Novavax’s COVID vaccine nears the finish line : Shots

Researchers at the College of Washington Medication Retrovirology Lab at Harborview Healthcare Center in Seattle procedure samples from Novavax’s stage 3 COVID-19 vaccine medical demo in February 2021.

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Scientists at the University of Washington Medication Retrovirology Lab at Harborview Health care Centre in Seattle process samples from Novavax’s period 3 COVID-19 vaccine scientific demo in February 2021.

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A new variety of COVID-19 vaccine is about to roll out all over the world. Though it would not swap the highly prosperous vaccines at this time available, it could make a variation in the class of the pandemic, in particular in reduced resourced countries.

These new vaccines are what is named protein subunit vaccines. They get the job done by injecting men and women with a very small part of the virus. In the scenario of the COVID-19 vaccine, that little portion is the so-named spike protein critical for the virus to enter cells.

An gain of protein subunit vaccines is they have a tendency to be pretty secure, so they never demand freezers for storage. A regular fridge is suitable. This will make distributing the vaccine much a lot easier.

“We ended up assuming that the protein subunit vaccines would engage in a huge job in accelerating growth of a COVID vaccine,” says Julie McElrath directs the vaccine and infectious disease division at the Fred Hutchinson Cancer Analysis Heart in Seattle. McElrath claimed she and her colleagues’ self confidence arrived because there had been by now subunit vaccines on the marketplace for infectious illnesses.

When Procedure Warp Pace started investing billions of bucks to aid the advancement of a COVID-19 vaccine, it selected three vaccine systems to again: mRNA vaccines remaining formulated Pfizer and Moderna, a viral vector vaccine proposed by Johnson & Johnson, and protein subunit vaccines to be designed by Sanofi and Novavax.

The 1st two systems were prosperous, and there are now billions of vaccine doses in this place and all over the globe.

A yr ago, Novavax was confident its vaccine would also be out there.

“We have a significant quantity of persons working on scaling up our vaccine,” Gregg Glenn, Novavax’s president of investigate and growth mentioned in an interview in September 2020. “I am extremely optimistic by the year-close we will have a large amount of merchandise and we’re conversing about a lot more than 2 billion doses in 2021.”

But Glenn’s optimism was misguided. A significant review of the vaccine took longer to entire than was hoped, and the company ran into manufacturing complications.

Sanofi stumbled with its protein subunit vaccine, much too.

McElrath is persuaded that subunit vaccines can even now enjoy an crucial role in bringing the pandemic beneath manage. “It really is just that they are just a tiny more guiding than the other folks,” she suggests.

“Getting multiple alternatives is constantly a fantastic plan,” claims Ali Ellebedy, an immunologist at Washington College

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Physician assistants prefer ‘associate.’ Doctors suspect a power grab : Shots

Leslie Clayton, a physician assistant in Minnesota, says a name change for her profession is long overdue. “We don’t assist,” she says. “We provide care as part of a team.”

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Leslie Clayton, a physician assistant in Minnesota, says a name change for her profession is long overdue. “We don’t assist,” she says. “We provide care as part of a team.”

Liam James Doyle for KHN

After 23 years as a physician assistant, Leslie Clayton remains rankled by one facet of her vocation: its title. Specifically, the word “assistant.”

Patients have asked if she’s heading to medical school or in the middle of it. The term confounded even her family, she says: It took years for her parents to understand she does more than take blood pressure and perform similar basic tasks.

“There is an assumption that there has to be some sort of direct, hands-on oversight for us to do our work, and that’s not been accurate for decades,” says Clayton, who practices at a clinic in Golden Valley, Minn. “We don’t assist. We provide care as part of a team.”

Seeking greater understanding for and appreciation of their profession, physician assistants are pushing to rebrand themselves as “physician associates.” Their national group formally replaced “assistant” with “associate” in its name in May, transforming into the American Academy of Physician Associates. The group hopes state legislatures and regulatory bodies will legally enshrine the name change in statutes and rules. The total cost of the campaign, which began in 2018, will reach nearly $22 million, according to a consulting firm hired by the association.

Doctors are pushing back

But rechristening the PA name has spiked the blood pressure of physicians, who complain that some patients will wrongly assume a “physician associate” is a junior doctor — much as an attorney who has not yet made partner is an associate. The head of the American Medical Association has warned that the change “will undoubtedly confuse patients and is clearly an attempt to advance their pursuit toward independent practice.” The American Osteopathic Association, another group that represents doctors, accused PAs and other nonphysician clinicians of trying “to obfuscate their credentials through title misappropriation.”

In medicine, seemingly innocuous title changes are inflamed by the unending turf wars between various levels of practitioners who jealously guard their professional prerogatives and the kind of care they are authorized to perform. Just this year, the National Conference of State Legislatures catalogued 280 bills introduced in statehouses to modify scope-of-practice laws that set the practice boundaries of nurses, physician assistants, pharmacists, paramedics, dental hygienists, optometrists and addiction counselors.

Lawmakers allowed North Carolina dental hygienists to administer local anesthetics; permitted Wyoming optometrists — who, unlike ophthalmologists, do not attend medical school — to use lasers and perform surgeries in certain circumstances; and authorized Arkansas certified nurse practitioners to practice independently. Meanwhile, the physicians’ lobby aggressively fights these kinds of proposals in state legislatures, accusing other

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Telehealth visits by cell phone may well quickly close except legislators act : Shots

Group clinics say the easing of limitations on telehealth through the pandemic has produced it probable for health and fitness employees to hook up with tricky-to-access individuals through a phone simply call — folks who are very poor, elderly or stay in distant areas, and you should not have entry to a pc or cellphone with online video functionality.

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Community clinics say the easing of constraints on telehealth for the duration of the pandemic has designed it attainable for health and fitness personnel to link with really hard-to-access sufferers via a cellular phone phone — individuals who are weak, elderly or stay in remote parts, and don’t have accessibility to a pc or cellphone with video clip capacity.

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Caswell County, where William Crumpton works, operates together the northern edge of North Carolina and is a rural landscape of largely former tobacco farms and the occasional rapid-food stuff restaurant.

“There are vast locations where cellphone indicators are just nonexistent,” Crumpton claims. “Issues like satellite radio are even a challenge.”

Crumpton, who grew up in this area, is CEO of Compassion Wellness, a federally funded community overall health centre. The county has no hospital or crisis area. And for substantially of the pandemic, about 50 % of the center’s individuals could only be attained the old fashioned way: a fundamental voice connect with on a cellular phone landline.

“We have persons who live in residences that would not be in a position to make a cellphone connect with if they required to,” he claims. “Significant-velocity net is not available to them in addition, the only link that they had to the exterior earth in some scenarios is a rotary dial mobile phone.”

So when state and federal governments quickly eased privacy and security limitations on telehealth early in the pandemic, a lot of patients across the nation ended up able to get identified and addressed by health professionals above telephones that will not have video clip or digital camera functions. That, in flip, built it doable for wellbeing treatment employees to link with challenging-to-achieve individuals — individuals who are bad, elderly or dwell in remote areas.

But now, the procedures that temporarily eased licensing and reimbursement constraints in strategies that expanded the use of this form of telehealth assistance are rapidly shifting.

There are about 1,000 proposals pending prior to condition and federal legislatures that address extending or expanding telehealth further than the pandemic’s community wellness unexpected emergency. To date, about half of all U.S. states have passed measures keeping audio-only telehealth in place. In the remaining states, absent legislation, aged limitations governing telehealth have kicked back again in or will some will sunset when the federal public well being emergency ends someday immediately after the end of the calendar year, even though others have set their very own timelines.

In the meantime, insurance policy coverage procedures are also in flux. Medicare, for instance, says it will protect

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New CA law takes aim at long wait times for mental health care : Shots

When Greta Christina heard that Kaiser Permanente mental health clinicians were staging a protest on Oct. 13, 2019, over long wait times for therapy, she made her own sign and showed up to support them. She’s had to wait up to six weeks between therapy appointments for her depression.

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When Greta Christina heard that Kaiser Permanente mental health clinicians were staging a protest on Oct. 13, 2019, over long wait times for therapy, she made her own sign and showed up to support them. She’s had to wait up to six weeks between therapy appointments for her depression.

Ingrid Nelson

When Greta Christina fell into a deep depression five years ago, she called up her therapist in San Francisco — someone she’d had a great connection with when she needed therapy in the past. And she was delighted to find out that he was now “in network” with her insurance company, meaning she wouldn’t have to pay out of pocket anymore to see him.

But her excitement was short-lived. Over time, Christina’s appointments with the therapist went from every two weeks, to every four weeks, to every five or six.

“To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks,” she says. “It’s not enough. It’s not even close to enough.”

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Then, this summer, Christina was diagnosed with breast cancer. Everything related to her cancer care — her mammogram, biopsy, surgery appointments — happened promptly, like a “well-oiled machine,” she says, while her depression care stumbled along.

“It is a hot mess,” she says. “I need to be in therapy — I have cancer! And still nothing has changed.”

A new law signed by Gov. Gavin Newsom in October aims to fix this problem for Californians. Senate Bill 221, which passed the state Legislature with a nearly unanimous vote, requires health insurers across the state to reduce wait times for mental health care to no more than 10 business days. Six other states have similar laws limiting wait times, including Colorado, Maryland, and Texas.

Unequal access to behavioral health care is pervasive

Long waits for mental health treatment are a nationwide problem, with reports of patients waiting an average of five or six weeks for care in community clinics, at the VA, and in private offices from Maryland to Los Angeles County. Across California, half of residents surveyed said they have to wait too long to see a mental health provider when they need one.

At Kaiser Permanente, the state’s largest insurance company, 87% of therapists said weekly appointments were not available to patients who needed them, according to a survey by the National Union of Healthcare Workers, which represents Kaiser’s therapists — and was the main sponsor of the legislative bill.

“It just feels so unethical,”

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Bill of the Month: Critically ill woman skips ER after spouse’s costly stitches : Shots

Jason Dean received six stitches and a tetanus shot after he cut his knee in May. In August, his wife, DeeAnn, feared going to the same emergency room where he was treated, delaying her diagnosis of Rocky Mountain spotted fever.

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Jason Dean received six stitches and a tetanus shot after he cut his knee in May. In August, his wife, DeeAnn, feared going to the same emergency room where he was treated, delaying her diagnosis of Rocky Mountain spotted fever.

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Jason and DeeAnn Dean recently relocated to her hometown of Dellrose, Tenn., where she grew up on a farm. Both in their late 40s, they’re trying to start a green dream business that combines organic farming with a health and wellness consulting company. They want to inspire people to grow their own food in this fertile rolling farmland just north of the border with Alabama.

Until the business fully launches, Jason is working in construction. In May, he was injured on the job site when a piece of sheet metal slipped and caught him on the kneecap. He bled quite a bit. After closing the wound with a butterfly bandage, he thought that might be enough. But on his drive home, he figured it would be best to have a professional stitch it up.

It was late in the day, and the emergency room seemed the best option since his doctor’s office was closed. He and DeeAnn had opted for a health plan with lower monthly payments and a high deductible. So he knew the cost of care wouldn’t be cheap — and he was right. When the bills for thousands of dollars came, they were shocked. They were in the midst of fighting them in August when DeeAnn started feeling as bad as she has ever felt.

“I haven’t eaten. I’m not drinking. I have a horrible fever. I can’t get out of bed. I’m shaking,” she said.

She was pretty sure she had contracted COVID-19 — the delta variant was surging across the South. She was kicking herself for putting off vaccination. She got tested and the result was negative. The next day, she visited a doctor who said her condition was bad enough to go to the ER — but she regarded that option as financially perilous.

“That is fear,” said DeeAnn. “If they charged Jason this much, what would they charge me?”

She was terrified of a potential bill from the same ER in Pulaski, Tenn., that had treated her husband. So even though she was deliriously ill, she hit the road in search of cheaper treatment, asking her parents to drive her. They headed south. The first stop was an ER in Huntsville, Ala., but it was so full of COVID-19 patients that she would have had to wait all day. Then they drove north nearly an hour to Maury Regional Medical Center, a public hospital in Columbia, Tenn., where she was

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Biden’s plan to add dental coverage to Medicare faces pushback : Shots

Like many seniors, William Stork of Cedar Hill, Mo., lacks dental insurance and doesn’t want to pay $1,000 for a tooth extraction he needs. Health advocates see President Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage to people like Stork who are on Medicare. An unlikely adversary: the American Dental Association.

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Like many seniors, William Stork of Cedar Hill, Mo., lacks dental insurance and doesn’t want to pay $1,000 for a tooth extraction he needs. Health advocates see President Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage to people like Stork who are on Medicare. An unlikely adversary: the American Dental Association.

Joe Martinez for Kaiser Health News

William Stork needs a tooth out. That’s what the 71-year-old retired truck driver’s dentist told him during a recent checkup.

That kind of extraction requires an oral surgeon, which could cost him around $1,000 because, like most seniors, Stork does not have dental insurance, and Medicare won’t cover his dental bills. Between Social Security and his pension from the Teamsters union, Stork says, he is able to live comfortably in Cedar Hill, Mo., about 30 miles southwest of St. Louis.

But that $1,000 cost is significant enough that he has decided to wait until the tooth absolutely must come out.

Stork’s predicament is at the heart of a long-simmering rift within the dental profession that has reemerged as a battle over how to add dental coverage to Medicare, the public insurance program for people 65 and older — if a benefit can pass at all.

A once-in-a-generation opportunity

Health equity advocates see President Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage for those on Medicare, nearly half of whom did not visit a dentist in 2018 — well before the pandemic paused dental appointments for many people. The rates were even higher for Black (68%), Hispanic (61%) and low-income (73%) seniors.

The coverage was left out of a new framework announced by Biden on Thursday, but proponents still hope they can get the coverage in a final agreement. Complicating their push is a debate over how many of the nation’s more than 60 million Medicare beneficiaries should receive it.

Advocates of dental coverage for everyone on Medicare find themselves up against an unlikely adversary: the American Dental Association, which is backing an alternative plan that would give dental benefits only to low-income Medicare recipients.

Medicare has excluded dental (and vision and hearing) coverage since its inception in 1965. That exclusion was by design: The dental profession has long fought to keep itself separate from the traditional medical system in order to preserve the field’s autonomy.

Dental care and health are intertwined

More recently, however, dentists have stressed the link between oral and overall health. Most infamously, the 2007 death of a 12-year-old boy that might have been prevented by an $80

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