Month: March 2022

On Wednesday, under increasing criticism for the state’s slow vaccine rollout, Gov. Gavin Newsom (D) announced that all Californians 65 and older will be eligible for the shot.

But if you were a Californian who wanted to find more information about where to get that shot for yourself or your loved one, you would’ve been out of luck. While the state’s website has been updated to say that individuals 65 or older are eligible, there are no tools to find a nearby location where vaccines are available. The state’s official FAQ answers the question, “How can I get the Covid-19 vaccine?” with, “Most Californians will be vaccinated at community vaccination sites, doctor’s offices, clinics, or pharmacies” — no links, no instructions about how to find one near you.

So, fed-up Californians are taking matters into their own hands: they’re crowdsourcing it. In the last two days, an effort has sprung up to report on where shots are available to the elderly. Volunteers have set up a spreadsheet with a simple premise: One person can call each location every day and ask if vaccines are available, and then publish the information for everyone to see. (There’s a way to submit updates and corrections, too.) Once the team is confident in their two-day-old system, they’ll open up crowdsourcing and reporting, soliciting more help and more publicity so it can reach more Californians.

The crowdsourced list of where Covid-19 vaccines are available, and to whom, is a microcosm of both everything good and everything utterly broken about the United States’ coronavirus response.

Throughout the pandemic, national coordination has been lacking, causing public health tasks to fall to states and counties that vary dramatically in their preparedness to take them on. Coordination tasks that should be the business of government — from ensuring that there’s enough personal protective equipment (PPE) for hospital workers to reporting data on Covid-19 cases to letting people know which clinics offer vaccines — have fallen to hospitals themselves, or even to individuals.

Against that grim backdrop, people have stepped up, over and over, to get things done where our institutions have failed. In Washington State, university researchers studying the flu were among the first to detect the novel coronavirus in the country, while the CDC floundered. In Florida, a lone fired data scientist kept the state’s citizens updated about coronavirus case numbers. Journalists and researchers like Zeynep Tufekci told the public to wear masks and to worry about ventilation long before official organizations like the CDC and WHO recommended that. A group of citizens developed and published a risk points calculator to help people understand the risks of different daily activities.

And now in California, volunteers are trying to figure out which hospitals have enough vaccine supply to vaccinate elderly Americans. Should such a task fall to them? No. But since it has, I’m glad we have them.

How California got an unofficial vaccine availability dashboard overnight

Few US states have done an impressive job of rolling out the desperately needed Covid-19 vaccines in the month since the FDA approved them, but the most populous state, California, is among those having a particularly poor showing. The state with the best vaccination program, West Virginia, has used 78.6 percent of the doses shipped to it; California has used 27 percent, putting it 49th in the country. (Only Alabama, at 21 percent, is doing worse.) Seven percent of West Virginians have been vaccinated; only 2.5 percent of Californians have.

On Wednesday, January 13, Newsom announced that people aged 65 and older could be vaccinated in California, as part of a push to improve the state’s dismal overall vaccination performance. (Newsom’s office has not responded to a request for comment.) Yet California is lacking the infrastructure for vaccine availability reporting that many other states have, though some counties have their own systems. For instance, West Virginia’s vaccination website lists every clinic conducting vaccinations each day, with an address and specific details about how to get a vaccine. Texas has a huge map of vaccination locations across the whole state, with the ones with availability highlighted.

The unofficial California dashboard came together as a result of a call to arms on Twitter from Patrick McKenzie, a well-known tech worker and writer currently at Stripe, a payments company that before the pandemic was based in San Francisco.

McKenzie went on to clarify that he and others would reimburse anyone who spent their own money out of pocket on setting up a system. Californians immediately chimed in with their stories of frustration at trying to get a vaccine:

Having every person in California who needs a vaccine call every doctor’s office until they find one that has availability is, obviously, a terrible way to distribute vaccines; doctors’ offices will be swamped with calls, while at-risk Americans may become dispirited and give up on getting the shot.

So more than 70 volunteers got to work. Ideally, every clinic would get only one call, every day, asking about availability that day; then the information would be made public so eligible residents could figure out where they could get the vaccine without having to make the calls themselves. A Google spreadsheet was linked, then migrated to an AirTable (a spreadsheet/database service with more flexibility than Google Sheets offers). A list of clinics and hospitals and contact information was compiled, and the team got to work calling them.

The reports started flowing in, each one a window into a chaotic vaccination system. “Only doing 75 and older right now, and asked me to call the county public health department at 408 792 5040 to schedule an appointment. That number redirects to 211 at the moment for Coronavirus related concerns and reached a full voicemail box otherwise,” the notes for one report for a hospital read.

Another reads, “says that Yolo county hasn’t had any direction [to start vaccinating elderly Californians], still on [Phase] 1A only.”

“We’re not offering that in LA County yet. I know Orange County’s offering it, but you have to be an Orange County resident,” another caller was told.

There was some good news too. As of January 14, Kaiser, the Oakland-based health care system, has availability for Kaiser patients 65 and older. Sutter Health, another California-based health care system, has availability for Sutter Health patients 75 and older. Ralph’s, the Southern California grocery store, has some slots.

And the site has already been used to get some people vaccinated:

But overall, Newsom’s Wednesday declaration that people 65 and older are eligible to be vaccinated hasn’t translated to policy changes at the vast majority of hospitals in California. Whatever has California so far behind West Virginia, it will take more than an expansion of eligibility — or a crowdsourced tool — to fix.

State and local governments have been put to an extraordinary test over the last year. Many California county health departments have been models of how to handle the pandemic, from their early action declaring an emergency in March to the low death counts all year.

But the vaccination rollout has made it clear that good local governance can’t solve everything. Without good statewide coordination and communication, and without funding, counties simply can’t help everyone eligible for a vaccine arrange to get one. Good county governments and individual/crowdsourced efforts can take over many key government functions, but without state and federal coordination, vaccine distribution will be more chaotic than it should be.

In light of that, perhaps the biggest benefit from a tracking project like this one is accountability. Calling up clinics across California systematically makes it clear that many counties and many hospitals aren’t vaccinating people aged 65 and older, whatever Newsom says. In some areas, clinics are still vaccinating their own health care workers, even though many other states finished vaccinating all willing front-line health care workers earlier this month and moved on to other priority groups.

It makes it clear that many of the state’s most vulnerable citizens are getting shuffled between websites and phone lines, often with no vaccine at the end of the journey — and it cuts through that confusion and mess to find the locations that are getting shots into elderly residents’ arms.

Eventually, maybe Californians will get answers about why the vaccine rollout was botched so badly. In the meantime, though, the answer that can’t wait — which clinics are open — is available online.

Click Here:

President-elect Joe Biden announced a plan on Friday for what will likely be his most pressing challenge when he takes the White House next week: fixing America’s messy Covid-19 vaccine rollout.

The plan builds on Biden’s $1.9 trillion economic stimulus proposal, which included a $400 billion Covid-19 plan, announced on Thursday. It seeks more support to states and lower levels of government, a greater expansion of vaccine eligibility, funding for more public health workers, a boost in vaccine production, better communication about the vaccines, an education and awareness campaign, and more. He promises 100 million vaccine doses delivered in his first 100 days in office.

Above all, the plan aims for something that President Donald Trump’s administration didn’t do with Covid-19 more broadly and the vaccine in particular: greater federal involvement. The Trump administration has repeatedly pushed against a bigger federal role — even characterizing more support for states so they can get shots in arms as a “federal invasion.” Biden has rejected that rhetoric, calling for a bigger role by the feds, and cementing it with his plan.

Click Here:

The stakes are as high as they’ve ever been. The country now averages 240,000 Covid-19 cases and more than 3,300 deaths each day. The American death toll is among the worst in the world, with the country now approaching a total of 400,000 dead. If the US had the same death rate per million people as Canada, over 230,000 more Americans would likely be alive today.

The vaccine is America’s — and the world’s — chance at fixing this mess. Experts say the country must vaccinate at least 70 percent of its population, and possibly more, to reach herd immunity and protect a sufficient amount of the population from the virus. Only then can outbreaks truly be curbed.

But the US has been slow in rolling out a vaccine. The Trump administration overpromised and underdelivered: It promised 40 million doses and 20 million people vaccinated by the end of 2020; two weeks into 2021, only 31 million does have been delivered and just 11 million Americans have received at least the first dose of a vaccine, according to federal data. The country is currently not on track to reach 70-plus percent vaccination rates by the end of the summer.

Biden’s immediate challenge is to clean this all up. His presidency may count on it — his handling of the country’s most pressing crisis will likely be what Americans judge him on over the next year.

More seriously, it’s a matter of life or death: With thousands of people dying each day, ending the epidemic in the US even days or weeks earlier than otherwise could save up to tens or hundreds of thousands of lives.

Here’s how Biden plans to do it.

What Biden’s vaccine plan does

Biden promises to leverage “the full strength of the federal government,” in partnership with state, local, and private organizations, for a truly national vaccine plan. You can read the full proposal here, but these are some of the key points:

• More federal work to get shots to people: Biden calls for more involvement by the federal government in getting vaccine doses to people. That includes new vaccination centers, mobile vaccination units in underserved communities, reimbursement of states’ National Guard deployments, and expanding vaccine availability in pharmacies. He also promises to target hard-to-reach, marginalized communities with extra support, particularly those that have been hit the hardest by Covid-19.
• Boost the supply of vaccines: Biden says he’ll make greater use of federal powers, such as the Defense Production Act, to boost the manufacture of vaccines and related supplies. He also says he’ll improve communication with states so they can better understand when and how much vaccine they can expect to get — addressing a big complaint from states today, as the Trump administration has often failed to inform them of even these basic details.
• Expanded vaccine eligibility: Biden calls for expanding vaccine eligibility to include everyone 65 and older as well as frontline essential workers, including teachers, first responders, and grocery store employees. Several states have already moved in this direction, but Biden promises more support and encouragement toward this objective.
• Mobilize a larger public health workforce: Building on his stimulus plan, Biden vows to hire and use a larger public health workforce to help deploy the vaccine across the country. He’ll also take other steps, like allowing retired medical professions who aren’t currently licensed under state law to help administer vaccines “with appropriate training.”
• Launch a national public education campaign: To help convince people to get vaccinated, Biden also plans to launch an education campaign “that addresses vaccine hesitancy and is tailored to meet the needs of local communities.”

All of that is on top of Biden’s broader Covid-19 plan, which promises $400 billion more funds to combat the coronavirus and, specifically, $20 billion more for vaccine efforts.

Biden’s plan hits many of the marks that I’ve heard from experts over the past few weeks as I’ve asked them about what’s going wrong with America’s vaccine rollout.

First, the plan has clear goals to address what supply chain experts call the “last mile” — the path vaccines take from storage to injection in patients — by making sure there’s enough staff, infrastructure, and planning to actually put shots in arms. Second, it takes steps to ensure that supply chain problems are fixed proactively, with careful monitoring and use of federal powers when needed to address bottlenecks. Last, but just as crucially, there’s a public education campaign to ensure that Americans actually want to get vaccinated when it’s their turn.

The question, of course, is if all of this can get implemented properly. As the US response to Covid-19 has floundered, a key question has been how much of the failure is attributable just to Trump versus bigger systemic problems, like the country’s size and sprawl, fractured health care system, and fragmented federalist government.

There’s also the question of whether Biden can get the congressional support needed for all these efforts. Democrats will control both houses of Congress. But more moderate wings of the party may scoff at the high price tag: Biden’s stimulus plan is estimated at $1.9 trillion and the Covid-19 plan alone (which is included in the bigger plan) at $400 billion. The cost of borrowing money is low, and Biden argues that the risk right now is doing too little instead of too much, but it remains to be seen if he gets enough backing in Congress.

If he pulls it off, though, Biden has a chance to show how much of a difference true federal leadership can make — and demonstrate how much the previous administration failed by refusing to embrace a larger role for itself.

Biden wants a federal role that Trump disavowed

At the core of Biden’s plan is a posture of more federal involvement that Trump has resisted at every step throughout the Covid-19 crisis.

This was clear in Biden’s broader Covid-19 plan, too: The ideas in the proposal aren’t at all new. Experts have called for expanding testing, preparing for mass vaccination efforts, supporting schools, providing emergency paid leave, and much more in the past year. Biden himself proposed many of these things last March. You can see many of these ideas in article after article in Vox and elsewhere, dating back to early 2020.

The Trump administration declined more aggressive steps, repeatedly taking a stance that it wasn’t the federal government’s proper role to get hands-on with the Covid-19 response. With protective equipment, Trump resisted using the Defense Production Act to get more masks, gloves, and other gear to health care workers. On testing, the Trump administration left the bulk of the task to local, state, and private actors, describing the federal government as merely a “supplier of last resort.” On tracing, the administration never had anything resembling a plan to make sure the country could track down the sick or exposed and help them isolate or quarantine.

This kind of hands-off, leave-it-to-the-states attitude culminated in the messy vaccine rollout. While there are many factors contributing to America’s slow vaccine efforts — including the country’s size, sprawl, and fragmented health care system — a key contributor is the lack of federal involvement. In effect, the Trump administration purchased tens of millions of doses of the vaccines, shipped them to the states, and then left the states to figure out the rest.

This was clear in the funding numbers. State organizations asked for $8 billion to build up vaccine infrastructure. The Trump administration provided $340 million. Only in December did Congress finally approve $8 billion for vaccine distribution, but experts say that money comes late, given that vaccination efforts are already well underway and the funds could’ve helped in the preparation stages.

When asked about the botched vaccine rollout, the Trump administration has stuck to its anti-federalist stance — arguing that it’s on states and localities to figure out how they can vaccinate more people. Brett Giroir, an administration leader on Covid-19 efforts, argued, “The federal government doesn’t invade Texas or Montana and provide shots to people.”

Characterizing greater federal support for Covid-19 efforts as a federal invasion is of course absurd, but it’s emblematic of the Trump administration’s approach to the crisis.

On vaccines, as with the coronavirus in general, Biden’s promise has long been that he’ll embrace a bigger role for the federal government. With his plan, Biden is putting some specific details to that end. The question now is if he can pull it off — if he gets the support he needs from Congress, and if the feds really can deliver what Biden has promised.

For the nearly 100 million people around the world who’ve been infected with the coronavirus, new science offers some comfort: Reinfections appear to be rare, and you may be protected from Covid-19 for at least five months.

Click Here:

The study, the largest of its kind, followed more than 20,000 health workers in the UK, regularly testing them for infection and antibodies. Between June and November, the researchers — from Public Health England (PHE) — found 44 potential reinfections out of the 6,614 participants who had tested positive for antibodies or had a previous positive PCR or antibody test when they joined the study. Meanwhile, of the 14,000-plus people who had tested negative for the virus at the start of the study, there were 409 new infections.

Only two of the 44 potential reinfections were designated “probable” and the rest were considered “possible,” “based on the amount of confirmatory evidence available,” according to the health agency. Fifteen people — or 34 percent — had symptoms.

So if all 44 reinfections are real, that translates to an 83 percent lower risk of reinfection compared to health workers who never had the virus. If only two are confirmed, that rate of protection goes up to 99 percent. Either way, it suggests natural immunity might provide a similar level of protection as the approved Covid-19 vaccines.

But as with the vaccines, it’s not yet clear how long immunity after an infection lasts. Antibodies may fade after five months or last much longer, something the researchers behind the ongoing study, which will run for a total of 12 months, plan to investigate.

“This [new] study does provide some comfort that naturally acquired antibodies are pretty effective in preventing reinfections,” Akiko Iwasaki, an immunobiologist at Yale University, told Vox. The findings also square with another paper on health workers, published in the New England Journal of Medicine in December: Researchers found people who had Covid-19 antibodies were better protected from the virus for six months than people who did not.

Iwasaki added, “You can also interpret these data to mean that protection against reinfection is not complete — especially for people who had Covid during the first wave, say in March-April 2020.”

People who had the virus may still be able to pass it on if reinfected

The good news for individuals who have had Covid-19 also comes with a warning about the risk they can still pose to other people. While antibodies might protect against a second case of Covid-19 in most people, “early evidence from the next stage of the study suggests that some of these individuals carry high levels of virus and could continue to transmit the virus to others,” PHE warned in its press release.

“We now know that most of those who have had the virus, and developed antibodies, are protected from reinfection, but this is not total,” Susan Hopkins, a senior medical adviser at PHE and the study lead, said in a statement, “and we do not yet know how long protection lasts.”

In other words, even if you’ve had Covid-19, while you’re unlikely to get really sick again anytime soon, you should still consider yourself a potential risk of spreading it to others if you catch the virus again and are asymptomatic. That means continuing to take precautions — like mask-wearing and social distancing, Iwasaki added. And it’s one reason why immunologists have said people who’ve already been infected with the virus should still plan to get the vaccine when their turn comes.

So there’s still a lot more to learn about immunity after Covid-19: How will the new coronavirus variants affect it? Lab data from South Africa, where the 501Y.V2 variant has been spreading, suggests it might be able to escape antibodies produced by prior infections in some people.

Who is most likely to have a strong immune response? We do have some evidence that different individuals mount different antibody responses after Covid-19 infections, but the PHE researchers found no statistically significant difference in rates of protection between people who reported symptoms and those who did not. It’s also possible factors like gender and disease severity influence the strength of a person’s immune response.

For now, though, the research suggests that survivors of the virus might just help us get to herd immunity faster — if their immunity lasts long enough. But given the virus has only been known to humans for a little over a year, it may take a while to authoritatively answer the question.

There’s a reason why a new, more contagious variant of SARS-CoV-2 appeared first in the UK: The country does a lot of viral genetic sequencing. Since the start of the pandemic, researchers in the UK have uploaded 151,859 individual SARS-CoV-2 sequences to GISAID, an international platform for sharing viral genomic data. That’s the highest number of sequences shared by any country in the world.

If a more contagious strain of SARS-CoV-2 first evolved in the United States, scientists likely would not have noticed so quickly. Despite having a larger population than the UK, a sophisticated biomedical research industry, and tens of millions more cases of Covid-19, to date US labs have only uploaded 69,111 sequences, according to GISAID.

“It’s embarrassing, is all I can say,” Diane Griffin, a microbiologist and immunologist at Johns Hopkins, told Vox.

The US has lagged behind on so many aspects of pandemic response — from an initial lack of testing, to the current strained and clumsy rollout of the Covid-19 vaccines. Lack of genetic surveillance is just another. Without it, we’re kept in the dark: Scientists can’t see, clearly or quickly, how and if the virus is mutating in concerning ways. It also leaves us without another useful tool to deploy in contact tracing studies.

And it’s one this country ought to invest in, and get right, scientists say — at least before the next pandemic strikes.

How the US fails on testing viral genomes

Earlier this year, Griffin was on a committee making recommendations for a recent National Academies of Science report on the state of genomic surveillance in the US. Genomic surveillance is used, routinely, around the world to track flu, and to try to predict which flu vaccine strains will be most effective in a given season. Genetic sequencing tools are not a new technology, and the Academies wanted a report to survey how they were being deployed in the pandemic in the US. Genetic sequencing is of particular import when it comes to coronaviruses because they use RNA as their genetic code, and RNA viruses are known to mutate frequently.

The report, when it was published in July, outlined a bleak landscape of SARS-CoV-2 mutation tracking. It’s not just that the US isn’t collecting enough genome samples of the virus. It’s doing so in an unsystematic, patchwork way.

“Current sources of SARS-CoV-2 genome sequence data … are patchy, typically passive, reactive, uncoordinated, and underfunded in the United States,” the report concluded. And the data that did exist? The report found it was “inadequate to answer many of the pressing questions about the evolution and transmission of the virus.”

Early on in the pandemic — way back in March — the UK government invested £20 million ($27 million) to launch the COVID-19 Genomics UK (COG-UK) consortium, which coordinates the collection of this data from public health labs. The consortium also tracks viral genetic samples from health clinics, university research labs, and public health research facilities, to help generate a close-to-real-time snapshot of how the virus is changing in the country.

It’s what allows researchers to generate maps like this one, which shows how the new, more contagious strain of the virus spread geographically in the country over time.

The rich genetic data, when paired with case reports, also guides researchers to ask and answer crucial questions, such as: Is this new variant more deadly than other ones? Scientists were able to quickly determine the answer is “no.” (That said, a more contagious virus can still end up killing more people than a more virulent one.)

The US Centers for Disease Control and Prevention does have a genetic surveillance program called SPHERES (SARS-CoV-2 Sequencing for Public Health Emergency Response, Epidemiology, and Surveillance), but it’s less well coordinated than the UK effort. Right now labs have to essentially raise their hands and volunteer to contribute. And the funding for their efforts isn’t consistent. That leads to a patchwork of surveillance across the country. “So you might know what’s going on in Boston, or New York City, but have no idea what’s going on in Iowa,” Griffin says.

“In other words,” says Stanford microbiologist David Relman, who also contributed to the National Academies report, “anybody who has the means and interest to engage in genomics is certainly encouraged to do so.” But genomic sequencing, he says, hasn’t been made a “mainstream central pillar of public health efforts.”

What we lose out on when we don’t collect genetic samples of circulating viruses

The National Academies report was published in July. Has the situation gotten much better since? “No,” Griffin says. There has been a little bit of positive movement: Recently, private genomics companies Illumina and Helix have started to help in the detection of new variants in the United States. Even so, James Lu, president of Helix, told MIT Technology Review the US still needs to go from sequencing a few hundred samples a day to around 7,000 per day.

Viral genomics surveillance doesn’t just allow researchers to spot new variants, it helps them learn crucial lessons about how the virus is spreading.

Click Here:

Scientists take advantage of the fact that viruses are constantly making copies of themselves. And every time they make a copy, they may make a little typo in their genetic code. Most of the time, these mutations are meaningless, but they occur at a regular rate. And that makes it possible to make a family tree of the virus. If one viral sample and another have similar typos, researchers can determine they are more closely related.

This can generate key insights.

“In the beginning of the pandemic, we got our hands on some of the first cases that were identified in Connecticut,” says Mary Petrone, a PhD student who works in a molecular biology lab at Yale. Using genomic data, Petrone and her colleagues were able to figure out whether these cases were introduced from abroad, or came from somewhere in the United States. The genetic data revealed that the viruses more closely resembled those circulating on the West Coast than strains from abroad. “It was telling us: there is actually domestic transmission going on,” she says.

Petrone’s lab delivered a key early insight into understanding the virus’s spread in the US. But it wasn’t like the CDC directed them to do so. “Our lab was actually originally set up to do this type of research for mosquito-borne viruses,” she says. “When the pandemic hit we switched over, because there was an urgent public health need to answer some of these questions. So we just happened to really to be set up to do this type of work.”

Setting up more labs to do this work could also help with contact tracing efforts, overall. “For example, if 10 college students test positive,” Julie Segre, a scientist at the National Human Genome Research Institute, writes in an email, “did they come to school already colonized [i.e. infected] or did they transmit the virus while at school.” Genetic evidence can help answer such a question and help prevent future outbreaks.

What needs to happen: coordination, and money

And it’s not necessarily cheap or easy work to do. While the technology that sequences the viral genomes has become relatively inexpensive in recent years (a plug-in USB sequencer will set you back around $1,500), it still takes a lot of skilled lab work to prep samples for analysis. “You definitely don’t need a PhD to be able to do it,” Petrone says. “But you do need to be pretty well trained in molecular biology in the lab. There are a lot of steps where you can contaminate your samples. It can be quite expensive to do.”

Petrone’s lab can do full genome sequencing; that is, they can read every letter of a virus’s genetic code. But not all labs would need to do that to contribute to a surveillance effort. For instance, Petrone’s group is working on a simpler test that can identify the more contagious B117 variant that first was detected in the UK. “That is something you’d be able to run in a clinic,” she says.

But creating a widespread surveillance network for the new variant would require a lot more coordination than what’s currently taking place.

That’s why the US government needs to be more proactive on this, and help set up a nationwide network for genomic data. And that may be coming. According to STAT, the incoming Biden Administration plans to scale up the country’s genomic sequencing efforts as part of a $415 billion emergency Covid-19 spending package it will ask Congress to approve. (Perhaps also auspicious: Biden has selected Eric Lander, a geneticist who co-led the Human Genome Project, to lead the White House Office of Science and Technology Policy, which will be elevated to a Cabinet-level position.)

For a robust genetic surveillance network to be most useful, it needs to be backed up with other rich datasets too. New variants pop up all the time. What matters is whether those variants are linked to worse health outcomes, more reinfections, or faster spread.

“We would ideally have access to good, consistent data about each sample — at the least, geographical location, but more would be better,” Adam Felsenfeld, director of genome sciences at the National Human Genome Research Institute, writes in an email. If possible, too, “one would need details about the medical record of the patients,” he writes, to try to determine if genetic changes in the virus correspond to different disease courses. Again, this would take coordination, as researchers would need informed consent from people to collect this personal data.

A network of viral genome surveillance isn’t just needed for this pandemic, but for future ones too.

“This won’t be the last pandemic,” Griffin says. “If we could get the infrastructure right and get the approach right, then you have things in place you could activate” … for the next time.

More than 80 million Covid-19 vaccine doses have been distributed around the world so far. Only 55 — 55! — have gone to people in low-income countries. In fact, just one country: Guinea.

Those 55 doses in Guinea don’t even represent “the start of a ‘real’ national vaccination rollout,” said Edouard Mathieu, head of data at Oxford University’s Our World in Data, which has been tracking the global vaccine effort. Rather, a few Guinean public officials were vaccinated at the end of December — with the Russian Sputnik V vaccine — on an experimental basis, the Associated Press reported.

“Then nobody was vaccinated after that,” added Mathieu. (The Guinea health ministry has not responded to Vox’s request for comment.) As a result, Our World in Data stopped tracking Guinea’s rollout.

As the coronavirus continues to spread around the world, with new, dangerous variants picking up pace, the vaccination campaigns in all the world’s poorest countries haven’t even begun. Meanwhile, wealthy nations already vaccinating have pre-purchased access to supplies that can more than cover their populations — about four times over, in the case of the US, according to a December New York Times analysis.

This doesn’t mean there are “warehouses full of extra vaccine doses” sitting around in high-income countries, explained Andrea Taylor, a Duke University researcher who has been analyzing the deals. But the countries with deals have priority manufacturing slots for 2021, “meaning that even if other countries make purchases now, they may have to wait months or even a year for delivery.”

The result: “High-income countries have 16 percent of the world’s population but currently hold 60 percent of the vaccine doses that have been purchased,” Taylor added.

With this kind of vaccine access, the people in rich countries will start to see their epidemics slow down over the next year, and life may regain some of its pre-pandemic rhythm. People in poor countries, meanwhile, may experience no such benefit. In fact, it will likely take years for many low-income countries to even start fully fledged vaccine campaigns, said Agathe Demarais, of the Economist Intelligence Unit, in a recent briefing. “Most developing countries will not have widespread access to the shots before 2023 at the earliest.”

“That’s not just unconscionable,” said Georgetown global health law professor Lawrence Gostin, “but it also is very much against the interests of high-income countries.”

This greed will help the coronavirus continue to spread globally, allowing more opportunity for variants that resist the vaccines to emerge and Covid-19 outbreaks to reignite, including in rich countries. This is a cycle that repeats with just about every disease threat: Rich countries benefit from new health technology first, while poor countries have to wait years, or decades, for it to trickle to them, as the New Yorker’s Michael Specter wrote. But there are growing calls to break the pattern — and Norway is showing the rest of the world how it can be done.

Click Here:

How rich countries exacerbated the global Covid-19 vaccine scarcity

As of January 27, the majority of the 80.2 million Covid-19 vaccine doses administered worldwide have gone to people in only a handful of high- and middle-income countries and regions (namely, the US, China, the EU, the UK, Israel, and the United Arab Emirates).

Several middle-income countries — the poorest among them include India, Myanmar, Ecuador, and Indonesia — have doled out 2.3 million doses in total. Most — 2.03 million — went to people in India.

But the lowest-income countries — for instance, Zambia, Bolivia, Tajikistan, and Nepal — have not begun vaccinating at all.

So why, in this pandemic, are such disparities allowed? It’s pretty simple: Covid-19 vaccines aren’t a public good. Capital rules who gets access first, and those with capital — rich and middle-income countries — have bought first dibs in the vaccine supply, through lucrative pre-purchase agreements with vaccine developers.

“That’s left a global scarcity and also resulted in a bidding war which has made the prices more expensive,” Gostin said. “As a result, [for] countries themselves which are lower income, there aren’t any doses to buy and they are too expensive.”

Because countries inked deals with manufacturers before clinical trials were complete, betting on which companies might come out with vaccines that work, they each signed multiple agreements, covering their populations many times over.

The pre-purchase agreements “made sense in the world we lived in six months ago, because we didn’t yet know which, if any, of the vaccine candidates would come to market,” said Taylor. But the result was that, by November, high-income countries — along with a few middle-income countries — had already pre-purchased the rights to 3.8 billion vaccine doses, with options for another 5 billion, according to an analysis by Taylor and her colleagues at Duke.

Yes, that’s just about as many doses as there are people in the world.

This vaccine hoarding happened in parallel with an unprecedented multilateral effort to support the development and equitable distribution of 2 billion doses of Covid-19 vaccines to the world’s poorest countries before the end of 2021, called Covax.

The initiative has two parts: a purchasing pool for higher-income countries, and a fundraising effort for poorer countries. By promising to buy a certain number of vaccine doses from manufacturers, countries that join get access to any vaccines that are approved in Covax’s portfolio, while also creating a global market for the shots and driving prices down.

More than 190 countries signed on — including rich ones. But the bilateral deals have undermined Covax. Rich countries “want to have it both ways,” Gostin said. “They join Covax so they could proclaim to be good global citizens, and at the same time rob Covax of its lifeblood, which is vaccine doses.”

How to stop hoarding

In the first quarter of the year, Covax is planning to begin delivering a first batch of 100 million vaccine doses. But vaccine distribution is already lagging in rich countries, where manufacturers have failed to deliver the doses they initially promised, and governments are struggling to set up systems to get millions of people through the door at once.

The emerging disparity has prompted calls for rich countries to stop hoarding vaccines and share their excess supply with poorer countries through Covax. It’s also stirring discussion about how countries and manufacturers can get creative and bolster supplies for the world.

Right now, “the biggest constraint for everyone to get vaccinated is the number of doses,” Nicholas Lusiani, at Oxfam America, told Vox. Instead of fighting over the crumbs, he said, Oxfam has suggested countries build regional vaccine production hubs to churn out vaccines at a lower price in the places they’re needed (and where production costs are lower).

The US, Europe, and other high-income countries could also push companies with effective vaccines to collaborate with other manufacturers on production, sharing their technology, or even waiving intellectual property rights. (AstraZeneca has already done so, sharing information with the Serum Institute in India.)

Then there’s simple donating of vaccines. Gostin and colleagues have called on the US to work with other high-income countries and inoculate only their most vulnerable groups — health workers, older adults — first, then give the excess supply to Covax, which could distribute vaccines to high-risk groups in the rest of the world.

“There’s a certain ethical and political justification for putting your own country first because every government’s first duty is to its own population,” Gostin said. “But that’s to a point.”

Still, Taylor said, “it is complex and there is no easy solution. … It would be a very hard sell for the leader of a rich country to start donating doses to other countries while still vaccinating their own population — this is what needs to happen, but it is hard to imagine.”

Norway has managed to do it. Much like the US, the Nordic country will have access to three times as many vaccines as it needs. “This allows us to redistribute vaccines to other countries,” said Norway’s minister of international development, Dag-Inge Ulstein. “The distribution will be started gradually and in parallel to the current vaccination of the Norwegian population as soon as relevant vaccines are approved.”

The Norwegian government decided it was both ethical and self-interested to ensure people in low-income countries can access effective vaccines as soon as possible. “Otherwise,” Ulstein added, “it will be a long time before these countries are able to vaccinate a sufficiently large proportion of their populations. [And] that would not benefit anyone.” Now it’s time for other countries to follow suit.

Since the start of the pandemic, SARS-CoV-2, the virus that causes Covid-19, has been mutating, its genetic code slowly changing as it spreads from person to person across the globe. For most of that time, the mutations didn’t concern scientists. The genetic changes didn’t seem meaningful in terms of how dangerous the virus is. Mutations are normal. Some even weaken the virus.

Now, things are different.

There are three mutated variants of SARS-CoV-2 of particular concern around the world. Researchers do not have the same level of evidence for each: One is more well understood than the others. But in each case, researchers see a seed of something concerning.

There’s B.1.1.7 (yes, all these variants are clunkily named). This variant was first detected in the UK in September. Scientists strongly suspect it’s more transmissible (i.e., contagious) than past versions of SARS-CoV-2, and there’s some preliminary evidence that it might be slightly more deadly.

Then there’s a pair of variants — one discovered in South Africa in October, and another in Brazil in December — that are less well understood. But scientists are beginning to suspect that they might have evolved ways to evade the human immune system, at least a little bit.

A reasonable question you might be asking: Why now? Why have these three variants of concern popped up in such quick succession? The fact that the virus is mutating isn’t new. It’s been mutating all along.

“We’ve had many, many variants in SARS-CoV-2 for a long time now, and scientists have even been tracking these in fairly detailed ways since the summer of 2020,” Emma Hodcroft, a molecular epidemiologist at the University of Bern, says. “The big difference is that, before December, we hadn’t really seen any variants that seemed to be behaving any differently.” (By “behaving differently” she means that the virus itself didn’t seem at the time to be more infectious, or more dangerous in any intrinsic way.)

Hodcroft and others who study the evolution of viruses provide a few overlapping answers to the question “Why now?” None of them perfectly explain what’s going on.

But thinking through them brings us to another, perhaps even more critical question: How might the coronavirus continue to evolve? Will even more variants emerge that challenge our fight against the virus? And what does that mean for the pandemic?

Overall, experts outlined four reasons we’re seeing these variants now. And it all boils down to one thing: evolution.

Reason 1: The virus’s genetic diversity increases over time

First off, it’s helpful to get a refresher on how evolution works. At its core, evolution requires two things: individual differences and natural selection. Evolution is a nonstop process. Organisms — as a group — accumulate change over time through mutations, and the environment helps determine which changes stick around in a population, and which become less prevalent.

Viruses mutate because they’re constantly making copies of themselves in enormous numbers. If you were writing a draft of something millions of times on a computer, extremely quickly, you’d probably make some typos. This has happened millions and billions of times across the globe. The longer the pandemic rages on, the more chances the virus has to evolve.

In the beginning of the pandemic, the viruses infecting people were really similar to one another, because they weren’t that far removed from the original virus that began the outbreak. But now the virus has been changing genetically over the past year, branching out like a family tree. So many genetic changes have accumulated, in different places.

“We have no evidence that the underlying mutation rate is changing,” Sarah Cobey, an epidemiologist who studies viral evolution at the University of Chicago, says. The virus is still making its typos at the same rate. It’s just that those changes start to accumulate the longer the pandemic continues. If you kept copying a book, over and over, making typos in each copy, you’d end up with a somewhat different book than you started with. Likewise, according to Cobey, you’d expect the genetic diversity of the virus to increase over time.

So that’s one major part of it. The virus has just had a lot of opportunities to become something slightly different.

But that’s not all of it. The increased diversity doesn’t quite explain why we’re seeing these particular — seemingly more concerning — variants at this particular time. “We are seeing evidence of adaptive evolution,” Cobey says. These variants appear to be either getting better at infecting people or possibly evading the immune system, and they are doing so in similar ways.

Genetic diversity alone doesn’t explain that. Natural selection does.

Reason 2: It’s possible the virus is evolving in response to increasing human immunity

The virus’s increasing genetic diversity only explains part of the story. The other part of the story: natural selection.

Some of the virus’s genetic changes provide an advantage, which has led, in some cases, to these variants outperforming older strains of the virus. “Some of those [genetic] substitutions are actually helping the virus replicate better,” Cobey says, which then can lead to the variants infecting an increasingly larger proportion of people compared to other variants.

Both the P.1 variant found in Brazil and the 501Y.V2 variant found in South Africa have a mutation called E484K, which changes the part of the virus that attaches to human cells (it’s also the part that the immune system most readily recognizes after someone is vaccinated). That mutation, Hodcroft says, “might allow reinfection.” In other words, people who have already been infected with SARS-CoV-2 could potentially be a little bit more susceptible to these variants (though this is still not confirmed).

Hodcroft suspects that both the P.1 and 501Y.V2 variants may have evolved in response to human immunity. And she stresses: What follows is mostly speculative at this point.

In the beginning of the pandemic, no human had been exposed to SARS-CoV-2 before. That means everybody’s immune systems were equally bad at recognizing the virus. If there had been a variant that was good at evading the human immune system, it wouldn’t have risen to prominence because it wouldn’t have outperformed its viral peers.

As Hodcroft explains it: “Even if this [E484K] mutation popped up — which we know it did, we can see that it popped up a few times — it might not have been in a place where this was an advantage.”

In many places around the world, there are lots of people who have already been infected and who have developed some level of immunity to the virus.

So now, variants that can evade the immune system have an advantage. They could grow and replicate where other variants cannot. And that variant could quickly become the dominant one.

“I want to be really clear: We aren’t 100 percent sure, scientifically, that this is what’s happened,” Hodcroft says. “But these are the kinds of things to think about when we think about why we might be seeing different variants now. We’ve changed the rules of the game.”

Reason 3: The virus has spread so far that rare things are starting to happen

The longer the pandemic goes on, the more chances there are for rare — and sometimes consequential — things to happen.

The B.1.1.7 variant might be one of these consequences. It appears to have acquired significant genetic changes over a short period — so many that scientists suspect the variant might have emerged in an immunocompromised person.

In most people, Hodcroft explains, the immune system mounts a full-on assault on the virus, eliminating it in a couple of weeks. “In people that have compromised immune systems, though, there’s a very different dynamic,” she says. “So, for one thing, the virus could be in them for months instead of weeks.” That gives the virus more time to evolve, to accumulate mutations that might make it easier to thwart the immune system.

Many things have to happen for this to occur. Not only does an immunocompromised person have to get the virus (and many immunocompromised people are being particularly cautious), the virus would have to acquire mutations, and then the immunocompromised person would have to spread the virus to another person.

“These are all like ‘super-edge cases,’” Hodcroft says. But “by keeping cases so high, you increase the chance that sooner or later, you’re going to hit that jackpot … we keep rolling the die when we keep the cases up so high.”

Reason 4: Some Covid-19 treatments might have instigated some evolution

The rise of these variants “may have something to do with the use of convalescent plasma,” says Michael Worobey, the head of the department of ecology and evolutionary biology at the University of Arizona.

Convalescent plasma treatments are blood plasma transfusions from people who have recovered from SARS-CoV-2. The idea is that along with the transfusion come antibodies that can help someone else with Covid-19 fight off the disease. The problem is that within certain recipients, the plasma could conceivably also create an environment that favors a stronger variant of the virus.

“So there are cases where the identical [mutations] that characterize the UK variant have also evolved in patients who are chronically infected with the virus and were then given convalescent plasma,” Worobey says. “It’s a perfect storm.” The virus has built up genetic diversity in the patient, and then the convalescent plasma acts as a force of natural selection, choosing among those variants one that could evade antibodies in that plasma.

Worobey is not saying that this definitely happened with the B.1.1.7 variant, just that it’s possible. (A similar thing, he says, could have happened with using monoclonal antibodies — synthetic antibodies produced as a Covid-19 treatment — on immunocompromised patients.)

It’s not that these treatments never should have been used. In many cases, they may have helped save lives when there are few treatment options for Covid-19. But in the case of using convalescent plasma on immunocompromised people, Worobey says, it may have been “a bit irresponsible.”

The virus will keep evolving. Vaccinations need to happen quickly, and cases need to decrease.

The virus will keep changing, and there will be more variants. Not all will be variants of concern, though.

“I think one thing that we definitely have to keep in mind, particularly in the next few weeks and months, is that a lot of people are now very interested in doing [viral genetic] sequencing and looking for variants,” Hodcroft says. “And that’s fantastic. This is exactly what I’ve been kind of begging for for a long time — for more countries to really dedicate resources to this.” But with the increased vigilance, she says, “we’re going to see a lot of false alarm variants.”

But there also might be more variants of concern in the near future, as the virus is about to get hit by another big selection pressure: vaccines.

If, due to random mutations, there’s a strain of the virus that is just a little bit better at evading the immunity provided by vaccines, it could spread.

That’s why these viral evolution experts want vaccination to happen as fast as possible. Just as partial immunity in a single immunocompromised person can act as a selection pressure for evolution, partial immunity in the population at large can as well.

“What we don’t want is for there to be high levels of virus circulating and spending a lot of time with a partially vaccinated population,” Hodcroft says. “We want to keep case numbers while we’re vaccinating as low as we can.”

That’s because “once you vaccinate hundreds of millions of people, the virus is going to be under really quite intense pressure to evolve [immune] escape variants,” Worobey says. Some of these variants, he warns, “may already be in existence” among the public but have not yet been detected — or may soon form as the pandemic continues. “And those variants, I think, we can expect to sweep up to much higher frequency once vaccination provides this huge selective force.”

Evolution happens when there’s a lot of genetic diversity, which then meets a selection pressure. This is what’s happening as the pandemic continues during a vaccination campaign.

The good news is that, for now, it appears the existing vaccines will still be broadly effective against the variants, and that it’s possible to update the vaccines to account for future changes. But how can we stop more viral evolution from happening in the first place?

“The best way to avoid it is to go back in time and not allow the pandemic to spin so out of control,” Worobey says. “If we had done that, and then vaccinated, then we would have been in a much less dangerous situation.”

Click Here:

THEY WERE THE days of their lives. At least that is what his father often tells him. Regularly they gather and reminisce about that famous summer. In 2014, Darragh Joyce captained Kilkenny to All-Ireland minor glory against a Limerick team that included Sean Finn, Cian Lynch, Barry Nash, Peter Casey and Seamus Flanagan.

Afterwards, Tipperary and Kilkenny played out a thrilling draw in the senior final. Still giddy from success, a few weeks later Joyce and his team-mates boarded the bus to Dublin and journeyed to Hill 16. From there he watched his older brother Kieran, who didn’t play the first day, put in a man-of-the-match performance as the Cats claimed the Liam MacCarthy Cup.

Source: Cathal Noonan/INPHO

Darragh won a minor title with the club in 2013.  A year later his older brothers, Kieran and Conor, played for Rower-Inistioge as they won the All-Ireland intermediate championship in Croke Park. On the rise and triumphant in the heartland of hurling. All the road signs pointed one way. A path firmly mapped out.

Until he veered off course. Fast forward two years. Joyce has accepted a rookie contract with AFL outfit St Kilda. Pursing a chance as a professional athlete in a world he knew little about. He landed and found himself scrambling to get organised. The teenager agonised over the decision, discussing it at length with local legends like Eddie Brennan.

This was a double-barrelled transition, to a new sport and a new realm. Any presumptions about the pervasive luxuries of a professional environment quickly proved wide of the mark. Routinely, the Irish Down Under point at our proximity to the UK football scene as the cause of so much misconception. The average salary in the AFL for an established player is around €240,000. The average in the Premier League is 10 times that. These planets are in separate solar systems.

Joyce had to figure it all out for himself. Before he’d even received his first paycheck, he had to organise a loan so he could buy a second-hand car. Imagine the pain when his new pride and joy broke down with engine issues shortly after. 

In every club, the Irish recruit starts at the bottom of the ladder. Number 45 on a list of 44. The smallest fish in a sizeable pond.

At the start, Joyce was mistakenly called ‘Daryl’ more than once and the centre of attention as the Irish novelty. A few months in and he was dropped. Not from the seniors, from the reserves. Down to a league he scarily knew existed. It doesn’t anymore. The development league. ‘Two’s twos.’

Source: Ryan Byrne/INPHO

Togging out at 10 in the morning to play as a curtain-raiser for the VFL as dogwalkers and recoiling Saturday night partygoers passed by obliviously.   

Every day, Joyce would trek home from training. On the way, he’d pass a travel agent. Quickly he developed a routine. Head in and the same refrain: ‘I was just wondering how much flights to Ireland are today? Two routes loomed large on his horizon. Fight or flight. Returning home was the understandable one. The route the majority would opt for.

Joyce elected for a different approach. He dug in. Persevered. Persisted. Transformed his body and his attitude. Bottled all his frustration. As a key defender, he will never have 30 possessions. It is about shutting your opposite man out. Daily physicality and tenacity. He started embracing rather than dreading every weight and skin fold test. 88kg of puppy fat became 96kg of sheer brawn. All the while, channelling any slight to create an arsenal of aggression, unleashed in every single practice match.  

“Around 2018 he wasn’t getting a look, but I always found him a really tough opponent and defender,” recalls star AFL goalkicker Joshua Bruce. Bruce has 150 AFL appearances. He was St Kilda’s leading goalkicker in 2015 and the Western Bulldogs’ leading goalkicker in 2021. He and Joyce were regular training opponents. 

“His bodywork and strength and speed were really good for that lockdown defender role. It felt like he obviously still needed to work on his game sense, but I kept telling the coaches that he was a bloody hard match-up. I think I kept using the phrase ‘best defender we’ve got’ to force it home.”

Eventually, the message registered with the selection committee and they took his advice on board. Darragh Joyce debuted in July 2018.  

“Turns out they actually listened and did give him a few games,” says Bruce. “I think physically he’s bloody annoying to play on which is always a good sign as a key defender!”

Source: AAP/PA Images

Since then, Joyce has played 10 games for the club. He was set for his first prolonged stint in the first team last year until fate dealt another cruel blow. Three concussions in 12 months and a Covid contact scare after attending a rugby international severely hampered his campaign. Despite serious interest from one other club, he signed a new deal with the Melbourne outfit ahead of a crucial 2022. 

St Kilda are looking to kick on from a disappointing season and have recruited another Irishman to help them do it. Cavan native Nicholas Walsh was recently appointed high-performance manager of the club. The same Walsh that was once told he wasn’t capable of coaching football because he was Irish and wouldn’t understand the technicalities of the game.

These are just some of the remarkable Irish in Australia yarns. In some ways, it seems a shame they aren’t given due recognition. Coverage closer to home struggles to scratch the surface. Basic details like statistics, achievements or the clubs they play for are often wrong. Not everyone opts for the Stuart Magee approach and actually calls up to correct the record.

As a child, Magee and his family boarded a boat in Belfast and docked in Williamstown weeks later. He went on to amass 216 appearances for South Melbourne and Footscray. So, you can imagine his reaction when he opened the paper to read about Zach Tuohy’s big milestone.

“It said, ‘The second Irishman after Jim Stynes to reach that milestone,’” Magee recalled last year.

“We got the paper here and I was looking at it thinking, ‘I came over in a boat. I lived in a hostel, and we put up with some of the worst things. I travelled all over Melbourne to play. Do I not count?’

“What happened to me? That is why I rang the bloke from the paper. I said, ‘my name is Stuart Magee, I was born in Belfast in 1952. I travelled to Australia and played for South Melbourne. I captained the Western Bulldogs.’”

For the current crop Down Under, the scars from how the media treated Conor McKenna after his Covid case still linger. And in Ireland, such missteps are understandable. Australia is, after all, on the other side of the globe. Gaelic football and AFL are similar sports but also, totally different. It is a near-impossible task to understand a different sporting history and contextualise foreign achievements within that sphere.

Source: Tommy Dickson/INPHO

65 GAA converts have made the move since Sean Wight in 1982. Five of them have played over 150 games. The vast majority return after a few years. Still, recruiters maintain that it is a promising strike rate when compared to the AFL draft. There any prospect picked outside the top 20 is doing extremely well to come anywhere close to 100 games. Outside of the top 50 picks, the average appearance is less than 50.

At the end of last year, Luke Towey and Stefan Okunbor’s stints with the Gold Coast Suns and Geelong respectively came to an end. Mark Keane and Anton Tohill voluntarily elected to leave Collingwood and return home. Oisin Mullin also turned down the opportunity to join Geelong.

Any fears that this would prompt clubs to reconsider Irish recruitment have proven to be ill-founded. Clubs continue to utilise a rich and varied scouting network. Discussions about a return of the combine, perhaps in a joint capacity for males and females, are ongoing. A few more will make the move over the next few years and attempt to scale an arduous mountain.  

This season, Joyce, Hawthorn’s rejuvenated Conor Nash, Sydney Swans stalwart Colin O’Riordan and Brisbane flyer James Madden will all hope for regular game time. Zach Tuohy and Mark O’Connor aspire to be leading lights as Geelong chase an elusive Premiership. Callum Brown looks to kick on with GWS Giants. Sydney’s Barry O’Connor and Essendon’s Cian McBride want to debut and put the chaos of two Covid-compromised years behind them. At Brisbane, Deividas Uosis will continue his development. Fionn O’Hara is just starting out on his career with Hawthorn.  

All striving to defy the odds and make their mark. Continuing to produce chapters in a great Irish sporting story. 

Ireland internationals Devin Toner and Lindsay Peat were our guests for The Front Row’s special live event, in partnership with Guinness, this week. The panel chats through Ireland’s championship chances ahead of the final round of Guinness Six Nations matches, and members of the Emerald Warriors – Ireland’s first LGBT+ inclusive rugby team – also join us to talk about breaking down barriers in rugby. Click here to subscribe or listen below:

People who are pregnant are now eligible to get the coronavirus vaccine in more than 40 states — typically ahead of their lower-risk peers. And more than 60,000 of them have already rolled up their sleeves, according to the Centers for Disease Control and Prevention.

Although the Covid-19 vaccines authorized in the US were not studied in pregnancy, early data is now starting to emerge suggesting — as researchers expected — that the vaccines are likely safe during pregnancy and confer protection not only to the recipient but also, potentially, the baby.

“It’s all very positive,” says Stephanie Gaw, a maternal-fetal medicine specialist at the University of California San Francisco Medical Center, of the findings so far.

There have been many reasons to suspect the vaccines should be safe in pregnancy, including the lack of major adverse events reported so far, solid studies in animals, and a good understanding of how the vaccines work in the body (they don’t contain live virus, and they are quickly broken down). “The data that we’re collecting on it so far has no red flags,” Anthony Fauci, the top US infectious disease doctor, said in February.

Meanwhile, new research, published March 25 in the American Journal of Obstetrics and Gynecology, found that the vaccines offer strong immune protection for people who are pregnant, just like their non-pregnant peers.

Preliminary research also suggests vaccines might provide some protection to newborns, who are unlikely to have their own approved Covid-19 vaccine anytime soon (and are also vulnerable to more severe illness). The new AJOG paper joins other early findings that antibodies to Covid-19 generated by pregnant mothers after receiving their vaccines were passed through the placenta to the fetus.