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NEW YORK — An influential scientific panel on Tuesday voted to recommend to the CDC that when a COVID-19 vaccine becomes available, both front line health care workers and residents in long-term care facilities should be prioritized first. The Advisory Committee on Immunization Practices voted 14-1 in favor of adopting the following recommendation: When a COVID-19 vaccine is authorized by FDA and recommended by ACIP, vaccination in the initial phase of the COVID-19 vaccination program (Phase 1a) should be offered to both 1) health care personnel and 2) residents of long-term care facilities.Watch the meeting live here."About one (American) dies every minute from COVID-19. During this ACIP meeting, about 120 people will die," Dr. Beth Bell said during initial remarks at the beginning of the virtual meeting Tuesday.The ACIP met Tuesday afternoon in an open-to-the-public, virtual meeting to vote on the proposal that gives priority to health care workers and patients in nursing homes and other long-term care facilities. The two groups together represent around 23 million Americans out of a population of about 330 million; about 21 million in health care professions and less than 3 million adults living in long-term care facilities.Current estimates project around 40 million doses combined available by the end of 2020. And each vaccine product requires two doses.The CDC said Tuesday they expect 5-to-10 million doses available each week after a vaccine is authorized by the FDA. They say these numbers necessitate the need for sub-group prioritizing, since not all health care workers or long-term care facilities can be vaccinated at once. Another consideration the panel discussed is not having an entire unit or group get vaccinated at once; if there are side effects like fatigue or other symptoms that necessitates taking a day or two off, this could leave a unit critically short-staffed. During Tuesday's presentation, Dr. Kathleen Dooling talked about statistics from COVID-19 patients in the US and how it lead to health care workers and long-term facility staff and patients to be at the top of the vaccine list. Long-term care facilities are responsible for six percent of COVID-19 cases and 40 percent of COVID-19 deaths in this country, she said. Later this month, the Food and Drug Administration will consider approval of two vaccines made by Pfizer and Moderna. The panel meeting Tuesday said they hope to learn more about the safety and effectiveness of the vaccines as more information is released by the FDA.Dr. Dooling said one of the questions they hope to ask about the Phase 3 trial data of both Pfizer and Moderna is how effective one dose of the vaccine has shown to be. They will also be taking a deeper look at the age groups of those included in the trial, and the efficacy of the vaccines on older people. Some of the comments during the public comment section referenced the lack of transparency released at this time about the vaccines and the panel trying to make vaccination decisions without it. However, the panel, while voting, expressed faith in the FDA's process of approving the vaccine as safe for all Americans. Once vaccines are given, the CDC and FDA will be asking all health care providers and facilities to use the existing Vaccine Adverse Event Reporting System, VAERS, to monitor any side effects and adverse reactions to the COVID-19 vaccines. The advisory panel will meet again at some point to decide who should be next in line. Among the possibilities: teachers, police, firefighters and workers in other essential fields such as food production and transportation; the elderly; and people with underlying medical conditions.Experts say the vaccine will probably not become widely available in the U.S. until the spring.ACIP is a 15-member panel of outside scientific experts, created in 1964, that makes recommendations to the director of the Centers for Disease Control and Prevention, who almost always approves them. Childhood vaccine schedules are one example of the work of this group. The recommendations are not binding, but for decades they have been widely heeded by doctors, and they have determined the scope and funding of U.S. vaccination programs.It will be up to state authorities whether to follow the guidance. It will also be left to them to make further, more detailed decisions if necessary — for example, whether to put emergency room doctors and nurses ahead of other health care workers if vaccine supplies are low. 4517

NOGALES, Mexico — Eighteen-year-old Joshua escaped violence in Guatemala with his father two months ago and has ended up just steps away from the U.S.-Mexico border.Saying that gangs control almost all of Guatemala, he says they will likely request asylum in the United States.The Kino Border Initiative, headquartered in Nogales, Arizona, helps provide for those fleeing danger who end up like Joshua: far from home and uncertain about the future."A lot of people are fleeing violence in the northern part of Central America and parts of southern Mexico," said Fr. Sean Carroll. "That reality is not changing."Immigration figures show that before 2013, only one in 100 asylum seekers was able to convince authorities they faced a credible fear of violence in their home country, a crucial step toward qualifying for asylum.Now, one out of every ten applicants is able to meet that standard.The asylum process has been under intense political scrutiny as thousands of people have organized into large groups and moved to seek a better life in the United States.The caravans have drawn increasing criticism from President Trump and others in the White House, who have looked for ways to thwart the migrants' ability to enter the U.S. or request asylum.For Joshua, he says he has one request for immigration officials: do him the favor of saving his life. 1386

North Dakota Senator Heidi Heitkamp is facing the very real possibility that she may have to say good bye to the seat she's held for the past six years.Heitkamp is a moderate Democrat, who touts her ability to make tough choices and not always voting based on politics. One of the hardest moments for her was voting "no" to Supreme Court nominee Brett Kavanaugh."I think that a lot of people wrote the political obituary after that vote, and it may in fact be that," says Heitkamp.Voting against Trump was also a risky move, in a state that voted for the president by a 36-point margin.When asked if that factored into her decision at all, Heitkamp replied, “No, because when you’re making this decision, especially on a Supreme Court justice, there’s no do-overs.”In recent polls, Heitkamp trailed her opponent, Congressman Kevin Cramer, by double digits.Having someone always stand with Trump seems to be what some voters in North Dakota are looking for.“She voted ‘no’ on Kavanaugh; that was a big deal to me,” says one voter.But there were plenty who would say the opposite.“I really admired her for doing what was right in her heart, rather than what she was pressured to do,” says another voter. “So, I admire her independence on that.”Heitkamp hopes that come Tuesday she'll beat the odds and be elected to serve another term. 1346

NEW YORK (AP) — The one-time bookselling giant Barnes & Noble is being acquired by a hedge fund for 6 million.The national chain that many blamed for the demise of independent bookstores has been ravaged by Amazon.com and other online sellers. Independent bookstores have also persisted in the face of digital publishing.The company said in October that it might put itself up for sale after it was approached by a number of potential buyers, including founder Leonard Riggio who opened Barnes & Noble stores across the country and turned it into a superstore.Barnes & Noble said Friday that it's being acquired by Elliott Management for .50 per share, an approximately 9% percent premium to the company's Thursday closing stock price. Elliott bought the U.K. bookseller Waterstones in June 2018.Waterstones CEO James Daunt will also take on the role of CEO at Barnes & Noble.The sale, valued at about 3 million including debt, is targeted to close in the third quarter if approved by regulators and shareholders.Shares of the New York company jumped 11% before the opening bell. 1111

NORMAL HEIGHTS, Calif. (KGTV) - A local photographer, known for her poignant pictures of pets, says she’s no longer able to work after being hit by a car on Sunday.Tamandra Michaels said she was crossing El Cajon Boulevard in North Park in a marked crosswalk when she was hit from behind by a car making a left-hand turn.“Just T-boned completely,” she said. “My wheel took a good hit, instead of my body. Then I slammed into the ground.”MAP: Track crime happening in your neighborhoodHer service dog, Justice, was on the other side of her and made it away uninjured.Michaels said she didn’t break any bones, but along with scrapes and bruises, she has a lingering pain in her left shoulder.That has compounded problems from previous shoulder and arm injuries and has made it nearly impossible for her to lift herself into her car, which has been modified for her to drive without foot pedals but does not have a ramp or lift.She has been trying to raise funds to buy a van with a wheelchair lift for more than a year, but the need has become more urgent.“I have to,” she said of buying a van, “if I want to keep my independence.”Her GoFundMe page can be found here. 1178