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With the new omicron coronavirus variant in the US, doctors and public health officials are strengthening their call for coronavirus boosters as maximum protection against severe COVID-19 disease.
With the expectation that omicron would reach the US and add to the wave of COVID-19 cases caused by the delta variant, the Centers for Disease Control and Prevention strengthened its recommendation last week that all US adults “should” get a booster. (Though all adults have been eligible since mid-November, the CDC previously split hairs over who “should” get one and who “may” get a booster.) Health officials are calling on adults to be as protected as possible this winter through the same health measures that’ve been used throughout the pandemic to curb infection. While scientists need more time to determine if omicron is as contagious as it seems — likely more so than delta but less severe in disease (early data from South Africa is encouraging, but not definitive) — health officials say the same measures used to curb previous variants will also be effective against omicron.
“We know what we need to do to protect people,” Dr. Anthony Fauci, President Joe Biden’s chief medical adviser, said at a briefing last week. “Get vaccinated if you’re not already vaccinated. Get boosted if you’ve been vaccinated for more than six months with an mRNA (Pfizer or Moderna) or two months with J&J (Johnson & Johnson).”
The booster rollout, and the idea of giving extra shots to otherwise healthy adults, has been a controversial one. Just 6.3% of people in low-income countries have received a coronavirus vaccine, according to Our World in Data. The Biden administration has said the US can continue vaccine donations to other countries while also providing boosters to Americans, pledging to donate 1.2 billion doses. On Tuesday, White House COVID-19 Response Team Coordinator Jeff Zients said the US has now donated 300 million doses of COVID-19 vaccine
All adults can get any of the three available COVID-19 vaccines in the US as a booster shot — a “mix and match” approach to COVID-19 vaccines. Currently, the CDC doesn’t have a “product preference” on one booster over the others — noting that it’s generally recommended to stick to the same brand for primary and second vaccine series, but people can choose whichever booster they’d like or is available to them.
Here’s what we know now about mixing COVID-19 vaccines and how to choose your booster.
Are the boosters effective against omicron?
Pfizer and its partner BioNTech announced Wednesday that two doses of their vaccine appear to be less protective against COVID-19, but a booster dose restores some of that power. Officials at BioNTech also said Wednesday that the companies could have an omicron-specific vaccine ready by March 2022, if research shows it’s needed. Moderna said it’s studying the effectiveness of its vaccine and could make an omicron-specific vaccine if necessary. Johnson & Johnson said it’s working with officials in South Africa to evaluate its vaccine’s effectiveness and also started work on a vaccine specific to omicron, if it’s needed.
In an interview with NBC from Nov. 28, Fauci said that even in the face of a variant of concern, you do well against it if you have the increased protection of a booster. “It may not be as good in protecting against initial infection, but it has a very important impact on diminishing the likelihood that you’re gonna get a severe outcome from it,” he said, adding that boosting gives an “extraordinary increase in protection.”
What’s the difference among the COVID-19 vaccines?
While all three vaccines have the same effect — protection against severe COVID-19 disease — the way they function is a little different. Pfizer and Moderna are mRNA vaccines, which teach our cells to make a specific protein and build immunity against a virus. Johnson & Johnson is a viral vector vaccine, which uses a harmless virus to activate an immune response and tell our bodies what to fight in future infections.
What are the benefits of ‘mixing and matching’ COVID-19 boosters?
Individual choice in boosters means health care providers can make recommendations based on patients’ circumstances. A member of the CDC’s advisory panel, which meets prior to recommending a vaccine or booster, pointed out at a meeting about mixed boosters that allowing it could lead to fewer doses being wasted if health care providers only have to open one bottle of vaccine for patients in the waiting room, for example. Hopefully, more flexibility with boosters will lead to an easier vaccination process in places that administer many doses at once, such as nursing homes. People may also opt for a different vaccine if they’re at higher risk for a rare side effect from a particular vaccine.
In a study published in the journal Nature in May, researchers in Spain found that people who received one dose of AstraZeneca (a similar vaccine to Johnson & Johnson) and then received a dose of Pfizer seem to produce a higher antibody response than people who receive two doses of AstraZeneca. It isn’t clear whether this group had a higher immune response than people who received two doses of Pfizer.
Early research funded by the National Institutes of Health prior to the CDC’s recommendation also found that mixing vaccines is safe and effective, or perhaps even beneficial in some cases.
According to booster data on primary series and booster choice the CDC is collecting, over 4 million Americans so far have opted for a different vaccine brand as a booster. (Most have chosen their original vaccine as a booster.) However, there isn’t a lot of data on mixing COVID-19 vaccines in the US because it hasn’t been allowed until recently. Information from outside the US has been promising, though, as other countries have been officially allowing (or even recommending) people receive two different vaccines, including Germany, Canada, Sweden, France, Spain and Italy.
Which booster shot should I get if I got Pfizer?
Both mRNA vaccines, Pfizer and Moderna, have proven to be effective and continue to protect against severe disease caused by COVID-19. A study published by the CDC in September that compared vaccine effectiveness among adults in the real world found that two doses of Moderna’s vaccine were 93% effective at preventing hospitalization, two doses of Pfizer were 88% effective and one dose of Johnson & Johnson was 71% effective.
Pfizer’s booster is the same dose as its original vaccine (30 micrograms), while Moderna’s booster (50 micrograms) is half the size of its original vaccine. Johnson & Johnson’s booster is also the same size as its original vaccine. In a study that examined people’s responses to all three vaccines as boosters, people who originally got Pfizer had the strongest antibody response to a Moderna booster. However, that study examined a full dose of Moderna (100 micrograms), rather than the authorized half-dose of the company’s booster, which likely minimizes Moderna’s edge over Pfizer, The Atlantic reported.
For most adults who were vaccinated with Pfizer, sticking with another dose of Pfizer makes the most sense, Dr. Robert Wachter, chair of UC San Francisco’s Department of Medicine, told the Los Angeles Times.
“I got Pfizer and stuck with getting another Pfizer — just seemed simpler. Why introduce a new agent into my body for probably zero, or maybe tiny, benefit?” he told the LA Times. “But if your goal were to give yourself any possible advantage in immunity, you can make an argument to switch to Moderna.”
If you’re in a group that would benefit most from every inch of immunity (which includes the elderly and people with health conditions that make them most susceptible to severe COVID-19), it might be worth a quick call to your health care provider to discuss your personal circumstances. However, the urgency of a new variant might also influence your decision, which includes what’s available to you the soonest.
The definition of “fully vaccinated” hasn’t changed. A person is considered fully vaccinated two weeks after their second dose of Pfizer or Moderna, or two weeks after a single dose of Johnson & Johnson.
Sarah Tew/CNET
What if I got Moderna?
Similar to Pfizer, most Moderna recipients probably don’t have a need to choose a different booster, unless how quickly they can get an appointment is an issue.
There might be exceptions — if you had an allergic reaction to Moderna’s vaccine, for example, you should consult a doctor and choose a different vaccine for future shots. An early report on Canadian data also suggested Moderna might carry a higher risk of myocarditis, an uncommon side effect of the mRNA vaccines mostly seen in men under 30, compared to Pfizer. With this assumption, a man under 30 who originally received Moderna but is concerned about myocarditis may ask a health care provider about switching to Johnson & Johnson or Pfizer. But again, Moderna’s booster is a smaller dose than its original vaccine, which could be a factor in your decision.
Some public health experts have argued that a second shot for people who got Johnson & Johnson is more like completing the series, rather than getting a booster. In a clinical trial shared by Johnson & Johnson, a second dose of J&J two months after the first shot made the vaccine 94% protective against symptomatic COVID-19. However, some experts also argue that Johnson & Johnson recipients are better off choosing either mRNA vaccine while pointing to a different study that showed higher antibody responses following a boost of mRNA vaccine compared with a boost of J&J. (Antibody response is not the only element of immunity, however.)
Women under 50 who originally got J&J should be especially aware of the availability of other vaccines, the CDC says, because they’re at an increased risk for the rare but serious blood-clotting disorder associated with J&J’s vaccine (which isn’t seen with Pfizer’s or Moderna’s). For example, Dr. Leana Wen, physician and public health professor at the Milken Institute School of Public Health at the George Washington University, detailed her decision to get a Pfizer booster after being vaccinated with Johnson & Johnson in a report for The Washington Post.
Older men who might be at an increased risk of the rare neurological disorder associated with J&J’s vaccine may also choose another type of vaccine. In general, people who originally received Johnson & Johnson’s vaccine and have a health condition that makes them more susceptible to severe COVID-19 should be especially aware of the benefits of mixing with an mRNA vaccine and the higher immune response it seems to bring.
As of now, the CDC’s recommendation is that all adults in the US “should” get a booster. This is because even if the omicron variant lowers the efficacy of the vaccines, scientists expect COVID-19 vaccines to remain protective against severe disease.
Before omicron, earlier in November, the CDC advisory panel voted unanimously to recommend boosters for all adults, but they also acknowledged that some people need them more than others. The guidance was that people age 50 and older “should” get a booster (a younger age than the previous guidance for everyone age 65 and older), in addition to other groups who “should” get one because of a clearer benefit, including adults living in long-term care facilities and everyone who received Johnson & Johnson’s vaccine. For all other adults, the choice was more dependent on personal circumstances or preference.
Are you fully vaccinated after your booster?
Importantly, the definition of fully vaccinated hasn’t changed. You’re fully vaccinated two weeks after your second Pfizer or Moderna shot or two weeks after your Johnson & Johnson vaccine. Whether someone has received a booster doesn’t affect their “fully vaccinated” status.
Can I mix and match the first two shots?
No, the CDC’s statement on mixing COVID-19 vaccines only applies to boosters. As of now, the FDA has only authorized a mixed-series booster, meaning the first coronavirus vaccine series must be one dose of Johnson & Johnson or two doses of Moderna or Pfizer.
Once the mixed-series boosters start rolling out to Americans in greater numbers, there will be more data on the safety and effectiveness of a mixed COVID-19 series. Although it might be too early to hope, this might mean that data on mixing for boosters will inform decisions on primary coronavirus vaccine series being used together, making it easier to reach underserved communities, and possibly reducing health care and vaccine inequity.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
Skinstitut Holiday Gift Kits take the stress out of gifting
Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.
In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.
“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.
There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.
Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.
Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.
In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.
Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?
It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.
Here’s how you can prepare your digital life for your survivors:
Apple
The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.
For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.
You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.
Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.
Google
Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.
When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.
You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.
There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.
Facebook and Instagram
Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.
When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.
The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.
You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.
TikTok
The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.
Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.
X
It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.
Passwords
Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?
Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.
But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.
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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.
The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.
New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.
The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.
Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.
Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.
“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.
“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”
McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.
But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.
The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.
He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.
“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.
“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.
McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”
McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.
He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.
“Early identification of reading difficulty can truly change the trajectory of a child’s life.”
This report by The Canadian Press was first published Oct. 23, 2024.
