriminate against an employee.

The thinking has been that if an incentive is large enough, that might make some employees feel pressured to disclose medical information in order to qualify for the incentive. On January 7, the EEOC issued a proposed rule that you can only offer what they call a “de minimis incentive” — like a water bottle or a gift card of modest value, which we think is around $20 or $25. Those rules were put on hold as part of the transition in administration and then withdrawn, so right now the EEOC stance is in limbo.

Now, a lot of employers are saying, “we’ll pay you for your time to get vaccinated, and maybe allow two hours or something like that.” I think this is a good approach. The employer can say it’s not an incentive. If the EEOC disagreed, the next thing you do is say that’s not enough to be coercive.

What are the risks to requiring your employees to get vaccinated?

Well, if you’re able to work through the people who say they need an accommodation, because of disability or religion, then the risks are you’re going to have 20 to 40 percent of your workforce just very upset, very distracted and not as productive as they would be. Do you want to have to fire them? You probably could legally, but as a practical matter, do you want to fire that many employees?

Is that worse for your company than having 20 or 40 percent of your employees not vaccinated?

I think each company has to decide. It depends a little bit on what you do, and how much interaction do you have with the public. One place it would make a lot of sense to mandate vaccines would be health care, where you’ve got some responsibility for the health and safety not just of yourself and your employees, but of people who are placed in your care. But even in the healthcare industry, I’m not seeing a huge rush to mandate vaccines. They’re making it available. But they’re not mandating it, whereas they have required flu shots.

Have you seen any particular industries that are inclined to mandate vaccinations?

We did a flash survey among clients and people who maintain regular contact with us. We got about 700 responses, and the agricultural and food production industry was at the top of the list among our respondents as to who was expecting to mandate the vaccination. But that was still only about 18 percent of the group.

How might this conversation be different in, say, July or August?

I think the legal issues are going to stay largely the same unless we get more guidance on incentives. From a practical point of view, by mid summer, we should see that a lot more people have been vaccinated. And we’re also going to have more data and more information to tell us more about side effects, and effectiveness of the vaccination. And we may know more about the extent to which being vaccinated prevents a person from transmitting the virus.

All of which will enable us then to improve our messaging to our employees, about why the vaccine makes sense and the risks, or lack of risks, associated with it compared to the benefits. And that’s going to give businesses a better idea of what’s feasible and what they’re going to do.

By: Robb Mandelbaum

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Some Vaccinated Travelers Are Already Getting Covid-19 Booster Shots But Experts Say That May Be Counterproductive

Since January, all travelers must test negative for Covid-19 within 72 hours of entering the U.S. There are many reports in recent months of both vaccinated and unvaccinated travelers testing positive within the last three days of their trip.

This can completely upend re-entry plans because a positive test result means delaying a return to the U.S.. Travelers must get retested until they receive a negative test result and, in the meantime, they must remain in their destination at their own expense, often under quarantine or isolation orders.

To give themselves an extra insurance policy against becoming a breakthrough case, some fully vaccinated American travelers are finagling a third shot of the vaccine a few weeks before leaving on their trip — even though the U.S. Food and Drug Administration (FDA) has yet to give booster shots an official green light. In some cases, they are simply presenting themselves as unvaccinated at pharmacies or other vaccine providers in order to get another dose. Others are getting a booster with the blessing of their doctors.

“People are acting in their own self-interest, and that doesn’t shock me,” said Dr. Kavita Patel, a primary care physician in Washington, D.C., who served as an advisor on health policy in the Obama administration.

“It’s unfortunate, because there remains no evidence that if you’re under 65 years old and otherwise healthy, that you need a third shot right now,” said Dr. Vin Gupta, a pulmonary critical-care physician and an affiliate assistant professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. “There needs to be guardrails here. We need to understand what three doses mean. Are we protected for five years or just another eight months? There are lots of open questions.”

The Biden administration has urged the FDA to release a booster rollout plan as soon as possible, given that some Americans, including first responders and immunocompromised people, received their initial doses in 2020 and officials want the most vulnerable people to be at the front of the line for boosters.

The FDA is currently evaluating when a wider swath of vaccinated Americans should begin receiving Covid-19 booster shots, which is likely to be either six or eight months after completing their initial doses. “The administration recently announced a plan to prepare for additional Covid-19 vaccine doses, or ‘boosters,’ this fall, and a key part of that plan is FDA completing an independent evaluation and determination of the safety and effectiveness of these additional vaccine doses,” said the agency in a statement.

Pending FDA approval, booster doses might begin rolling out to eligible Americans as early as this month, said U.S. Surgeon General Dr. Vivek Murthy on a call yesterday that was hosted by the U.S. Health and Human Services Covid-19 Community Corps.

It’s important for individuals to adhere to the FDA’s recommended timing of a third shot, said Dr. Patel. Just as with any other three-shot vaccine series, the intervals between shots will be gauged to give people robust immunity for a longer period of time.

“That’s actually consistent with what we do with other vaccines. Think of the timing of any pediatric vaccine or the human papillomavirus vaccine,” said Dr. Patel. “What I tell patients is that there’s actually a downside from getting a booster too early. They could be potentially harming themselves six to 12 months down the line. I mean, Covid is not going away.”

While Dr. Patel thinks “it’s inevitable” that everyone will eventually need another shot, “there’s unfortunately a perception that in order to go on a trip and avoid getting sick or avoid potential additional costs, people think that a booster is going to be what they need to do to stay protected. I think a lot of people are just thinking, ‘Well, if two is better than one and three is better than two, at some point, I’ll get four.’ And that’s a very dangerous assumption.”

In other words, instead of rushing to get a third shot before a planned trip, it makes more sense to stick to the optimal timing for a booster shot, then plan future trips accordingly.

Follow me on LinkedIn. Check out my website. Send me a secure tip.

I watch trends in travel. Prior to working at Forbes, I was a longtime freelancer who contributed hundreds of articles to Conde Nast Traveler, CNN Travel, Travel + Leisure, Afar, Reader’s Digest, TripSavvy, Parade, NBCNews.com and scores of other outlets. Follow me on Instagram (@suzannekelleher) and Flipboard (@SRKelleher).

Source: Some Vaccinated Travelers Are Already Getting Covid-19 Booster Shots—But Experts Say That May Be Counterproductive

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Moderna Vaccine Creates Twice as Many Antibodies as Pfizer, Study Shows

Coronavirus: Modern vaccine generated more than double antibodies than Pfizer shot. Moderna Inc.’s Covid vaccine generated more than double the antibodies from a similar shot made by Pfizer Inc. and BioNTech SE in research that directly compared immune responses with inoculations.

A study of nearly 2,500 workers at a major hospital in Belgium found antibody levels among people who had not been infected with coronavirus before receiving two doses of the Moderna vaccine averaged 2,888 units per day. Milliliters, compared to 1,108 units / ml in a similar group that received two shots of the Pfizer shot.

The results, published Monday in a letter to the Journal of the American Medical Association, suggested that the differences could be explained by:

– larger amount of active ingredient in the Moderna vaccine – 100 micrograms versus 30 micrograms in Pfizer-BioNTech. Longer interval between doses of the Moderna vaccine – four weeks versus three weeks for Pfizer-BioNTech

Moderna’s vaccine was associated with a double risk reduction against breakthrough SARS-CoV-2 infections compared to Pfizers in a review of humans in the Mayo Clinic Health System in the United States from January to July. The results were reported in a separate study released prior to publication and peer review on 9 August.

The Moderna COVID‑19 vaccine (pINN: elasomeran), codenamed mRNA-1273 and sold under the brand name Spikevax, is a COVID-19 vaccine developed by Moderna, the United States National Institute of Allergy and Infectious Diseases (NIAID) and the Biomedical Advanced Research and Development Authority (BARDA).

It is authorized for use in people aged twelve years and older in some jurisdictions and for people eighteen years and older in other jurisdictions to provide protection against COVID-19 which is caused by infection by the SARS-CoV-2 virus. It is designed to be administered as two or three 0.5 mL doses given by intramuscular injection at an interval of at least 28 days apart.

It is an RNA vaccine composed of nucleoside-modified mRNA (modRNA) encoding a spike protein of SARS-CoV-2, which is encapsulated in lipid nanoparticles

By:

Source: Covid: Moderna Vaccine Creates Twice as Many Antibodies as Pfizer, Study Shows – Bloomberg

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Can Health Insurance Companies Charge the Unvaccinated Higher Premiums? What About Life Insurers? 5 Questions Answered

Given the average cost of a COVID-19 hospitalization in 2020 ran about US$42,200 per patient, will the unvaccinated be asked to bear more of the cost of treatment, in terms of insurance, as well?

We asked economists Kosali Simon and Sharon Tennyson to explain the rules governing how health and life insurers can discriminate among customers based on vaccination status and other health-related reasons.

1. Can insurers charge the unvaccinated more?

This is a really interesting question and depends on the type of insurance.

Life insurance companies have the freedom to charge different premiums based on risk factors that predict mortality. Purchasing a life insurance policy often entails a health status check or medical exam, and asking for vaccination status is not banned.

Health insurers are a different story. A slew of state and federal regulations in the last three decades have heavily restricted their ability to use health factors in issuing or pricing polices. In 1996, the Health Insurance Portability and Accountability Act began prohibiting the use of health status in any group health insurance policy. And the Affordable Care Act, passed in 2014, prevents insurers from pricing plans according to health – with one exception: smoking status.

2. Are premiums or coverage being affected yet?

Fortune recently reported that while several of the biggest U.S. life insurance companies aren’t yet asking customers for their vaccination status, a few insurers told the magazine they are doing so for people at high risk. It wasn’t clear from the article whether this is affecting premiums.

A recent study comparing life insurance policies from 2014 through February 2021 found that premiums and coverage didn’t change a lot during the pandemic. The study did find some evidence that policy terms for the oldest individuals and those with high-risk health conditions did worsen.

The authors of the study suggested that the rapid development of vaccines may be why life insurance markets haven’t yet shown a dramatic response to COVID-19, but their work does not distinguish the vaccinated from the unvaccinated.

It’s important to note that no matter what, premiums and coverage on existing life insurance plans won’t change, so a death due to COVID-19 will definitely be covered. In general, denial of life insurance claims is rare and occurs only for specific documented reasons.

3. So smokers may pay higher premiums?

In life insurance, smokers definitely pay higher premiums, as do people who are obese.

ValuePenguin, a unit of LendingTree that provides research and analysis, found that smokers typically pay over three times more for life insurance than non-smokers.

The site also found that obesity increases premiums by about 150% – or more if the person also has medical conditions associated with being overweight.

As for health insurance pricing, the Affordable Care Act allows insurers to increase premiums by up to 50% for smokers. The difference between what smokers and non-smokers pay may actually be higher because the former can’t use a key government subsidy to pay for the smoker surcharge.

The ACA makes no similar exception for obesity.

4. How about discounts for the vaccinated?

There is a tool health insurers – including self-insured employers – have to lower premiums to those who are vaccinated: wellness incentives.

Just as insurers and companies offer discounts for things like trying to lose weight or stop smoking, they are also permitted to reduce the health insurance premiums that vaccinated employees pay.

In 2019, the average maximum incentive offered by employers for workers to participate in wellness activities was $783 per year.

Some employers are already incentivizing COVID-19 vaccinations this way. For example, Missouri State University offers a $20-a-month discount on health insurance premiums for employees who got a COVID-19 jab. Others are considering similar discounts.

And so, even though insurers can’t charge the unvaccinated higher premiums, people who refuse to get a shot can end up paying more than their vaccinated colleagues.

5. Do insurers consider other vaccine or flu shots in rates?

To the best of our knowledge, insurers haven’t specifically used vaccination status or getting a flu shot in setting premiums.

As part of having access to your medical records, life insurers might get to know whether you received vaccinations, but there are no systems in place to verify each year whether you got your flu shot. Health insurers can’t ask about vaccine status for the reasons listed above.

Employers can offer incentives to get a flu shot through their wellness programs.

[Like what you’ve read? Want more? Sign up for The Conversation’s daily newsletter.]The Conversation

Kosali Simon, Professor of Health Economics, Indiana University and Sharon Tennyson, Professor of Public Policy and Economics, Cornell University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

By:

Source: Can Health Insurance Companies Charge the Unvaccinated Higher Premiums? What About Life Insurers? 5 Questions Answered – HealthyWomen

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U.S. Set To Recommend Booster Covid-19 Vaccine Dose For Most People, Reports Say

U.S health officials are expected to recommend Covid-19 vaccine booster doses for Americans across all eligible age groups eight months after they received their second vaccine dose, to ensure lasting protection against the coronavirus as the more infectious delta variant spreads across the country partially blunting the efficacy of existing vaccine regimens.

According to the Associated Press, health officials could announce the booster recommendation as soon as this week, just a few days after an additional vaccine dose was recommended for people with weakened immune systems.

The Biden administration could then begin rolling out the third shots as early as mid-to-late September, the New York Times reported, citing unnamed officials.

The first booster shots will likely be administered to nursing home residents, health care workers and elderly Americans who were among the first people in the country to be inoculated.

The Associated Press notes that the formal deployment of the booster doses can only take place after the vaccines have been fully approved by the Food and Drug Administration—an action that is expected for the Pfizer jab in the next few weeks.

The Food and Drug Administration is expected to fully approve the Pfizer vaccine in the coming weeks which will formally open the door for it to be offered as a booster to millions of Americans who have already received two vaccine doses.

Big Number

59.4%. That’s the percentage of the eligible U.S. popuplation (12 years of age and older) that has been fully vaccinated against Covid-19, with 70% receiving at least one dose, according to the CDC’s tracker.

Surprising Fact

An estimated 1.1 million people have already received an unauthorized booster dose of the Moderna or Pfizer vaccine, ABC News reported last week, citing an internal CDC document reviewed by the broadcaster. The number is likely an undercount as it only accounts for people who received a third dose of an mRNA vaccine but does not count those who may have received a dose of the one-shot Johnson & Johnson vaccine and then received a second dose of either the Moderna or Pfizer vaccines.

Key Background

Last week, the U.S. Food and Drug Administration approved a booster dose of the Covid-19 vaccines made by Pfizer and Moderna for people with compromised immune systems. The targeted move was aimed at providing better protection for people who have undergone solid organ transplants or those diagnosed with conditions that are considered to be immunocompromised.

Unlike the eight-month gap being proposed for booster doses for the general population, immunocompromised patients can receive their third dose as early as 28 days after their second shot. The FDA’s decision followed similar moves undertaken by Israel, France and Germany who began administering an additional dose to vulnerable populations amid the threat of the more infectious delta variant of the virus.

Contra

As the more infectious delta variant of the coronavirus takes hold across the U.S. questions about the effectiveness or even the necessity of a booster dose remain unanswered. While some vaccines are slightly less effective against the variant, it is still unclear if protection against more severe disease and hospitalizations have been impacted significantly as well.

This makes any decision to authorize booster doses remains a controversial one in the global context as critics decry the fact that developed nations are administering an additional dose at a time when several poorer nations have limited access to vaccines. Earlier this month, the World Health Organization (WHO) called for a moratorium on Covid-19 vaccine booster shots until at least the end of September.

Further Reading

U.S. to Advise Boosters for Most Americans 8 Months After Vaccination (New York Times)

US to recommend COVID vaccine boosters at 8 months (Associated Press)

More Than 1 Million Have Received Unauthorized Third Dose (WebMD)

FDA Authorizes Extra Covid-19 Vaccine Dose For Those With Weakened Immune Systems (Forbes)

How Good Are Covid-19 Vaccines At Protecting Against The Delta Variant? (Forbes)

I am a Breaking News Reporter at Forbes, with a focus on covering important tech policy and business news. Graduated from Columbia University with an MA in Business and Economics Journalism in 2019. Worked as a journalist in New Delhi, India from 2014 to 2018. Have a news tip? DMs are open on Twitter @SiladityaRay or drop me an email at siladitya@protonmail.com.

Source: U.S. Set To Recommend Booster Covid-19 Vaccine Dose For Most People, Reports Say

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Covid Clusters Among The Vaccinated Point To Rise of Delta

They were gold miners in French Guiana, revelers in Cape Cod, and Indian health-care workers. Even though they inhabit worlds apart, they ended up having two things in common. All were vaccinated against covid-19. And they all became part of infection clusters.

In recent weeks, cases like these are proving that covid-19 transmission chains and superspreading events can occur even in groups where nearly everyone is vaccinated, setting off alarms among health officials and torpedoing hopes of a quick return to business as usual in the US.

In May 2021, the CDC had told vaccinated Americans they could safety go unmasked, but on Tuesday the agency reversed course, saying vaccinated people should wear masks in indoor public settings.

The reason was what investigators learned from an outbreak in Provincetown, Massachusetts, a seaside town on Cape Cod, which in early July hosted a rowdy parade and crowded weeks of pool parties. Since then, Massachusetts health investigators say, there have been more than 500 cases of covid-19 linked to those events in state residents, 73% of which are in people who were vaccinated. Including people from other states, the infection cluster involves over 900 people.

The Provincetown outbreak was caused by the so-called delta variant, which now accounts for most cases in the US.  In a statement released today, Rochelle Walensky, head of the CDC, said the “pivotal discovery” was that vaccinated people infected with delta in Provincetown appear to have just as much virus in their systems as those who are unvaccinated.

“High viral loads suggest an increased risk of transmission and raised concern that, unlike with other variants, vaccinated people infected with delta can transmit the virus,” she said.

The recommendation suggests a rapid return to a layered approach of countermeasures, including masks and social distancing, which could also complicate school reopenings starting next month in the US.

Infection at a gold mine

Investigations around the world have been building evidence of outbreaks among the vaccinated for weeks. For instance, a scientific team in Paris and French Guiana recently described how covid-19 tore through a South American gold mine in May, even though nearly all the miners had received Pfizer’s vaccine.

Despite being inoculated, 60% became infected by a variant called gamma. That surprised the scientists so much that they checked to see if the vaccines had been damaged in shipping, but they weren’t.

The initial studies of Pfizer’s vaccine, the mostly widely used in the US, showed it was more than 90% effective in preventing symptomatic disease. But that’s not what was seen in the gold miners; half ended up with symptoms like a fever. The vaccines may still have helped, though. None of the miners became seriously ill, even though most were older than 50 and some had risk factors like high blood pressure and diabetes.

More evidence comes from India, where health-care workers were eligible for the AstraZeneca vaccine starting in early 2021. But when a team from the UK and India looked at covid-19 cases in these workers, they found “significant numbers of vaccine breakthrough infections” at three Delhi hospitals, including a superspreading event that infected 30 people.

The breakthrough infections were much more likely to be caused by the delta variant, they say, than any of the older strains. The older variants were never able to cause a cluster of more than two linked cases among the health-care workers. But the researchers found 10 delta outbreaks that did so.

The reason the delta variant is different is that it transmits more easily; one reason is that the strain may be “evading” prior immunity, say researchers. That could help explain outbreaks among vaccinated people, and it also means that if you’ve already had covid-19, you could more easily get it again. The UK-India team estimated that natural protection against infection dropped by as much as half when people were exposed to delta.

Covid on Cape Cod

In the US, the Provincetown outbreak may have taken hold during the July 4 “Independence Week,” when the town hosts thousands of visitors. As July wore on, investigators learned of hundreds of covid-19 cases, and sequencing labs in Boston determined they were caused by delta.

The Provincetown outbreak set off alarm bells at the CDC because vaccines didn’t seem to prevent the virus from spreading person to person, even though most were vaccinated, according to the Washington Post, which obtained an internal CDC presentation that described delta as being as contagious as chicken pox.

Another key clue came from PCR tests run on about 200 people in the Provincetown cluster. Researchers found that the amount of virus in someone’s airway—and hence what the person might launch into the word with every cough and sneeze—was roughly the same, no matter whether people were vaccinated or not.

That doesn’t prove that vaccinated people transmit just as much, says Monica Gandhi, an infectious disease researcher at the University of California, San Francisco. She says that PCR tests detect virus fragments as well as live germs, so vaccinated people might be shedding less live virus or be infectious for less time. Gandhi adds that even with variants circulating, vaccines are still effective so far at preventing most major illness.

Nevertheless, “we are seeing more mild, symptomatic cases,” she says, as well as transmission among the vaccinated.

For the CDC, the new information posed a difficult communication problem: how to tell everyone the vaccine party might be over. In May, it had said that fully vaccinated Americans could dispense with masks and social distancing in most circumstances.

But by July 25, local officials in Provincetown had reintroduced an indoor mask mandate for the town, covering indoor restaurants, offices, bars, and dance floors, and said they would begin testing wastewater. Two days later, the CDC followed suit, recommending that in high-transmission areas everyone wear a mask in indoor public settings.

Because of the delta variant, much of the US may soon qualify as being a high-risk area. Since a low in June, covid-19 cases have risen more than sixfold.

Source: Covid clusters among the vaccinated point to rise of delta | MIT Technology Review

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Why Vaccinated People Are Getting ‘Breakthrough’ Infections

A wedding in Oklahoma leads to 15 vaccinated guests becoming infected with the coronavirus. Raucous Fourth of July celebrations disperse the virus from Provincetown, Mass., to dozens of places across the country, sometimes carried by fully vaccinated celebrants.

As the Delta variant surges across the nation, reports of infections in vaccinated people have become increasingly frequent — including, most recently, among at least six Texas Democrats, a White House aide and an aide to Speaker Nancy Pelosi.

The highly contagious variant, combined with a lagging vaccination campaign and the near absence of preventive restrictions, is fueling a rapid rise in cases in all states, and hospitalizations in nearly all of them. It now accounts for about 83 percent of infections diagnosed in the United States.

But as worrying as the trend may seem, breakthrough infections — those occurring in vaccinated people — are still relatively uncommon, experts said, and those that cause serious illness, hospitalization or death even more so. More than 97 percent of people hospitalized for Covid-19 are unvaccinated.

“The takeaway message remains, if you’re vaccinated, you are protected,” said Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center in New York. “You are not going to end up with severe disease, hospitalization or death.”

Reports of breakthrough infections should not be taken to mean that the vaccines do not work, Dr. Anthony S. Fauci, the Biden administration’s top pandemic adviser, said on Thursday at a news briefing.

“By no means does that mean that you’re dealing with an unsuccessful vaccine,” he said. “The success of the vaccine is based on the prevention of illness.”

Still, vaccinated people can come down with infections, overwhelmingly asymptomatic or mild. That may come as a surprise to many vaccinated Americans, who often assume that they are completely shielded from the virus. And breakthrough infections raise the possibility, as yet unresolved, that vaccinated people may spread the virus to others.

Given the upwelling of virus across much of the country, some scientists say it is time for vaccinated people to consider wearing masks indoors and in crowded spaces like shopping malls or concert halls — a recommendation that goes beyond current guidelines from the Centers for Disease Control and Prevention, which recommends masking only for unvaccinated people.

The agency does not plan to change its guidelines unless there is a significant change in the science, said a federal official speaking on condition of anonymity because he was not authorized to speak on the matter.

The agency’s guidance already gives local leaders latitude to adjust their policies based on rates of transmission in their communities, he added. Citing the rise of the Delta variant, health officials in several California jurisdictions are already urging a return to indoor masking; Los Angeles County is requiring it.

“Seatbelts reduce risk, but we still need to drive carefully,” said Dr. Scott Dryden-Peterson, an infectious disease physician and epidemiologist at Brigham & Women’s Hospital in Boston. “We’re still trying to figure out what is ‘drive carefully’ in the Delta era, and what we should be doing.”

The uncertainty about Delta results in part from how it differs from previous versions of the coronavirus. Although its mode of transmission is the same — it is inhaled, usually in indoor spaces — Delta is thought to be about twice as contagious as the original virus.

Significantly, early evidence also suggests that people infected with the Delta variant may carry roughly a thousandfold more virus than those infected with the original virus. While that does not seem to mean that they get sicker, it does probably mean that they are more contagious and for longer.

Dose also matters: A vaccinated person exposed to a low dose of the coronavirus may never become infected, or not noticeably so. A vaccinated person exposed to extremely high viral loads of the Delta variant is more likely to find his or her immune defenses overwhelmed.

The problem grows worse as community transmission rates rise, because exposures in dose and number will increase. Vaccination rates in the country have stalled, with less than half of Americans fully immunized, giving the virus plenty of room to spread.

Unvaccinated people “are not, for the most part, taking precautions, and that’s what’s driving it for everybody,” said Dr. Eric J. Rubin, the editor in chief of the New England Journal of Medicine. “We’re all susceptible to whatever anyone’s behavior is in this epidemic.”

Dr. Gounder likened the amount of protection offered by the vaccines to a golf umbrella that keeps people dry in a rainstorm. “But if you’re out in a hurricane, you’re still going to get wet,” she said. “That’s kind of the situation that the Delta variant has created, where there’s still a lot of community spread.”

For the average vaccinated person, a breakthrough infection is likely to be inconsequential, causing few to no symptoms. But there is concern among scientists that a few vaccinated people who become infected may go on to develop long Covid, a poorly understood constellation of symptoms that persists after the active infection is resolved.

Much has been made of Delta’s ability to sidestep immune defenses. In fact, all of the existing vaccines seem able to prevent serious illness and death from the variant. In laboratory studies, Delta actually has proved to be a milder threat than Beta, the variant first identified in South Africa.

Whether a vaccinated person ever becomes infected may depend on how high antibodies spiked after vaccination, how potent those antibodies are against the variant, and whether the level of antibodies in the person’s blood has waned since immunization.

In any case, immune defenses primed by the vaccines should recognize the virus soon after infection and destroy it before significant damage occurs.

“That is what explains why people do get infected and why people don’t get seriously ill,” said Michel C. Nussenzweig, an immunologist at Rockefeller University in New York. “It’s nearly unavoidable, unless you’re going to give people very frequent boosters.”

There is limited evidence beyond anecdotal reports to indicate whether breakthrough infections with the Delta variant are more common or more likely to fan out to other people. The C.D.C. has recorded about 5,500 hospitalizations and deaths in vaccinated people, but it is not tracking milder breakthrough infections.

Additional data is emerging from the Covid-19 Sports and Society Workgroup, a coalition of professional sports leagues that is working closely with the C.D.C. Sports teams in the group are testing more than 10,000 people at least daily and sequencing all infections, according to Dr. Robby Sikka, a physician who worked with the N.B.A.’s Minnesota Timberwolves.

Breakthrough infections in the leagues seem to be more common with the Delta variant than with Alpha, the variant first identified in Britain, he said. As would be predicted, the vaccines cut down the severity and duration of illness significantly, with players returning less than two weeks after becoming infected, compared with nearly three weeks earlier in the pandemic.

But while they are infected, the players carry very high amounts of virus for seven to 10 days, compared with two or three days in those infected with Alpha, Dr. Sikka said. Infected players are required to quarantine, so the project has not been able to track whether they spread the virus to others — but it’s likely that they would, he added.

“If they’re put just willy-nilly back into society, I think you’re going to have spread from vaccinated individuals,” he added. “They don’t even recognize they have Covid because they think they’re vaccinated.”

Elyse Freitas was shocked to discover that 15 vaccinated people became infected at her wedding. Dr. Freitas, 34, a biologist at the University of Oklahoma, said she had been very cautious throughout the pandemic, and had already postponed her wedding once. But after much deliberation, she celebrated the wedding indoors on July 10.

Based on the symptoms, Dr. Freitas believes that the initial infection was at a bachelorette party two days before the wedding, when a dozen vaccinated people went unmasked to bars in downtown Oklahoma City; seven of them later tested positive. Eventually, 17 guests at the wedding became infected, nearly all with mild symptoms.

“In hindsight, I should have paid more attention to the vaccination rates in Oklahoma and the emergence of the Delta variant and adjusted my plans accordingly,” she said.

An outbreak in Provincetown, Mass., illustrates how quickly a cluster can grow, given the right conditions. During its famed Fourth of July celebrations, the small town hosted more than 60,000 unmasked revelers, dancing and mingling in crowded bars and house parties.

The crowds this year were much larger than usual, said Adam Hunt, 55, an advertising executive who has lived in Provincetown part time for about 20 years. But the bars and clubs didn’t open until they were allowed to, Mr. Hunt noted: “We thought we were doing the right thing. We thought we were OK.”

Mr. Hunt did not become infected with the virus, but several of his vaccinated friends who had flown in from places as far as Hawaii and Alabama tested positive after their return. In all, the cluster has grown to at least 256 cases — including 66 visitors from other states — about two-thirds in vaccinated people.

“I did not expect that people who were vaccinated would be becoming positive at the rate that they were,” said Steve Katsurinis, chair of the Provincetown Board of Health. Provincetown has moved swiftly to contain the outbreak, reinstating a mask advisory and stepping up testing. It is conducting 250 tests a day, compared with about eight a day before July 1, Mr. Katsurinis said.

Health officials should also help the public understand that vaccines are doing what they are supposed to — preventing people from getting seriously ill, said Kristen Panthagani, a geneticist at Baylor College of Medicine who runs a blog explaining complex scientific concepts.

“Vaccine efficacy isn’t 100 percent — it never is,” she said. “We shouldn’t expect Covid vaccines to be perfect, either. That’s too high an expectation.”

By:

Source: Why Vaccinated People Are Getting ‘Breakthrough’ Infections – The New York Times

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The Lambda Coronavirus Variant Has Arrived In Australia Here’s What We Know So Far

We’ve seen the Alpha, Kappa and Delta variants cross our borders, but it turns out another strain of the virus that causes COVID-19 has reached our shores.

The variant, named Lambda by the World Health Organization (WHO) last month, was detected in an overseas traveller who was in hotel quarantine in New South Wales in April, according to national genomics database AusTrakka.

Some reports suggest the new variant could be fast spreading and difficult to tackle with vaccines. So what sets this variant apart from others and should we be concerned?

Here’s what we know so far.

Where did it originate?

Previously known as C.37, Lambda was first detected in Peru in December 2020. Since then, it’s spread to 29 countries, seven of which are in South America.

In April and May this year, Lambda accounted for over 80 per cent of COVID-19 cases in Peru, with a high proportion of cases also in Chile, Argentina, and Ecuador.

On 14 June, Lambda was listed as a ‘variant of interest’ by the World Health Organization due to its vast spread in South America.

Variants of interest are listed as such because they have the potential to be more infectious and severe, but haven’t yet had the devastating impact of those listed as variants of concern.

On 23 June, Public Health England classified it as a ‘variant under investigation’, after six cases were detected in the UK to date, which were all linked to overseas travel.

What makes it different from other variants?

There are now 11 official SARS-CoV-2 variants listed by the WHO.

All SARS-CoV-2 variants are distinguished from one another by mutations in their spike proteins — the components of the virus that allow it to invade human cells.

For instance, the Delta variant first detected in India has two key spike protein mutations — T478K and L452R  — that allow it to infect cells more easily and evade the body’s immune response.

According to research published last week but yet to be peer reviewed,  Lambda has seven unique spike protein mutations.

A Chilean team of scientists analysed blood samples from health workers in Santiago who had received two doses of the CoronaVac vaccine developed by Sinovac Biotech in China.

They found  the Lambda variant has a mutation called L452Q, which is similar to the L452R mutation seen in the Delta and Epsilon variants.

As the L452R mutation is thought to make Delta and Epsilon more infectious and resilient against vaccination, the team concluded that Lambda’s L452Q mutation might also help it spread far and wide.

While it’s possible that Lambda is indeed more infectious than other variants, it’s too early to know for sure, said Kirsty Short, a virologist at the University of Queensland.

“It’s very preliminary,” said Dr Short, who was not involved in the study.

“It’s a good starting point, but I certainly wouldn’t infer anything from that into the clinic.”

Are vaccines still effective against the Lambda variant?

The study also found signs that Lambda’s unique spike mutations could help it slip past the body’s immune response.

The results of the study suggested that the CoronaVac vaccine produces fewer neutralising antibodies — proteins that defend cells against infections — in response to the Lambda variant.

But according to Paul Griffin, who specialises in infectious diseases and vaccines at the University of Queensland, it’s important to remember that these antibodies are just one aspect of immunity.

“We know that [neutralizing antibodies] only tell a part of the story,” said Dr Griffin, who was not involved in the study.

“If that further immunity remains intact, then even with a reduction in neutralizing antibodies, sometimes that protection can still be enough.”

It’s also worth remembering that different vaccines work in different ways to respond to the virus and its variants.

“You can’t really extrapolate from one vaccine,” Dr Short said.

CoronaVac uses inactive versions of SARS-CoV-2 to kick the immune system into gear.

On the other hand, Pfizer contains a single strand of the genetic code that builds the virus’s spike proteins, while AstraZeneca contains a double-strand.

Dr Griffin said that more traditional inactivated vaccines like CoronaVac have proven to be less effective overall than others.

“As a broad category, the inactivated ones have been a little bit underwhelming, particularly compared to others that have such high rates of efficacy,” said Dr Griffin, who was not involved in the study.

While not much is known about how effective the Pfizer and AstraZeneca vaccines are against Lambda, their response to the Delta variant can offer clues.

A recent study from the UK found that two doses of either Pfizer or AstraZeneca are over 90 per cent effective at preventing hospitalisation due to the Delta variant.

Should Australia be worried?

While there has only been one case of Lambda recorded in hotel quarantine in Australia so far, it’s worth keeping an eye on the emergence and spread of SARS-CoV-2 variants around the world, Dr Short said.

“There’s a reason why it’s a variant that we’re watching and looking into more, but it’s certainly not at a point of panic or anything like that.”

Dr Griffin added that Lambda would need to out-compete Delta to become a major concern. “That’s certainly not what we’re seeing,” he said.  But as more people get infected, the more chance the virus has to evolve into new variants, Dr Short said.

The best way to tackle this is to focus on getting more people vaccinated, not just in Australia, but globally. “What this should emphasise to everyone is that we need global effort in the vaccination campaign,” Dr Short said.

 By: ABC Health & Wellbeing Gemma Conroy

Source: The Lambda coronavirus variant has arrived in Australia. Here’s what we know so far – ABC News

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The COVID-19 Symptoms Doctors Are Seeing The Most Right Now

More than a year into the coronavirus pandemic, experts have unraveled so many mysteries about how to treat the virus and prevent it. But at the same time, SARS-CoV-2 is always changing as new variants emerge. And accordingly, the ways in which the virus affects people seem to be shifting as well.

Here’s a quick rundown of some of the most common COVID-19 symptoms doctors are seeing right now, and how vaccines and variants fit into this picture.

The most common symptoms — such as cough, fever, and loss of taste and smell — are all still pretty much the same.

Since the COVID-19 pandemic began, the most common symptoms of the virus included a cough (often dry), shortness of breath, a fever of 100 degrees or higher, and the sudden loss of taste and smell.

Those, however, are by no means the only frequent symptoms. People also report everything from headaches to diarrhea, all of which are listed on the Centers for Disease Control and Prevention’s rundown of common possible symptoms.

For the most part, that list of the most common symptoms hasn’t really changed. “The symptoms are really the same as before. It’s the headache, cough, fatigue, runny nose, fever — those kind of generalized flu-like symptoms,” said Jonathan Leizman, chief medical officer of Premise Health, a health care company headquartered in Tennessee.

The emergency warning signs of COVID-19 have also stayed pretty much the same. Those include issues like trouble breathing, persistent chest pain or pressure, and new mental confusion.

With the delta variant, some people’s symptoms might look more like a common cold.

The delta variant (B.1.617.2) is circulating widely around the globe and is now the main strain here in the United States; it’s hitting areas with high numbers of unvaccinated Americans particularly hard.

There is some initial evidence that the symptoms associated with delta might be a bit different than those with the original SARS-CoV-2 virus, though experts caution that it remains too early to say definitively.

“The information we’re getting from the U.K. and Europe and some initial surveys here in the United States is that the delta virus infection seems to be more likely to produce symptoms that are more typical of a common cold,” said William Powderly, co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis, which has recently seen a big uptick in COVID-19 cases and hospitalizations. “That’s a sore throat, mild cough and nasal congestion.”

“The symptoms we were seeing earlier on, which were much more like lower respiratory and fever, are less common,” Powderly added. “That isn’t to say they don’t happen. But there does seem to be a shift in the frequency and type of symptoms being reported.”

Experts don’t yet understand why the symptoms might be slightly different. It could be simply that there are now more infections in younger people, Powderly said. At the same time, researchers are exploring how variants classified as “of concern” and “of interest” — including delta but also lambda and others — might be different in terms of their ability to be transmitted or to make people more or less sick.

The newer coronavirus variants could be making people sicker.

While some people infected with the delta variant have symptoms that are in line with a common cold, there is also preliminary evidence suggesting that other people’s symptoms may be “more intensely felt” with delta, Leizman said.

“We have seen that hospitalization rates are seemingly increased in younger populations with the delta variant,” he offered as an example.

But at this point, there’s no scientific consensus on whether the delta variant is likely to make people sicker than the initial strain, simply because it (and other variants) are so new. The best we have at this point are one-off studies, surveys or even just anecdotal information from the field.

“There’s now data coming out of England and Scotland showing that the severity of the disease may be increased, and it may be leading to an increased risk of hospitalization,” said Carlos Malvestutto, an infectious disease specialist at Ohio State University’s Wexner Medical Center.

“People who are not vaccinated are particularly vulnerable because the new variants — and particularly the delta variant — transmits faster and may be causing more severe disease,” Malvestutto added.

Symptoms tend to be mild in those who are fully vaccinated.

While the vast majority of new cases and hospitalizations occur in those who have not been vaccinated against COVID-19 (around 99% of new infections in some parts of the country), so-called “breakthrough cases” do occur among those who’ve received both shots of either of the Pfizer-BioNTech or Moderna vaccines or the Johnson & Johnson single-dose vaccine.

But the symptoms people experience in those instances tend to be relatively mild, according to the data that’s available at this point. About a third of people who got infected after being fully vaccinated were totally asymptomatic, for example.

The CDC now only tracks breakthrough cases that result in hospitalization or death, so there’s just not really robust data looking at how many people experience milder symptoms post-vaccine (or no symptoms at all), nor is there clarity about what variant those people may have caught. Still, there have been high-profile breakthrough infections in the news, like the New York Yankees cluster or entertainment reporter Catt Sadler, who recently said she had contracted COVID-19 after vaccination.

Ultimately, however, the goal of vaccination is not only to reduce transmission but to also drastically reduce hospitalizations and deaths — and the vaccines have done just that.

“The vast majority of individuals who are fully vaccinated do not have those severe consequences of disease, which makes us think the symptoms might be more mild in general for individuals who are fully vaccinated,” Leizman said.

Breakthrough cases also remain rare. As of mid-July, the CDC said that more than 157 million people in the United States had been fully vaccinated. There have been about 5,000 patients with COVID-19 vaccine breakthrough infections who were hospitalized or who died — though not all of those cases were directly attributed to COVID-19.

Which is why health experts are adamant that getting vaccinated is the best thing people can do to keep themselves and others safe — and to avoid developing any kind of symptoms at all.

“I’m in a state where we’re seeing a significant uptick in hospitalized patients … and they’re all people who have not been vaccinated, which is really hard and devastating, because these are completely preventable,” Powderly said.

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.

Source: The COVID-19 Symptoms Doctors Are Seeing The Most Right Now | HuffPost UK Wellness

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References :

The Delta SARS-CoV-2 variant first appeared in India in October 2020. This is the fastest-growing variant and is currently outpacing all other variants. This variant contains the “eek” mutation in the Spike protein, which helps the virus evade certain antibodies.  As a result, the Delta variant has shown significantly increased transmission.

This variant is responsible for the dramatic increase in COVID-19 cases in India over the past several months. Additionally, this variant has been identified in over 98 countries across the world as of July 2, 2021. Both the Pfizer/BioNTech (88%) and the AstraZeneca/Vaxzevria (67%) vaccine demonstrated protection was retained against severe disease caused by the Delta variant. Data is still limited relating to vaccine efficacy and the delta variant.

  1. Global Initiative on Sharing All Influenza Data (GISAID)
  2. Network for Genomics Surveillance in South Africa 
  3. Journal- Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021
  4. Journal- Effectiveness of COVID-19 vaccines against hospital admission with the Delta (B.1.617.2) variant
  5. Sheikh A, McMenamin J, Taylor B, Robertson C. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. 

 

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