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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 U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr.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

When Missy Owen heard that the non-profit National Safety Council was putting together a memorial for opioid victims called "Prescribed to Death" and was, in effect, looking for personal stories to help put a human face on the crisis, she was excited. “I was like, 'oh yes, this is a great idea,'” Owen said, “This is an awesome project, yes I’ll do that!”The project would be another way to try and keep the memory of her son Davis alive. Not only that, but it could potentially help make an impact on others in the hopes of one day ending the epidemic that takes 22,000 lives a year.“I knew that it would help other people,” she said.But months went by.“I procrastinated, and I procrastinated," she said.Owen said bringing herself to fill out the paperwork — to spell out, in detail, the pain she suffered when she lost her 20-year-old son, an honor student and class president — was so painful that she waited until the very last day the organization would accept submissions.But in the end, she said she knew this memorial would be something people would remember.“You look at all this, and you go up to it, and you see it, and you see those faces so close,” she said.With this exhibit, being close is the only way to experience it because it consists of 22,000 pills, one for each opioid death that occurs in the U.S. each year.Owen said when she sees the enormity of it, she thinks of 22,000 families that learned to “live differently,” as she had to.“(These families) learned their new normal, and learned to live without someone that they loved and cared for deeply,” she said.But there’s one more layer to the exhibit — each of the 22,000 pills has a likeness carved into it by a 3D printer. The faces are modeled after actual victims of the crisis. Among the 22,000 pills is Davis Owen.“I haven’t found him,” Missy Owen said, staring closely at the rows and columns of tiny white pills. “But I know he’s here.”Owen has seen it several times now. But it’s still an emotional experience. She recalls how Davis fell down the path of addiction.Davis was gifted, Missy said, but his brain had trouble “shutting off.” He had trouble sleeping when he was stressed, and one night he took a seemingly innocuous trip to the family medicine cabinet. “I’m supposing he was looking for something like Advil PM or Tylenol PM, something like that,” she said.He grabbed an old, leftover Vicodin prescription that Missy estimates may have had 30 pills in it. Its label: ‘May cause drowsiness.’“And he was one of those one in 10 people that have that euphoric experience when taking an opioid medication. And he continued to use that bottle until it was gone. By that time he was completely addicted,” she said.It soon turned into a need for the recreational opioid heroin, and that, in turn, led to his overdose in 2014.She and her family have since started the Davis Direction Foundation and The Zone, which helps former addicts to stay sober, to stay “in the zone,” as she put it.One of the hardest aspects for Missy Owen come to terms with is that his death, and those of so many others whose faces are now etched onto that wall, was preventable.“Davis’s story is so sad,” Owen said, “and so awful.”“But it’s not uncommon,” she said.She said she hopes the memorial can help to humanize the epidemic for people who haven’t had to suffer the loss of a loved one, in the hopes that we can stem the epidemic.Maureen Vogel, spokesperson for the National Safety Council, said people have walked away visibly moved.“(People say) ‘it’s encouraging me to change. It's encouraging me to talk to my doctor,’ and ‘it's encouraging me to talk to my own family,'” Vogel said.The exhibit premiered in Chicago late last year, and it goes on display outside the White House this month. Vogel says 14 other cities have expressed interest in hosting the memorial so far. “Data only tells part of the story,” Vogel said. “You have to put a face on the statistic for people to really relate to it,” she said.Missy Owen said she hopes this year is the year the epidemic turns a corner.“We are losing a whole generation of people. It has to be a turning point," she said.  4228

When students of Marjory Stoneman Douglas return to class after spring break next week, they'll be required to carry clear backpacks.The move is meant to ramp up security measures after last month's deadly shooting and a series of breaches since then."Clear backpacks are the only backpacks that will be permitted on campus," said Broward County School Superintendent Robert Runcie said in a letter sent to parents. 423

With five weeks remaining in the college football season, the College Football Playoff selection committee unveiled the first poll, and there is little surprise at who is at the top. Alabama, the defending national champs, was ranked No. 1 in the poll released Tuesday, followed by the 2017 champs No. 2-ranked Clemson. With Alabama and Clemson both sporting unbeaten records, it is not surprising to see the two squads at the top of the ranking. But the selection committee's third choice might leave some fans scratching their head. Rather than picking unbeaten Notre Dame at No. 3, the selection committee slotted one-loss LSU as the third pick. Notre Dame, who has a win over Michigan who is ranked at No. 5 in the CFP ranking, was at No. 4. With the toughest part of Notre Dame's schedule in the past, and no remaining Top 25 games remaining on the schedule, the Irish's chances of making the College Football Playoff are in question given that a one-loss team is already ahead of Notre Dame. A group of other one-loss teams are poised to potentially overtake Notre Dame at the No. 4 spot since most of those squads will get the opportunity to play in a conference title game. With Notre Dame being an independent, the Irish do not get the benefit of playing in a conference championship. Behind Michigan is a quintet of teams sporting 7-1 records going into Week 9. Those teams are No. 6 Georgia, No. 7 Oklahoma, No. 8 Washington State, No. 9 Kentucky and No. 10 Ohio State. UCF, who is the only other unbeaten team besides Alabama, Clemson and Notre Dame, was ranked No. 12. The top four teams at the end of the season advance to play in the College Football Playoff.  1728

While we're all focused on COVID-19 as we head back to school this fall, Patti Wukovits is focusing on Meningitis B.“She loved to entertain and make people laugh. She enjoyed life. When I think of Kim the one word that comes to mind is joy,” said Wukovits. It's still painful for Wukovits to talk about her only daughter. Kimberly Coffey was a high school senior who was in her last two weeks of school. She'd been accepted to nursing school and was ready to launch her career. She wanted to follow in her mom's footsteps and be a nurse. One day she came home from school with a fever.“By the next morning she wasn’t fine at all. She said 'mommy everything hurts from my eyelashes to my toes.' This is really, really bad. She couldn’t pull her head off the pillow and was completely lethargic,” Wukovits recounted. Kimberly told her mom that it felt like her ankles were bleeding. Patti saw purple dots and rushed her daughter to the emergency room. “One of the doctors pulled me aside and said 'we believe your daughter had bacterial meningitis.' I said 'That’s not possible. I made sure Kim was vaccinated with the meningitis vaccine.'”She learned that Kim wasn't fully protected. "At the time, in 2012, when she got sick we didn’t have a Meningitis B vaccine in the United States so I couldn’t protect her with that. She didn’t have the privilege of having a Meningitis B vaccine."Doctor Paul Offit, Professor of Pediatrics at Children's Hospital of Philadelphia says it's a vaccine that's necessary and reduces your chances of the type of pain, loss and suffering that Patti lives with everyday.“There’s five different strains that causes these, one vaccine prevents 4 of them: a, c, w, y and then there’s a b category, so 5- A, c, y,w and b. A few of the vaccines just do a c w and y and couple just do b, so 2 vaccines to prevent all 5 strains,” said Dr. Offit. Wukovits says, "her organs were failing and she was in septic shock and she went into cardiac arrest this is a child who was just in her classroom the day before talking with her friends about prom and how her beautiful dress was on her closet door and excited about graduation and starting nursing school.”Out of Kimberly's tragedy - came the Kimberly Coffey Foundation and the Meningitis B Action Project. “I am promoting awareness of her story so that this does not happen to anyone else. It does not have to happen any longer, we have a vaccine and it should not be happening. We shouldn’t lose one more child. But again, if parents don’t know about it we might not know to ask about it,” Wukovits said.Even in the COVID-19 era, Wukovits is doing webinars, educating everyone about the two separate vaccines, and empowering parents and families to have the conversation before they head back to school this fall. “I know we’re making a difference I know that. Kimberly’s dream was to be a pediatric nurse and save children’s lives and this is not how she or I planned she would save children’s lives but she still is and through me. I’m her voice.”A powerful message from a mom on a mission to save lives, just like Kim would have wanted. 3118