🌳💉💥 Wen Da Feds Put Up Tree Defense Fo Fight ‘Da Tripledemic

⬇️ Pidgin | ⬇️ ⬇️ English

Dis fall, Americans goin’ get urged fo get shots against da flu, Covid, and, if dey mo’ oldah, R.S.V. 💉🤧💪

Fo prevent one repeat of last winter’s “tripledemic” of respiratory illnesses, Americans goin’ be encouraged fo roll up dey sleeves not jus’ fo flu shots but fo two oddah vaccines, one of ’em brand spankin’ new. 💪💉🌬️

Da Federal health officials, dey already wen ask da manufacturers fo produce reformulated Covid vaccines fo be distributed later dis year. Recently, da Centers fo Disease Control and Prevention took one additional step, endorsing two new vaccines against respiratory syncytial virus fo older Americans. 💼💉🌡️

Da three shots — flu, Covid, and R.S.V. — may help fo reduce hospitalizations and deaths later dis year. But get uncertainties ’bout how da vaccines da best way fo administer, who goin’ benefit da most, and what da risks may be. ❓💉🏥

Fo older and immunocompromised Americans, all three vaccines stay one “godsend,” said Dr. Ofer Levy, director of da precision vaccines program at Boston Children’s Hospital and one adviser to da Food and Drug Administration. “Da numbah of elders who mahke from viral infection every winter in our intensive care units, and sometimes even in da summah, stay big — it’s in da tens of thousands of individuals,” Dr. Levy said. “Each of dese vaccines stay one huge win.” 🙌💉👵

Yet we no too sure how much Americans goin’ opt fo da shots. Some 71 percent of adults ages 65 and oldah wen get one flu shot dis past winter, but only ’bout 43 percent wen choose fo get da Covid booster. 😷💉😕

Da misery of da past winter may help change minds. Da flu may have led to as many as 58,000 deaths, peaking in December, according to da C.D.C. Covid claimed roughly 50,000 lives between November and March. 😢💔💉

R.S.V. kills up to 10,000 people each year, most of ’em older. Infections dis year wen peak in November and result in ’bout twice as many hospitalizations, including children, as in prepandemic years. 😷🌬️🚑

Only da Covid and flu vaccines wen stay available last fall. Da R.S.V. vaccines fo’ adults stay new, and in clinical trials wen prove fo’ be highly effective against infection of da lower respiratory tract, which includes da lungs. 💉🌬️🦠

In May, da F.D.A. wen approve da first two versions, made by Pfizer and GSK, fo’ older adults. Da C.D.C.’s advisers recommend dat Americans age 60 and oldah get da shot aftah talking to dey doctors. (Da Pfizer vaccine stay also being evaluated fo’ use in pregnant women fo’ protect newborn infants.) 👴💉🤰

Bundling all three inoculations into one visit to one clinic or pharmacy goin’ likely encourage mo’ people fo’ get immunized, Dr. Levy said. “Plus, you like fo’ get dese shots in arms befo’ da viral respiratory season in da winter,” he added. 💪💉🏥❄️

But oddah scientists no too sure ’bout dat idea, citing da lack of data onsafety and effectiveness when all three vaccines given at da same time. Sometimes, vaccines can work against each oddah when administered simultaneously. According to data presented to da C.D.C.’s advisers, da R.S.V. and flu vaccines wen produce lower levels of antibodies when given at da same time den when dey given alone.

“I would say, when possible, it might be good fo’ spread dem out,” said Dr. Camille Kotton, one physician at Massachusetts General Hospital and one member of da C.D.C. scientific advisory panel.

“I stay clinically concerned, especially when da influenza vaccine no give as much protection as we would like,” she said. Da majority of people at risk fo’ illness and death from dese viruses stay dose 75 and oldah. In dat group, da benefit from each of da vaccines clearly outweighs any safety concerns, Dr. Kotton and oddah experts said. 👩⚕️💉😷

Up to 85 percent of flu-related deaths in recent years stay among dose age 65 and oldah, according to da C.D.C. Da agency recommend dat oldah adults get one high-dose flu vaccine or one wit’ an adjuvant, one ingredient dat can produce one stronger immune response.

Hospitalizations and deaths from Covid also happen mostly in da oldest Americans, and Covid boosters stay now thought to be beneficial mostly fo’ oldah adults and people wit’ weakened immune systems. 💉🏥💪

In June, da F.D.A. advised Pfizer-BioNTech, Moderna, and Novavax fo’ manufacture Covid shots designed to target XBB.1.5, da Omicron variant dat accounts fo’ roughly 27 percent of cases. However, dat variant seem fo’ be receding, and one newer variant, XBB.1.16, stay on da rise. 🦠💉📉

R.S.V. stay da main cause of infant hospitalizations in da United States and one of da top killers of young children in low- and middle-income countries. Da virus wen nevah really get recognized as one respiratory threat to adults until recently. 🚼😷🌡️

Da virus can lead to as many as 160,000 hospitalizations and 10,000 deaths among older adults every year, according to da C.D.C. — and dose numbers probably stay undahestimated. For every one million adults age 65 and oldah who get da vaccine, 25,000 outpatient visits, 2,500 hospitalizations, and 130 deaths would be prevented, according to one analysis presented to da agency’s advisers. 💔🏥💉😢

Fo’ many decades, vaccines against R.S.V. stay one challenge fo’ design. But in 2013, dey wen get one breakthrough, and dat wen inspire efforts by several companies. In one recent trial, da GSK vaccine, to be sold as Arexvy, stay effective even into da second year, and dey still studying how effective it can be even longah. Pfizer stay still checking how long-lasting deir vaccine stay gonna be, and dey gonna market it as Abrysvo. If da vaccines stay effective ova long periods, people may no need one R.S.V. shot every year. 💉🎉🌬️

Da trials by da companies no wen have enough people who was immunocompromised, medically frail, living in long-term care facilities, or dose 75 and oldah fo’ see how effective da vaccines stay in dose groups. And dose groups stay da most vulnerable to R.S.V.

Even though flu and oddah vaccines carry small risk of da autoimmune disease Guillain-Barré syndrome, da numbers usually stay ’bout one or two cases per million. When evaluating da new R.S.V. vaccines, da manufacturers wen report three cases of neurological problems, including Guillain-Barré syndrome, within 42 days of vaccination in a population of ’bout 40,000 people.

Still, da trials no wen be big enough fo’ determine if dose cases happen by chance or caused by da vaccines. “We no can get dat information until aftah da vaccines stay licensed and recommended and roll out,” said Dr. Helen Chu, one physician and immunologist at da University of Washington.

Influenza, Covid, and R.S.V. infections themselves pose da risk of Guillain-Barré syndrome and oddah neurological problems, so da balance between risks and benefits still strongly favors vaccination, Dr. Chu said.

However, da reports of adverse events related to da R.S.V. vaccines make some C.D.C. advisers hesitant fo’ recommend dem fo’ people who no face high risks from da infection.

Dat’s partly why da scientific panel said dat anyone age 60 and oldah “may” choose to get da vaccine aftah consulting wit’ one doctor, instead of issuing one blanket recommendation fo’ all adults ova 60 or even 65.

Dis decision can deepen da racial inequities when it comes to vaccination, according to some experts. Many people of color, who often face higher risk of severe illness or death, no get easy access to one healthcare provider who can help dem weigh da risks and benefits of R.S.V. vaccination.

Dis recommendation also put da responsibility on general physicians and oddah healthcare providers fo’ weigh da risks and benefits, Dr. Chu pointed out.

“It’s hard fo’ da committee,” she said, referring to da C.D.C.’s expert panel. “And it’s definitely gonna be much, much harder fo’ one G.P.” 😬👩⚕️💭

Da C.D.C.’s recommendations make sure dat most Americans no need fo’ pay outta dey own pocket fo’ da vaccines. Dis fall stay da first time dat da distribution of Covid vaccines no goin’ be managed by da federal government, but insurance companies goin’ still cover da costs.

How much Pfizer and GSK goin’ charge fo’ da new R.S.V. vaccines still stay unclear. Pfizer wen say da price of deir vaccine still stay in negotiation, but it might be ’bout $180 to $270.

GSK wen double deir initial price of $148 two weeks before da C.D.C. advisers was supposed to meet, giving da agency staff li’l time fo’ redo dey cost-effectiveness analysis, according to one C.D.C. scientist wit’ knowledge of da matter. GSK now settled on one range of $200 to $295.

GSK wen raise deir price ’cause of da new data showin’ effectiveness into da second season, said Alison Hunt, one spokeswoman fo’ da company.

Ongoing research goin’ provide mo’ information ’bout da new R.S.V. vaccines. In preliminary data, one second dose of da GSK vaccine no wen boost antibody levels, which puzzled da science advisers at last week’s meeting.

Pfizer stay investigatin’ whether one second dose of deir vaccine, given one year aftah da first, goin’ boost immunity. Dem results expected sometime early next year. Da companies also studying whether people who have already been infected wit’ R.S.V. should still get da vaccine. 🧪💉🔬

While da road ahead still full of questions, da efforts to combat da triple threat of da flu, Covid, and R.S.V. continue. Da hope remain dat widespreadvaccination will help protect individuals, especially da older adults and those wit’ weakened immune systems, from da severe consequences of dese respiratory illnesses. Da vaccines offer a ray of hope in da face of da ongoing pandemic and da looming threat of seasonal respiratory infections. It’s crucial fo’ individuals to stay informed, consult wit’ healthcare providers, and make informed decisions ’bout vaccination.

As we move forward, da collective effort to combat da tripledemic requires collaboration between federal officials, healthcare professionals, vaccine manufacturers, and da general public. By working togethah, we can strive fo’ a healthier and safer future, where da impact of these respiratory illnesses is minimized, hospitalizations and deaths are reduced, and our communities can thrive once again. 💪💉🌍🤝

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NOW IN ENGLISH

🌳💉💥 Federal Officials Hatch a Three-Pronged Defense Against Another ‘Tripledemic’

This fall, Americans will be urged to get shots against the flu, Covid, and, if they’re older, R.S.V. 💉🤧💪

To prevent a repeat of last winter’s “tripledemic” of respiratory illnesses, Americans will be encouraged to roll up their sleeves not just for flu shots but for two other vaccines, one of them entirely new. 💪💉🌬️

Federal health officials have already asked manufacturers to produce reformulated Covid vaccines to be distributed later this year. Recently, the Centers for Disease Control and Prevention took an additional step, endorsing two new vaccines against respiratory syncytial virus for older Americans. 💼💉🌡️

The three shots — flu, Covid, and R.S.V. — may help to reduce hospitalizations and deaths later this year. But there are uncertainties about how the vaccines are best administered, who is most likely to benefit, and what the risks may be. ❓💉🏥

For older and immunocompromised Americans, all three vaccines are a “godsend,” said Dr. Ofer Levy, director of the precision vaccines program at Boston Children’s Hospital and an adviser to the Food and Drug Administration. “The number of elders who die of viral infection every winter in our intensive care units, and also sometimes in the summer, is large — it’s in the tens of thousands of individuals,” Dr. Levy said. “Each of these vaccines is a huge win.” 🙌💉👵

Yet it’s unclear how many Americans will opt for the shots. Some 71 percent of adults ages 65 and older got a flu shot this past winter, but only about 43 percent chose to get the Covid booster. 😷💉😕

The misery of the past winter may help change minds. The flu may have led to as many as 58,000 deaths, peaking in December, according to the C.D.C. Covid claimed roughly 50,000 lives between November and March. 😢💔💉

R.S.V. kills up to 10,000 people each year, most of them older. Infections this year peaked in November and resulted in about twice as many hospitalizations, including children, as in prepandemic years. 😷🌬️🚑

Only the Covid and flu vaccines were available last fall. The R.S.V. vaccines for adults are new, and in clinical trials proved to be highly effective against infection of the lower respiratory tract, which includes the lungs. 💉🌬️🦠

In May, the F.D.A. approved the first two versions, made by Pfizer and GSK, for older adults. The C.D.C.’s advisers recommend that Americans age 60 and older get the shot in consultation with their doctors. (The Pfizer vaccine is also being evaluated for use in pregnant women as a way to protect newborn infants.) 👴💉🤰

Bundling all three inoculations into a single visit to a clinic or pharmacy is likely to encourage more people to get immunized, Dr. Levy said. “Plus, you want to get these shots in arms before the viral respiratory season in the winter,” he added. 💪💉🏥❄️

But other scientists hesitated to endorse the idea, citing the paucity of data on safety and effectiveness when all three are given at the same time. Sometimes, vaccines work against one another when administered simultaneously. According to data presented to the C.D.C.’s advisers, the R.S.V. and flu vaccines produced lower levels of antibodies when given at the same time than when either was given alone.

“I would say, when possible, it might be good to spread them out,” said Dr. Camille Kotton, a physician at Massachusetts General Hospital and a member of the C.D.C. scientific advisory panel.

“I remain clinically concerned, especially where influenza vaccine doesn’t engender as much protection as we might like,” she said. The vast majority of people at risk for illness and death following infections with these viruses are those 75 and older. In that group, the benefit from each of the vaccines clearly outweighs any safety concerns, Dr. Kotton and other experts said. 👩⚕️💉😷

Up to 85 percent of flu-related deaths in recent years were among those age 65 and older, according to the C.D.C. The agency recommends that older adults get a high-dose flu vaccine or one with an adjuvant, an ingredient that can produce a stronger immune response.

Hospitalizations and deaths from Covid also occur primarily in the oldest Americans, and Covid boosters are now thought to be beneficial primarily for older adults and people with weakened immune systems.

In June, the F.D.A. advised Pfizer-BioNTech, Moderna, and Novavax to manufacture Covid shots designed to target XBB.1.5, the Omicron variant that accounts for roughly 27 percent of cases. That variant seems to be receding, however, and a newer variant, XBB.1.16, is on the upswing. 🦠💉📉

R.S.V. is the leading cause of infant hospitalizations in the United States, and among the top killers of young children in low- and middle-income countries. The virus was underappreciated as a respiratory threat to adults until recently. 🚼😷🌡️

The virus may lead to as many as 160,000 hospitalizations and 10,000 deaths among older adults each year, according to the C.D.C. — and those numbers are likely to be underestimates. For every one million adults age 65 and older who get the vaccine, 25,000 outpatient visits, 2,500 hospitalizations, and 130 deaths would be prevented, according to one analysis presented to the agency’s advisers. 💔🏥💉😢

For decades, vaccines against R.S.V. proved challenging to design. A breakthrough in 2013 galvanized efforts by several companies. In a recent trial, the GSK vaccine, to be sold as Arexvy, retained much of its potency into the second year, and its efficacy is being studied for an even longer period. Pfizer is still evaluating the durability of its vaccine, which will be marketed as Abrysvo. If the vaccines remain effective over a long time, an R.S.V. shot may not be needed every year. 💉🎉🌬️

The companies’ trials did not enroll enough people who were immunocompromised, medically frail, live in long-term care facilities, or were 75 and older to gauge efficacy in those groups. These are also the Americans most vulnerable to R.S.V.

Although flu and other vaccines carry a small risk of the autoimmune disease Guillain-Barré syndrome, those numbers generally are on the order of one or two cases per million. Evaluating the new R.S.V. vaccines, the manufacturers each reported three neurological cases, including Guillain-Barré syndrome, within 42 days of vaccination in a population of about 40,000 people.

Still, the trials were not large enough to determine whether those cases occurred by chance or were caused by the vaccines. “That informationreally can’t be obtained until post-licensure and post-recommendation and rollout,” said Dr. Helen Chu, a physician and immunologist at the University of Washington.

Influenza, Covid, and R.S.V. infections themselves pose a risk of Guillain-Barré syndrome and other neurological problems, so the risk-benefit balance still heavily favors vaccination, Dr. Chu said.

Still, the reports of adverse events related to the R.S.V. vaccines made some C.D.C. advisers reluctant to back them for people who do not face high risks from the infection.

That’s partly why the scientific panel said that anyone age 60 and older “may” opt to get the vaccine in consultation with a doctor, instead of issuing a blanket recommendation for all adults over 60 or even 65.

That decision risks deepening racial inequities regarding vaccination, some experts said. Many people of color, often at disproportionate risk of severe illness or death, do not have easy access to a health care provider who might help them weigh the risks and benefits of R.S.V. vaccination.

The recommendation also places the onus on general physicians and other health care providers to weigh the risks and benefits, Dr. Chu noted.

“It’s hard for the committee,” she said, referring to the C.D.C.’s expert panel. “It’s certainly going to be much, much harder for a G.P.” 😬👩⚕️💭

The C.D.C.’s recommendations ensure that most Americans will not have to pay out of pocket for the vaccines. This fall marks the first time that the distribution of Covid vaccines will not be managed by the federal government, but insurance companies will continue to cover the costs.

How much Pfizer and GSK will charge for the new R.S.V. vaccines is still unclear. Pfizer said the price of its vaccine was still being negotiated, but might fall between $180 and $270.

GSK doubled its initial price of $148 two weeks before the C.D.C. advisers were scheduled to meet, giving the agency staff little time to redo its cost-effectiveness analysis, according to one C.D.C. scientist with knowledge of the matter. GSK now has settled on a range of $200 to $295.

GSK raised its price because of the new data showing effectiveness into a second season, said Alison Hunt, a spokeswoman for the company.

Ongoing research is likely to provide more information on the new R.S.V. vaccines. In preliminary data, a second dose of the GSK vaccine did not boost antibody levels, which puzzled the science advisers at last week’s meeting.

Pfizer is investigating whether a second dose of its vaccine, given one year after the first, will boost immunity. Those results are expected some time early next year. The companies are also studying whether people who are already infected with R.S.V. should still get the vaccine. 🧪💉🔬

While the road ahead still has some uncertainties, the efforts to combat the triple threat of the flu, Covid, and R.S.V. continue. The hope remains that widespread vaccination will help protect individuals, especially the older adults and those with weakened immune systems, from the severe consequences of these respiratory illnesses. The vaccines offer a ray of hope in the face of the ongoing pandemic and the looming threat of seasonal respiratory infections. It’s crucial for individuals to stay informed, consult with healthcare providers, and make informed decisions about vaccination.

As we move forward, the collective effort to combat the tripledemic requires collaboration between federal officials, healthcare professionals, vaccine manufacturers, and the general public. By working together, we can strive for a healthier and safer future, where the impact of these respiratory illnesses is minimized, hospitalizations and deaths are reduced, and our communities canthrive once again. 💪💉🌍🤝