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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 U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr.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 Kyle and Jessica Frankenstein found out they were pregnant, they were given Sunday, October 29 as their due date — so there was always the possibility of Jessica going a few days past her due date and delivering a Frankenstein baby on Halloween. Well, it happened! Jessica gave birth to Oskar Gray Frankenstein on Tuesday, October 31, 2017 after 14 hours of labor at Winter Park Memorial Hospital. "Honestly, I didn't think he would hold out till Halloween," Jessica Frankenstein said. "My husband and I discussed what it would be like having him on Halloween and how neat it would be when he gets older."Baby Frankenstein weighed in at 6 pounds (3 kilograms), 9 ounces (255 grams) and is 20 inches (50 centimeters) long."I am utterly in love with this little man and I couldn't have imagined a more perfect baby," Jessica said.Congratulations to the happy parents. FOLLOW Kelly Bazzle on Twitter 929

Wings and wagers? Buffalo Wild Wings thinks they're a natural fit.The sports bar chain, which has about 1,200 restaurants in all 50 states, said it is exploring the possibility of offering sports wagering now that the Supreme Court has opened the door for states to legalize sports betting."As the largest sports bar in America, we believe Buffalo Wild Wings is uniquely positioned to leverage sports gaming to enhance the restaurant experience for our guests," a company spokesperson said Thursday. "We are actively exploring opportunities, including potential partners, as we evaluate the next steps for our brand."Three states -- New Jersey, Delaware and Louisiana -- have legalized sports gambling since the Supreme Court decision in May. Before the ruling, Nevada was the only state where it was legal to bet on sports.Many other states are considering legislation that will allow for sports betting in the hopes of cashing in on what could be a multibillion-dollar industry."We're still waiting for state legislatures and regulators to hash out licensing rules, so it's unclear how they'll [Buffalo Wild Wings] have opportunity to participate," said John Decree, head of North America equity for Union Gaming, a boutique investment bank that focuses on the gaming industry.Current there are 43 states with some type of legal casino. But even states without casinos could move to allow sports gambling.Decree said that he thinks it's likely that Buffalo Wild Wings will partner with an established casino or other sports betting entity, rather than try to get licenses on its own as states move to allow sports wagering."It'll be hard for them to try to get licensed in every state that allows it. There's a lot of legal costs and time involved," he said.Much of the coming boom in sports gaming is expected to take place online, especially on mobile apps, meaning that many customers watching games at a Buffalo Wild Wings will be able to place bets at a variety of sports books in their states.Decree said it's likely that some states that allow online wagering will require people to put money on their account in person and using cash, rather than using a credit card.In that case, Buffalo Wild Wings could reach an agreement with some sports books that would allow people to put money on their account in one of their restaurants."That alone can generate a lot of foot traffic," he said.Buffalo Wild Wings was purchased for .9 billion earlier this year by privately-held Arby's. 2533

While experts are encouraged by early vaccine data, many still say there is a way to go before life returns to normalcy."Operation Warp Speed," is a Trump administration effort to develop and deliver a safe and effective COVID-19 in the coming months. The administration's goal is to make initial doses available by January 2021.The vaccine will initially be rationed while drugmakers produce more doses. Healthcare workers, people in nursing homes, first responders and those with high-risk health conditions will likely be the first people eligible to receive the vaccine. According to Dr. Anthony Fauci, the director of the National Insitute for Allergies and Infectious Diseases, the rest of the general population won't be able to receive the vaccine until later in 2021.Pfizer and Moderna have both announced that their vaccines are on track for potential emergency authorization from the Food and Drug Administration. But there are several other candidates that could also get approval soon — and could potentially overtake the market.Both Pfizer's and Moderna's vaccine candidates require two shots, which need to be taken 28 days apart. But health experts believe that if a single-dose vaccine gets approval, it could quickly become the standard for worldwide vaccination."So, if you can get a vaccine out there that actually requires only one dose, it could quickly overtake the market," said Dr. Marcus Schabacker the President & CEO, of Emergency Care Research Institute.Health experts are also encouraged that there are several vaccine candidates in the final stages of testing — they believe that more potential vaccines reduce safety risks."We have a lot of people in the world. We need to vaccinate in different countries under different criteria, and you always run the risk that there's something in the Pfizer vaccine that someone's allergic to that isn't in the Madonna vaccine," said Dr. Jill Roberts, an associated professor as USF Health.One question that hasn't yet been answered is how the vaccines will stand up to the newly infected."So if you're turning positive today, we know you are exposed to somebody that had COVID, and we vaccinate you today — will that actually prevent you from developing severe disease?" Roberts said.Merck is another U.S. based pharmaceutical company that is working on a single-dose COVID-19 vaccine. That vaccine is currently in early testing overseas. 2422

When it comes to the classroom, it's not unusual for teachers to have assistants. But those helpers aren't always people. At one school, students are learning in a completely new way.We all know it can be fun to play with a dog. But by helping Buster get through an obstacle course, Buster's also helping elementary school student Mason Gentry in ways he hadn't planned."Definitely with focus," Gentry said. "Because sometimes I just have a hard time focusing."But how?"Because I have to help focus on what Buster is doing in order to do what I need to do with him," Gentry said.Buster is teaching schoolmates Ashton Huffman and Grant Meurer, something else."Patience," Huffman said.And it goes beyond getting Buster through the course."It teaches us that if you were to ask for something you can't just go now now I want it now," Meurer said.Once a week dogs like Buster and Mojo, come to Van Arsdale Elementary School in Colorado to work with students.They lead them through courses they've planned out using commands, which helps them develop their communication and confidence."They will get more confident each week," said Vivan Mulhern, coordinator at HABIC Denver. "They will say it louder and then you just see their skills improving and wanting to learn more so then they can connect science together and they can do things like that."Teacher Denise Gillette started the program after seeing how it impacted a student with autism."Were you surprised after that initial student had such a positive reaction from working with the dog?" Kumasi Aaron, a national reporter with The E.W. Scripps Co., asked."Yeah, I think I was surprised," Gillette said. "It was just so beneficial, just such growth."Now more students are seeing that growth, learning a variety of skills that can be challenging to teach, like patience, confidence and focus."They can work on something through the dog that you wouldn't really want to address directly with them," Gillette said. "Like I think if you put the spotlight on them and say you need to have impulse control then you get a resistance but when it's over we need to teach the dog this and then they see, 'Oh that's a valuable thing.'"Gillette writes personalized books to complement her student's work with the dogs, weaving in the lessons each one is trying to learn."Nobody wants to be told you need this you need that," Gillette said. "But when you're helping the dog get it's like, 'Oh okay now you're the helper and you're not always the student who has a problem.'"So while Coen Stevenson has taught Mojo some pretty cool tricks, Mojo's made it easier for him to learn."It makes me feel better to like do more stuff in class and like work better," Stevenson said.A change in curriculum, adding man's best friend, and much more. 2810

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