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Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr. Francis Collins, director of the National Institutes of Health, recently told one of the advisory groups the government asked to help decide. “There will be many people who feel that they should have been at the top of the list.”Traditionally, first in line for a scarce vaccine are health workers and the people most vulnerable to the targeted infection.But Collins tossed new ideas into the mix: Consider geography and give priority to people where an outbreak is hitting hardest.And don’t forget volunteers in the final stage of vaccine testing who get dummy shots, the comparison group needed to tell if the real shots truly work.“We owe them ... some special priority,” Collins said.Huge studies this summer aim to prove which of several experimental COVID-19 vaccines are safe and effective. Moderna Inc. and Pfizer Inc. began tests last week that eventually will include 30,000 volunteers each; in the next few months, equally large calls for volunteers will go out to test shots made by AstraZeneca, Johnson & Johnson and Novavax. And some vaccines made in China are in smaller late-stage studies in other countries.For all the promises of the U.S. stockpiling millions of doses, the hard truth: Even if a vaccine is declared safe and effective by year’s end, there won’t be enough for everyone who wants it right away -- especially as most potential vaccines require two doses.It’s a global dilemma. The World Health Organization is grappling with the same who-goes-first question as it tries to ensure vaccines are fairly distributed to poor countries -- decisions made even harder as wealthy nations corner the market for the first doses.In the U.S., the Advisory Committee on Immunization Practices, a group established by the Centers for Disease Control and Prevention, is supposed to recommend who to vaccinate and when -- advice that the government almost always follows.But a COVID-19 vaccine decision is so tricky that this time around, ethicists and vaccine experts from the National Academy of Medicine, chartered by Congress to advise the government, are being asked to weigh in, too.Setting priorities will require “creative, moral common sense,” said Bill Foege, who devised the vaccination strategy that led to global eradication of smallpox. Foege is co-leading the academy’s deliberations, calling it “both this opportunity and this burden.”With vaccine misinformation abounding and fears that politics might intrude, CDC Director Robert Redfield said the public must see vaccine allocation as “equitable, fair and transparent.”How to decide? The CDC’s opening suggestion: First vaccinate 12 million of the most critical health, national security and other essential workers. Next would be 110 million people at high risk from the coronavirus -- those over 65 who live in long-term care facilities, or those of any age who are in poor health -- or who also are deemed essential workers. The general population would come later.CDC’s vaccine advisers wanted to know who’s really essential. “I wouldn’t consider myself a critical health care worker,” admitted Dr. Peter Szilagyi, a pediatrician at the University of California, Los Angeles.Indeed, the risks for health workers today are far different than in the pandemic’s early days. Now, health workers in COVID-19 treatment units often are the best protected; others may be more at risk, committee members noted.Beyond the health and security fields, does “essential” mean poultry plant workers or schoolteachers? And what if the vaccine doesn’t work as well among vulnerable populations as among younger, healthier people? It’s a real worry, given that older people’s immune systems don’t rev up as well to flu vaccine.With Black, Latino and Native American populations disproportionately hit by the coronavirus, failing to address that diversity means “whatever comes out of our group will be looked at very suspiciously,” said ACIP chairman Dr. Jose Romero, Arkansas’ interim health secretary.Consider the urban poor who live in crowded conditions, have less access to health care and can’t work from home like more privileged Americans, added Dr. Sharon Frey of St. Louis University.And it may be worth vaccinating entire families rather than trying to single out just one high-risk person in a household, said Dr. Henry Bernstein of Northwell Health.Whoever gets to go first, a mass vaccination campaign while people are supposed to be keeping their distance is a tall order. During the 2009 swine flu pandemic, families waited in long lines in parking lots and at health departments when their turn came up, crowding that authorities know they must avoid this time around.Operation Warp Speed, the Trump administration’s effort to speed vaccine manufacturing and distribution, is working out how to rapidly transport the right number of doses to wherever vaccinations are set to occur.Drive-through vaccinations, pop-up clinics and other innovative ideas are all on the table, said CDC’s Dr. Nancy Messonnier.As soon as a vaccine is declared effective, “we want to be able the next day, frankly, to start these programs,” Messonnier said. “It’s a long road.”___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 5581

Willie Nelson's 35th annual benefit concert Farm Aid is going virtual this year.Musicians John Mellencamp, Neil Young, Dave Matthews, and others will come together on Sept. 26 at 8 p.m. ET to help raise money for farmers who face challenges amid the coronavirus pandemic.“This pandemic and so many other challenges have revealed how essential family farmers and ranchers are to the future of our planet,” said Farm Aid President and founder Willie Nelson in a press release. “Farm Aid 2020 is going to give the whole country a chance to learn about the important work of farmers and how they’re contributing to our well-being, beyond bringing us good food.”The three-hour event will be live-streamed on Farm Aid’s YouTube channel, AXS TV, and Fans.com.You can find the full line-up here. 796

Whataburger is getting into the game with its own spicy chicken sandwich.The San-Antonio based fast-food chain introduced the sandwich last week.“At Whataburger, we’ve spent time meticulously crafting the Spicy Chicken Sandwich recipe – and it shows with each bite. It packs a delicious blend of marinated, crispy chicken that’s spicy from within and is paired with fresh veggies, cool, crisp lettuce, tomatoes, pickles, and mayo,” said Whataburger Vice President of Marketing and Innovation Rich Scheffler in the press release. “We can’t wait for our guests to enjoy this extremely flavorful new, limited-time sandwich.”Whataburger said the new item is available for a limited time only at all 840 locations. 717

Who doesn’t like a bargain? In honor of dads across America, a number of companies are offering discounts this weekend for Father’s Day.According to RetailMeNot, American consumers are planning on spending an average of per person on Father’s Day.And if you’re wondering what dad wants, RetailMeNot suggests giving a gift card.The top choices for Father's Day gifts include:40% prefer a gift card32% would like dinner from a restaurant27% would like an at-home prepared meal27% prefer clothing18% would like an alcohol purchaseIf you’re looking for a last-minute gift or to take advantage of a discount, here is a partial list of deals for fathers across the US (Note, participation may vary):Chili’s: On June 19th through June 21st, Chili’s is offering a 6 ounce Sirloin and lunch portion of Chicken Fajitas for its 3 for menu.Columbia: The outdoor clothing retailer is offering 25% off across its website this weekend.Eddie Bauer: Eddie Bauer is offering an additional 10% off of 50% by using code “EXTRA10” this weekend.El Pollo Loco: The restaurant chain is giving dads prizes like e-gift cards, grill sets and a grand prize of a ,050 custom Imperial Grill and grilling lesson from a top Grill Master. The promotion is on the company’s Instagram page.Kohl’s: By using promocode “DADSDAY,” customers can get a 20% off discount on select items.Whataburger: Now through June 28 at participating locations, customers can purchase one Honey BBQ Chicken Strip Sandwich and get a second one free. Customers can earn the free sandwich by downloading the restaurant’s smartphone app.If you’re looking for restaurant gift cards, Applebee’s, Cheesecake Factory, and the Olive Garden are all offering an additional gift card with the purchase of a gift card. 1776

WINDSOR, N.C. — At least six people were killed as Tropical Storm Isaias spawned tornadoes and dumped rain Tuesday along the U.S. East Coast after making landfall as a hurricane in North Carolina, where it caused floods and fires that displaced dozens of people.Two people died when Isaias spun off a tornado that struck a North Carolina mobile home park. Another person died in Pennsylvania when their vehicle was overtaken by water and swept downstream. Two others were killed by falling trees toppled by the storm in Maryland and New York City, and a sixth person died in Delaware when a tree branch fell on them, authorities said.Isaias sustained top winds of up to 65 mph more than 18 hours after coming ashore, but it was down to 45 mph max winds as of 10:50 p.m. EDT Tuesday, according to the National Hurricane Center. The storm's center was about 45 miles southeast of Montreal, moving northeast into Canada at about 38 mph.As Isaias sped northward, flooding threats followed. The Schuylkill River in Philadelphia was projected to crest early Wednesday at 15.4 feet, its highest level in more than 150 years. By Tuesday night, the river had already topped its banks in low-lying Manayunk, turning bar-lined Main Street into a coffee-colored canal.Aerial video by WRAL-TV showed fields of debris where rescue workers in brightly colored shirts picked through splintered boards and other wreckage of the Windsor, North Carolina, mobile home park where two people were killed. Emergency responders searching the area Tuesday afternoon found no other casualties, and several people initially feared missing had all been accounted for, said Ron Wesson, chairman of the Bertie County Board of Commissioners. He said about 12 people were hospitalized.“It doesn’t look real; it looks like something on TV. Nothing is there,” Bertie County Sheriff John Holley told reporters, saying 10 mobile homes had been destroyed. “All my officers are down there at this time. Pretty much the entire trailer park is gone.”In eastern Pennsylvania, a 44-year-old Allentown woman was killed after encountering high waters on a street in Upper Saucon Township that swept her vehicle downstream Tuesday afternoon, the Lehigh County coroner’s office said.While in New York City, a massive tree fell and crushed a van in the Briarwood section of Queens, killing Mario Siles, a 60-year-old construction contractor who was inside the vehicle, police said. A woman in Mechanicsville, Maryland, died when a tree crashed onto her car during stormy conditions, said Cpl. Julie Yingling of the St. Mary’s County sheriff’s office.In Delaware, authorities said a woman was outside assessing storm damage when she was hit and killed by a falling tree branch.Isaias toggled between hurricane and tropical storm strength as it churned toward the East Coast. Fueled by warm ocean waters, the storm got a late burst of strength as a rejuvenated hurricane with top sustained winds of 85 mph before coming ashore late Monday near Ocean Isle Beach, North Carolina. Its tropical storm status was sustained, but weakened, as it headed north into Canada on Tuesday night.Before making landfall late Monday, Isaias killed two people in the Caribbean and battered the Bahamas before brushing past Florida.Tornadoes were confirmed by the National Weather Service in Virginia, Maryland, Delaware and New Jersey. Power outages also spread as trees fell, with more than 3.7 million customers losing electricity across multiple states as of 10:15 p.m. EDT Tuesday, according to PowerOutage.US, which tracks utility reports. New York City's power utility said it saw more outages from Isaias than from any storm except Superstorm Sandy in 2012.In Doylestown, Pennsylvania, officials said four children were treated for minor injuries after high winds partially tore the roof off a day care center. Also in the Philadelphia suburbs, rescue workers in Delaware County were searching for a young person who fell or jumped into the fast-moving water of a swollen creek, said Timothy Boyce, the county emergency services director.In New York City, fierce wind and rain forced the Staten Island ferry and outdoor subway lines to shut down. The New Jersey Turnpike banned car-pulled trailers and motorcycles.Some of the worst damage Tuesday seemed to be east and north of where the hurricane’s eye struck land in North Carolina.“Fortunately, this storm was fast-moving and has already left our state," Gov. Roy Cooper said Tuesday afternoon.In North Myrtle Beach, South Carolina, the storm sent waves crashing over the Sea Cabin Pier late Monday, causing a big section to collapse into the water as startled bystanders taking photos from the pier scrambled back to land.“I'm shocked it's still standing,” said Dean Burris, who watched from the balcony of a vacation rental.The Hurricane Center had warned oceanside dwellers near the North Carolina-South Carolina state line to brace for storm surge up to 5 feet and up to 8 inches of rain.Eileen and David Hubler were out early Tuesday cleaning up in North Myrtle Beach, where 4 feet (1.2 meters) of storm surge flooded cars, unhinged docks and etched a water line into the side of their home.“When the water started coming, it did not stop,” Eileen Hubler said. They had moved most items of value to their second floor, but a mattress and washing machine were unexpected storm casualties.“We keep thinking we’ve learned our lesson,” she said. “And each time there’s a hurricane, we learn a new lesson.” 5507

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