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Get your kids vaccinated (I’m saying it again)

We have a long way to go.

In the two weeks since the federal government allowed emergency use of COVID-19 vaccines for children younger than 5, nearly 32,000 Texas kids in that age group have been vaccinated.

That accounts for just over 1% of the state’s youngest residents, a lower rate than doctors had hoped, but faster than the national rate for kids that age — even as Texas deals with a lower-than-average vaccination rate across the state.

[…]

Vaccine acceptance by parents of Texas babies and toddlers is slower than the medical community had hoped it would be after COVID-19 vaccines were approved for use in children ages 6 months to 4 years old in late June.

On June 17, the U.S. Food and Drug Administration granted emergency use authorization, after frequent delays over several months, to Pfizer’s COVID-19 vaccine for children ages 6 months to 5 years, as well as to Moderna’s vaccine for kids ages 6 months to 6 years. The Centers for Disease Control and Prevention recommended their use the following day.

So far, just over 1% of the estimated 1.8 million Texans under 5 have gotten at least one dose. Nationwide, the number is slightly lower, with less than 1% of the country’s 29 million kids under 5 having their first doses.

Hesitancy with the vaccine rises among parents of younger kids because they tend to be more skeptical about the need for them, said Dr. Jaime E. Fergie, director of pediatric infectious diseases and hospital epidemiologist at Driscoll Children’s Hospital in Corpus Christi.

When the vaccine was made available to Texas kids ages 5 to 11 in November, nearly 6% of the population was vaccinated in the first two weeks. For children ages 12-15, when they were approved for the vaccine a year ago, more than 11% were vaccinated in the same time frame, according to the Texas Department of State Health Services.

During that time, the delta variant was making an alarming and devastating impact on the nation’s children, killing twice as many Texas kids in August through October 2021 than COVID-19 did the entire first year of the pandemic. That likely fueled early interest in the vaccine for children ages 5 and up, while recent months with lower community spread have likely bred what Fergie called “complacency” among the parents of the state’s tiniest residents.

“The uptake [for younger children] has been low; it’s been pathetic,” Fergie said. “I think the misconception is that COVID-19 in children is not important. But even though the impact on children is much less than on adults, there is still death for children, and hospitalizations are rising. There are still very powerful reasons to vaccinate children.”

Children accounted for nearly 20% of all COVID-19 cases reported in the U.S. throughout the pandemic. But they are less likely to develop serious illness or die than are patients who are decades older, and the mortality rate has been relatively low compared with adults.

Still, at least 155 Texans age 19 or younger have died from COVID-19 since the beginning of the pandemic, according to state health data. One-third of them were younger than 10.

Some 61% of Texans are fully vaccinated, compared with 67% nationwide.

See here for some background, and go read the rest, it’s a long story. I do think that the earlier authorizations came during the delta period made for a faster initial rollout, though the overall vax rate for kids remains bafflingly low. The fact that with current variants, the shots now are about preventing bad outcomes rather than preventing infection has probably changed the risk calculus for some folks. Add in the lack of any coordinated push for people to get the shots, the continued resistance by numerous Republican factions, and the general weariness with the pandemic, and this is what you get. I don’t know what else to say.

Get your kids vaccinated

A good start, but we can do a lot more.

Texas Children’s Hospital has administered COVID-19 vaccines to nearly 6,000 children ages 6 months through 4 years old since the youngest age group became eligible to receive the shots last week, the hospital said Thursday.

“We’ve been waiting for a long time to be able to protect our youngest children,” said Dr. Stan Spinner, the chief medical officer and vice president of Texas Children’s Pediatrics. “We’ve had families asking for a long time ‘When is this vaccine going to be available for our kids?’ And now it is.”

Still, the overall share of children younger than 5 who have received the shot is incredibly low — hovering around 1 percent statewide.

Another 3,000 children are scheduled for vaccine appointments at Texas Children’s Hospital or more than 60 Texas Children’s Pediatrics locations in the Houston, Austin and College Station areas, hospital spokeswoman Natasha Barrett said during a news conference.

Vaccines are also available to kids under 5 at other hospitals, including Children’s Memorial Hermann, as well as pediatrician’s offices, pharmacies and other locations.

Across Texas,the overall interest in vaccines for children has been lagging. Just 26 percent of Texas residents aged 5 to 11 and 59 percent of residents aged 12 to 17 are fully v accinated, according to data from The New York Times. Just 4 percent of Texas residents under 18 years old have received a booster.

However, Texas Children’s doctors said they have also been encouraged by that fact that families with children 5 to 11 years old have been signing up for booster shots of the Pfizer-BioNTech vaccine. The U.S. Food and Drug Administration approved booster shots for that age group last month.

My kids are older and got vaxxed and boosted at their first opportunities. If there’s an omicron-specific booster this fall, they’ll get that, too. I’ve definitely been disappointed by the low vaccination rate among younger kids, but maybe that will turn around now. Even with the lower hospitalization and mortality rates, so many people have gotten an infection lately that perhaps the ongoing threat of this pandemic is sinking in again. We all still need to do our part to try to keep this under some control.

COVID vaccines for kids under 5 are now available

It’s been a long wait.

On Saturday, the Centers for Disease Control and Prevention Director Dr. Rochelle Walensky signed off on Covid vaccines for the youngest Americans. Her endorsement means shots can begin immediately, finally ending the two-and-a-half year wait on the part of parents of children under 5.

Walenksy accepted the recommendation within hours after the CDC advisory committee voted unanimously in favor of the Pfizer-BioNTech and Moderna vaccines for children as young as 6 months. A Centers for Disease Control and Prevention advisory committee on Saturday endorsed Pfizer-BioNTech and Moderna’s Covid-19 vaccines for the youngest children, the last step before CDC Director Dr. Rochelle Walensky could issue her final sign-off.

The unanimous recommendations from the CDC’s Advisory Committee on Immunization Practices followed the Food and Drug Administration’s authorization of the shots on Friday.

President Biden responded to the announcement Saturday hailing it as a “monumental step forward.”

“For parents all over the country, this is a day of relief and celebration,” Biden said. “As the first country to protect our youngest children with COVID-19 vaccines, my Administration has been planning and preparing for this moment for months, effectively securing doses and offering safe and highly effective mRNA vaccines for all children as young as six months old.”

Shortly before Saturday’s votes — one for Moderna and a separate one for Pfizer — many panel members celebrated the milestone, noting that parents will soon have two effective tools to protect their youngest children from Covid after more than two years of living with the virus.

“We want to say today that if you’re not going to immunize your children, we think that’s a misplaced concern and that you should immunize your children to save their lives,” said committee member Dr. Sarah Long, a pediatrician at St. Christopher’s Hospital for Children in Philadelphia.

While young children are generally less likely than adults to experience the most serious outcomes of the virus, some do. Among children 6 months old through age 4, there have been more than 2 million confirmed cases of Covid, more than 20,000 hospitalizations and more than 200 deaths, according to CDC data. Covid is the fifth most common cause of death in children younger than 5.

“This is an opportunity, which one doesn’t get very often, to participate in preventing the death of young children,” said committee member Dr. Beth Bell, a clinical professor in the department of global health at the University of Washington. “A death of a young child is an incredible tragedy, and we know that this disease is killing children.”

It’s a function of where we are now in this pandemic that this isn’t bigger and more exciting news than it is. The vaccination rate for kids in the 5 to 11 year old range remains disappointingly low, and the estimates I’ve seen suggest that maybe 20% of the under-five crowd will get their shots. We could of course mandate COVID vaccines for enrollment in schools, but, well, I think you know what would happen then. The best way forward, as even a modest number of kids getting their shots will help save lives, is for those of us who have kids in that age range to get them vaccinated, and for the rest of us to help persuade our family and friends who do to do the same. Your Local Epidemiologist, who has two young kids of her own, has some ideas on that front. COVID is still out there killing people, y’all. We should try to remember that.

The coming fight over medical abortion

Sure is a good thing SCOTUS will leave this up to the states, isn’t it?

Republican-led states are moving swiftly to restrict access to medication abortion.

The efforts so far have focused on regulations around the pills, such as banning them from being shipped or prescribed. But can states ban the actual abortion pill itself, even though the Food and Drug Administration has approved it? That question could be the next frontier in the abortion wars.

The short answer comes down to this: The issue isn’t settled law and will likely be litigated in the courts. Some argue states may be hard-pressed to ban the federally approved medication, though antiabortion advocates disagree.

[…]

Some states have introduced bills focused on banning abortion pills, but they haven’t gotten a lot of traction, per Elizabeth Nash, an interim associate director at Guttmacher Institute, a research group that supports abortion rights. (A recent exception is Oklahoma, whose Republican governor is poised to sign legislation banning abortions – including medication abortions – from the moment of “fertilization.”)

Rather, states are banning the practice of medicine around the pills. For instance: At least 19 states ban the use of telehealth for medication abortion, and some states have additional restrictions, like prohibiting pills from being mailed.

Yet, if Roe v. Wade is overturned, some states may try to ban the actual medication. And states already have gestational limits and other abortion bans on the books that could kick in quickly if Roe is overturned — and those likely encompass limitations on the pills, experts said.

Can states ban a medication the FDA has signed off on?

There’s no clear precedent here.

Some states may argue they can ban medication abortion because states have the authority to regulate the practice of medicine. The FDA, on the other hand, is the acknowledged authority on medical products, such as the abortion pill. But the line between medical practice and medical products is not always clear.

And if a state squared off against the federal government over an FDA-approved drug … “We don’t know how the court would rule. It’s an open question,” Patti Zettler, an associate professor of law at Ohio State University and former associate chief counsel in the FDA’s Office of the Chief Counsel.

See here for some background. Reminder #1: The state of Texas has made it a felony to provide abortion medication after seven weeks, after having already banned anyone but doctors from dispensing such medication, and only via an in-person office visit – no telemedicine. You can be sure that Texas will take this to the next level in the next legislative session if it is in position to do so.

Reminder #2: The same medicine that is used for abortion is also used to treat miscarriages. Needless to say, women who are suffering through a miscarriage will face – and as that story notes, are already facing – barriers to medical care that could threaten their health, their future ability to get pregnant and carry a child to term, and even their lives. That’s our future, and if you think I’m being alarmist, go back and read all those soothing articles about how this Supreme Court was never ever going to overturn Roe v Wade because it would cause too much upheaval.

Here comes BA.2 in Houston

But don’t panic, it’s just a change in the virus composition, not an increase in viral load.

Houston is seeing an uptick in the number of BA.2 cases, with genome sequencing and wastewater testing picking up higher levels this week compared to last week.

The more contagious omicron subvariant was identified in 24 percent of patients who were sequenced at Houston Methodist, a jump from the 1 to 3 percent previously reported. BA.2 was also detected at six wastewater treatment plants on March 21 — the most recent day for which data is available — after the Houston Health Department last week said it had not been detected at any plants.

“Previously, we saw some indications of mutations consistent with BA.2 but were not confident in the determination at the time,” health department spokesman Scott Packard said in an email. “Retrospective analysis indicates BA.2 was likely in the wastewater in low levels starting in mid-to-late January.”

The recent data is the first indication of a significant rise in BA.2 in the Houston-area. Eventually, the subvariant is expected to become the dominant strain here, lining up with the nationwide rate, according to the health department.

[…]

In Houston, the average positivity rate over the last two weeks is 1.8 percent, down from the high 30s in the early January. Wastewater testing shows an increasing viral load at nine wastewater plants, while the remaining 30 are plateaued or decreasing.

“Although BA.2 appears to be more contagious than BA.1, the good news is that countries experiencing a spike in cases are not seeing a proportionate spikes in hospitalizations,” Packard said. “That means being up to date on vaccines (initial shots plus boosters) remains highly effective against serious illness, even with BA.2.”

As a reminder, you can see the Houston wastewater dashboard here. I don’t know how long we will be in this trough, but at least in the short term our vax level plus the sheer number of people who contracted the BA.1 version of omicron should help.

In the longer term, as immunity wanes and new variants pop up, it will be time for more shots. A fourth shot has now been authorized by the FDA for us old folks.

A second round of booster shots was greenlighted for everyone over the age of 50 by public health officials on Tuesday, kicking off the regulatory process for shots to likely be available in pharmacies this week.

Everyone 12 and older is already eligible for a booster shot five months after their initial vaccine series if they received an mRNA vaccine like Pfizer or Moderna, or two months after getting the Johnson & Johnson vaccine.

But for those over 50, determined to be a vulnerable age group, officials at the Food and Drug Administration and Centers for Disease Control and Prevention have decided the data on waning immunity justifies making another shot available four months after the first boost. And while anyone who meets that criteria can now get another booster, CDC Director Rochelle Walensky said it was “especially important” for those 65 and older and those 50 and older with underlying medical conditions.

“This is especially important for those 65 and older and those 50 and older with underlying medical conditions that increase their risk for severe disease from COVID-19 as they are the most likely to benefit from receiving an additional booster dose at this time,” Walensky said in a statement on Tuesday.

My niece is getting married in June in Washington state. I expect all of us who will be there for it and who are eligible for that booster will have gotten it by then. I ain’t messing around.

More people are choosing the medical abortion option

It’s not like there are good alternatives right now in Texas.

The demand for abortion-inducing medication spiked in the month after Texas significantly limited abortion access and has remained high since, according to new data from a researcher at the University of Texas at Austin.

The study reviewed requests for abortion-inducing medication made to Aid Access, an international nonprofit that provides the medication via the internet to people who cannot otherwise legally access the procedure. Prior to September 2021, the organization typically received an average of 10.8 requests a day from Texans.

Then, the Texas Legislature passed Senate Bill 8, which prohibits abortions after about six weeks of pregnancy, a point at which many people do not know they are pregnant. In the first week after the law went into effect on Sept. 1, Aid Access received an average of 137.7 daily requests from Texas, an increase of over 1000%.

“That big of a spike in requests shows us the uncertainty and chaos created by Senate Bill 8 going into effect,” said Abigail Aiken, the lead researcher on the study. “If it’s not certain that you can go to a clinic and get the care that you need, people will be looking around for what other options they have.”

The demand for the medication has remained higher than normal in the months since, Aiken found.

Medical abortion is typically a two-drug regimen of mifepristone and misoprostol that has been shown to be effective at terminating a pregnancy through the first 10 weeks of pregnancy. In December, the federal government lifted a requirement that the medication be dispensed in person, allowing it to be prescribed by telemedicine and sent through the mail.

But Texas law does not allow the medication to be prescribed through telemedicine or mailed and has limited its use to the first seven weeks of pregnancy.

[…]

Aiken, the researcher behind the study, said it’s impossible to know how and when patients use the medication they access through Aid Access — or how many patients are terminating pregnancies through other means.

But as the U.S. Supreme Court considers whether to overturn the constitutional protection for abortion, Aiken said this Texas data serves as a snapshot of what whole swaths of the country may be facing.

“It’s clear from this research and many studies that just because you make abortion harder to get, it doesn’t mean the need for abortion goes away,” she said. “And many people, they will look for other ways of doing that.”

See here and here for some background. The forced-birth contingent is of course not happy with this and murmuring about ways to pursue “legal action” against international and out of state groups like Aid Access. Not sure how they could do that without being extremely invasive, but I have no doubt that such a thought does not bother them at all. On the assumption that SCOTUS is going to gut Roe v Wade in some significant way, the main question is whether people will mostly still be able to get abortion pills freely, or whether they will have to rely on more evasive options. Both seem very much in play. The Chron has more.

Simply having a COVIDful Christmastime

Sorry not sorry.

Houston has surpassed 300,000 COVID-19 cases, just days after the highly contagious omicron variant leapfrogged delta to become the dominant viral strain circulating in the region and around the United States.

The staggering milestone reached Thursday, when the Houston Health Department reported 2,397 new cases for a cumulative total of 302,460, underscores the virus’s ability to evade all attempts at containment nearly two years into a global pandemic few predicted would be this persistent or deadly.

“Twenty-one months ago I never imagined our cases would get anywhere close to this big,” Houston’s Chief Medical Officer Dr. David Persse said. “If you had told me 300,000 I would have politely told you, ‘I think you’re crazy.”

Yet the easily transmitted omicron variant, first detected last month in South Africa, appears poised to sweep the Houston area and is already fueling outbreaks and scuttling holiday plans across the region.

The milestone is almost certainly an undercount, Persse said. Prevalence studies have found between 20 and 25 percent of Houston residents carry the antibodies that indicated a previous COVID infection. Accounting for those who contracted the virus but were never tested could put the city’s true COVID case count closer to half a million people.

“It’s a lot of suffering,” Persse said.

Extrapolating out to Harris County, that’s something like 1.2 million people who have had COVID, maybe a bit more. Obviously, for a lot of those people the consequences have been fairly small so far, but who knows what the longer term effect may be. And of course, we’re in the early stages of the omicron surge. So check back again later to see where these numbers go.

This says a lot, too.

As the omicron variant of COVID-19 threatens to fuel another surge of infections this winter, the state’s vaccination data shows demand for booster shots has outpaced the demand for first doses of the vaccine in the last few months — even as millions of Texans remain unvaccinated.

The average number of people getting boosters in Texas every day has surpassed those getting their first shots since late September, according to the state’s data. As of Dec. 21, the daily average of Texans who received their booster shots over the last week was about 52,000 — compared with the approximately 20,000 who received their first doses.

So far this month, at least 1.2 million Texans have gotten booster shots — nearly triple the number of people who received their first doses of the vaccine during the same time.

Meanwhile, the number of people getting their first shot of the vaccine over the last few months has remained far below people getting boosters, though the rate of first shots slightly increased in November and December.

[…]

Booster rates have gone up as the Food and Drug Administration has gradually authorized their use among different age groups. Adults 18 and older are allowed to get booster shots, and this month, the FDA authorized emergency use for 16- and 17-year-olds who had the Pfizer vaccine as their initial two-dose treatment, making them eligible to receive the same vaccine as a booster.

Meanwhile, the amount of people getting their first vaccine doses has waned in the last few months as vaccines have become more widely available and more people take the next steps in their vaccination regime. The state’s data shows a slight bump in first doses in November as Thanksgiving approached.

Even so, 10 million Texans remain unvaccinated.

And while there isn’t one specific reason why first-dose rates lag behind booster shots, Dr. Emily Briggs, who specializes in family medicine and has seen the split in the demand for the vaccine from a private practice in New Braunfels, largely credits ideology.

“We are at that point of anybody who believes in science acknowledges that we have had benefit from this vaccine. Those who are politically motivated or have been given fear and are focused on that fear are not vaccinated,” she said.

The people who have taken this pandemic seriously and have done what they can to minimize their risk and protect their communities are continuing to do so. The people who have not done so are still not doing so. Same as it ever was.

Same as it ever was.

As other states are mobilizing to respond to the rapidly spreading omicron variant, Gov. Greg Abbott is not budging on his hands-off approach to the coronavirus pandemic that was cemented months ago.

In March, Abbott ended the statewide mask mandate, marking the beginning of a sharp shift toward preaching “personal responsibility” and an outright rejection of any government mandate — whether state or local — to curb the pandemic. That philosophy carried the state through the delta variant this fall, even as hospitals were overrun and deaths climbed. Now as the state stares down the latest variant, Abbott remains unmoved, continuing to rule out any mask or vaccine mandates and business shutdowns.

“We’re moving forward with life as we know it,” Abbott said Tuesday in a radio interview when asked about omicron.

[…]

Asked Tuesday what the state is doing to address omicron, Abbott’s spokesperson Renae Eze said in a statement that the governor recently got a briefing on the state response to the variant by John Hellerstedt, the commissioner of the Department of State Health Services, and Nim Kidd, chief of the Texas Division of Emergency Management. Eze otherwise gave no indication the state was doing anything differently, saying it was continuing to respond to the pandemic by “setting up therapeutic infusion centers, ramping up COVID vaccination efforts, and providing surge staffing and medical equipment to hospitals and nursing homes.”

Eze ended by calling vaccination the “best defense” against COVID-19 and encouraging Texans to get immunized.

Even as Abbott’s office says it’s prioritizing vaccines as the best defense against COVID-19, the state’s vaccination rate lags nationally. As of Monday, 56% of Texans were fully vaccinated, placing Texas in the back half of the 50 states when ranked by vaccination rates.

Abbott got vaccinated on camera late last year and has encouraged Texans to get the shot. But he does not go out of his way to promote vaccinations and he has expended much more energy in recent months fighting vaccine requirements by local and federal officials.

Abbott has been virtually silent on the booster, which the U.S. Centers for Disease Control and Prevention said last month every qualifying adult should receive. The word “booster” has never appeared on Abbott’s personal Twitter account, and a spokesperson did not respond when asked whether the governor has received a booster.

I’m sure he has been boosted. Abbott is not an idiot. He’s a coward, but he’s not going to risk his own health and well-being. Same as it ever was.

FDA lifts restrictions on medical abortion

Long overdue

The Biden administration on Thursday ended a long-standing restriction on a medication used to terminate early stage pregnancies, even as politicians across the United States intensified efforts that represent the most serious challenge to abortion rights in decades.

The elimination of the rule by the Food and Drug Administration means abortion pills can be prescribed through telehealth consultations with providers and mailed to patients in states where permitted by law. Previously, the pills could not be mailed, though that regulation had been temporarily suspended by the FDA.

In large swaths of the nation, however, strict state rules will dampen the impact. Several states ban sending abortion pills by mail and impose other restrictions.

The medication, mifepristone, was approved by the FDA in 2000 for what’s known as medication abortion. It is used with a second drug, misoprostol. The FDA required patients to pick up mifepristone in person at a hospital, clinic or medical office. There is no FDA requirement that the medication, also known as RU-486, be taken in a clinical setting, and most patients take it at home.

In April, the FDA waived the in-person dispensing requirement during the pandemic, saying research showed the action did not raise “serious safety concerns.” It then launched a scientific review to see whether restrictions on mifepristone should be lifted permanently, with Thursday as the deadline.

The agency, writing to a medical group that had sued the FDA over the rule, said it was dropping the in-person dispensing requirement “to minimize the burden on the health care delivery system” and “to ensure that the benefits of the drug outweigh the risks.” The FDA did not give an effective date for the change.

[…]

Loosening the federal restrictions will not change abortion access in many states with stricter regulations on the pills. Nineteen states have banned receiving the drugs through telehealth appointments, making the relaxed FDA rules irrelevant in places including Alabama, Arizona and Missouri. Some states impose other limitations on medication abortion, including allowing only physicians to prescribe the drug and mandating that patients take the pills under a doctor’s supervision rather than at home.

As federal officials have moved to ease restrictions on the drug, many states have tightened access. At least 16 states have proposed new restrictions on medication abortions this year, said Elizabeth Nash, state policy analyst for the Guttmacher Institute.

“State legislatures have been watching very carefully what happens at the federal level,” Nash said.

The highest-profile limitations were enacted in Texas, where lawmakers made it a felony to provide abortion pills after seven weeks of pregnancy and outlawed sending the drugs through the mail. Texas also banned nearly all abortion within the state by making any form of abortion illegal after about six weeks of pregnancy, though that law is being challenged in the courts.

The differing rules have the potential to widen disparities in abortion access, Nash said.

“Access looks very different depending on where you live,” Nash said. “Abortion access will continue to be very limited in states in the South, in the Plains and in the Midwest, and more accessible in states along the West Coast and the Northeast. … That’s problematic in and of itself, and could become an even bigger divide.”

Yeah, it sure is an issue here in Texas. The main question I have is how effectively will Texas be able to enforce its restrictions. It seems to me that there will be a lot of effort put into avoidance, and as such the only way to really make that law work as intended is to be pretty darned invasive. I don’t know how that will work.

Restrictive state laws are spurring an increase in some areas of what’s known as “self-managed abortions” in which patients buy illegal medication on the Internet and terminate pregnancies without interacting with the health-care system.

While some see this as a dangerous trend, others say the situation is sharply improved from decades earlier — because of the abortion pills.

Abigail Aiken, assistant professor of public affairs at the University of Texas at Austin, said she is often asked whether the country is headed to “back-alley abortions and infections” if Roe v. Wade is struck down.

“One of the things we have that we didn’t have in the ’60s and ’70s is access to abortion pills that are very safe, very effective if you have the right instructions,” Aiken said. “Self management is a safety net. And it’s also an ability to take your health care into your own hands when the state legislature is trying to block access.”

That sounds logical to me. And it should be known, this way around the law has been in use for some time. Again, the question to me is how vigorously Texas will try to crack down on that, and how heavy-handed such enforcement will be. I feel very confident saying that the zealots who pushed the bounty hunter law will not be satisfied by anything other than an all-out crackdown, whatever the consequences. If you think I’m being alarmist, look at where we are now and tell me honestly it’s not far worse than you thought it would be. The 19th and Mother Jones have more.

By the way, medical abortion is now more tightly restricted in Texas, too

Another piece of crap from the special session.

Misoprostol

A new law limiting the use of abortion-inducing medication in Texas goes into effect Thursday.

The law makes it a felony to provide the medication after seven weeks of pregnancy, putting Texas at odds with federal regulations. It also makes it a crime to send the medication through the mail.

Medical abortion is the most common way women in Texas terminate their pregnancies, according to state data.

These new restrictions reflect a growing concern among abortion opponents about the rise of “self-managed” abortions, in which pregnant people obtain the medications from out-of-state or international providers, with or without a prescription.

There’s evidence that more women turn to self-managed abortions when legal abortion is restricted. Texans have been unable to access abortions after about six weeks of pregnancy since Sept. 1, when a controversial new ban went into effect.

“Texas is looking at the ways that people are navigating around restrictions and trying to essentially make that as unsafe and as frightening for people as possible in order to deter them,” said Farah Diaz-Tello, senior legal counsel for If/When/How, a reproductive justice legal group.

Diaz-Tello and other advocates worry that the new criminal penalties may make pregnant Texans fearful of seeking medical care after a self-managed abortion.

[…]

Texas’ new law also specifies that no one may provide abortion medication “by courier, delivery or mail service.”

Texas already required the medication to be provided by a physician in person. But this specific clause addresses a growing concern among abortion opponents that patients are trying to circumvent the required doctor visit by getting the drugs by mail, especially with the state’s new restrictions that bans abortions after around six weeks.

Called a “self-managed abortion,” this usually entails ordering abortion-inducing drugs online, with or without a prescription, from doctors, pharmacies and other providers out of state or overseas.

The FDA has attempted to crack down on some providers, including AidAccess, a group founded in 2018 by Dr. Rebecca Gomperts, a European doctor. AidAccess provides abortion-inducing medications to women in areas that have restricted access to the procedure.

Gomperts has said she will continue prescribing to patients in Texas. She told CBS News in September that she believes she is on solid legal ground since it is legal to prescribe this medication where she is based.

See here for the backgroun; I didn’t blog it at the time for whatever the reason. A bit more than half of all abortions in Texas are medical abortions, which the FDA says are safe up to ten weeks. I suspect Dr. Gomperts and others like her if they exist will get more business now, despite the prohibition on sending the medication via mail. It’s really a matter of enforcement, and it’s not clear to me how Texas will be able to do that. That FDA action against her was from 2019, by the way. It would be nice for the current FDA to maybe revisit that now. I don’t have anything positive to end with. This is where we are right now.

The Pfizer pill

This would be a big step forward.

Pfizer Inc. said [recently] that its experimental antiviral pill for COVID-19 cut rates of hospitalization and death by nearly 90% in high-risk adults, as the drugmaker joined the race for an easy-to-use medication to treat the coronavirus.

Currently most COVID-19 treatments require an IV or injection. Competitor Merck’s COVID-19 pill is already under review at the Food and Drug Administration after showing strong initial results, and on Thursday the United Kingdom became the first country to OK it.

Pfizer said it will ask the FDA and international regulators to authorize its pill as soon as possible, after independent experts recommended halting the company’s study based on the strength of its results. Once Pfizer applies, the FDA could make a decision within weeks or months.

Since the beginning of the pandemic last year, researchers worldwide have been racing to find a pill to treat COVID-19 that can be taken at home to ease symptoms, speed recovery and keep people out of the hospital.

Having pills to treat early COVID-19 “would be a very important advance,” said Dr. John Mellors, chief of infectious diseases at the University of Pittsburgh, who was not involved in the Pfizer study.

“If someone developed symptoms and tested positive we could call in a prescription to the local pharmacy as we do for many, many infectious diseases,” he said.

[…]

Study participants were unvaccinated, with mild-to-moderate COVID-19, and were considered high risk for hospitalization due to health problems like obesity, diabetes or heart disease. Treatment began within three to five days of initial symptoms, and lasted for five days. Patients who received the drug earlier showed slightly better results, underscoring the need for speedy testing and treatment.

Pfizer reported few details on side effects but said rates of problems were similar between the groups at about 20%.

It’s much better to prevent COVID than to treat it, in the same way that it’s much better to prevent malware from getting on your computer than to clean up after it. As such, getting vaccinated is still far and away the best thing to do to mitigate the risk of COVID. But if I want to extend the cybersecurity analogy, you must have multiple layers of defense to truly have good security practices, and so having a safe and reliable treatment to COVID that can keep people out of the hospital is crucial. I look forward to both the Pfizer and Merck pills getting approved by the FDA.

More kids are getting their COVID shots

So good to see.

The possibility of the parties, vacations and family gatherings energized six families who attended the COVID-19 vaccination event on Wednesday inside Memorial Hermann, the morning after the Centers for Disease Control and Prevention officially expanded eligibility to kids from 5- to 11-years-old. Eager parents are clamoring for an opportunity to vaccinate their children after an especially challenging wave of infections, which hit a peak in late August just as kids returned to school.

Texas Children’s Hospital administered its first dose of the vaccine at 6:15 a.m., and is expected to administer thousands more throughout the week to children with an appointment, which are now only available as soon as Nov. 18. Memorial Hermann is making the vaccine available to walk-ins at its hospital campuses, beginning Thursday morning.

Parents, many of whom were affiliated with the Memorial Hermann system, shared their own harrowing experiences with the virus at Thursday’s vaccine event. Chris Lange, the father of 8-year-old and 5-year-old girls, said he is still dealing with brain fog after an aggressive bout with COVID during the February winter freeze.

The kids caught a less severe infection, but the experience raised the urgency of vaccination, he said.

“This whole (pandemic) is just such a drain on everyone,” he said. “Knowing that now maybe we don’t have to worry about schools closing. We don’t have to worry about kids staying home. I mean, that’s a big win.”

I’ve seen plenty of celebrating, on Facebook and Twitter, by friends who have kids in the 5-11 age range, much as I did when the shots were cleared for ages 12 and up. I figure we’ll see a big spike in vax rates in the first couple of weeks, then it will settle at a much lower level as the eager folks all get it done and what’s left are the more hesitant and resistant. Every little bit helps, that much is for sure.

Get your kids ready for their COVID shots

At long last.

The U.S. Food and Drug Administration on Friday authorized the emergency use of the Pfizer-BioNTech COVID-19 vaccine on children ages 5-11, marking a long-awaited milestone in the nearly two-year fight against the deadly virus that experts say has likely already infected nearly half the population in that age group.

In Texas, that makes up to 2.9 million children eligible for the vaccine.

The federal regulatory agency said the vaccine is safe and effective for children in that age group. The Pfizer test results shared with the FDA show that its vaccine prevents symptoms in most children and causes no side effects more serious than those already seen in older age groups. FDA panelists decided that the benefits of the vaccine for children ages 5-11 — many of whom have suffered isolation, depression and learning loss throughout the course of the pandemic — outweigh the risks associated with the Pfizer shot.

“As a mother and a physician, I know that parents, caregivers, school staff, and children have been waiting for today’s authorization. Vaccinating younger children against COVID-19 will bring us closer to returning to a sense of normalcy,” said Dr. Janet Woodcock, acting FDA commissioner. “Our comprehensive and rigorous evaluation of the data pertaining to the vaccine’s safety and effectiveness should help assure parents and guardians that this vaccine meets our high standards.”

Still uncertain, however, is whether the U.S. Centers for Disease Control and Prevention will limit the shots to only children with preconditions that put them at high risk of serious disease from COVID-19 — a decision expected next week.

The FDA’s announcement, which follows a recommendation by its vaccine advisory panel earlier this week, triggers an initial federal allocation of more than a million doses destined for children ages 5-11 to providers in nearly half of Texas counties. Those will start landing in Texas pharmacies, pediatrics offices, health clinics and hospitals within a few days, state health officials said.

After the first federal shipment, others will continue on a weekly basis. The amounts will vary based on providers’ requests, officials said.

Most of the parents I know nowadays have older kids who are already vaccinated, and yet I know plenty more who will be ready and eager to get their kids vaxxed. As with every other instance of this vaccine, I expect there will be a big surge up front as all of the willing people stampede to get it done, followed by a long fallow period in which the reluctant, the folks with access issues, and eventually some of the holdouts who meet up with mandates of one form or another get around to it. The boost to the overall vaccination rate in the state should help keep things under control, more or less, through the winter. It’s good news for many, and we have been waiting for it. The Chron has more.

More on the Abbott max anti-vaxx order

Businesses will face a choice that they would rather not have to face.

Companies doing business in Texas face new and complicated challenges after Gov. Greg Abbott this week banned COVID-19 vaccine mandates for all entities in the state — including private businesses — for employees or customers.

The ramifications for businesses could begin as soon as Friday, when companies that enter into contract work with the federal government will be required to have all employees vaccinated under orders from the White House.

This conflicts with Abbott’s ban on vaccine mandates, putting the many Texas businesses that receive federal contracts in a tough position: Comply with federal law and violate Abbott’s ban, or comply with Abbott and turn down business from the federal government.

[…]

“This harms Texans directly,” Karen Vladeck, an employment lawyer in Austin, said of the new order from Abbott. “I just think it wasn’t well thought out.”

Abbott’s office did not reply to a request for comment.

On top of prohibiting any entity in Texas from requiring vaccinations, Abbott’s order also lists several expanded exemptions. Vladeck and other employment lawyers said that this adds to the vaccine dilemma facing businesses in Texas. Under Abbott’s new rule, people may opt out of a vaccine requirement for medical reasons, including if they prove they have had COVID-19 in the past, despite scientists widely agreeing that this does not protect people against contracting the virus.

“The executive order’s medical reason language is a bit strange because usually you exempt people for medical reasons if they have a severe allergic reaction to a vaccine,” said Elizabeth Sepper, a law professor at the University of Texas at Austin. Abbott’s order is “meant to cover people who don’t want to get the vaccine because they believe, quite wrongly, that they’re completely protected by already having COVID.”

Abbott’s rule also allows people to opt out of a vaccine requirement if they prove they hold a deep personal belief against getting jabbed.

Any entity that fails to comply with Abbott’s rule could receive up to a $1,000 fine.

Abbott’s Monday order is a reversal from his position in August, when the Pfizer vaccine received final approval from the U.S. Food and Drug Administration. At the time, Abbott’s spokesperson said that businesses had the option of mandating vaccination for employees and “private businesses don’t need government running their business.”

“It’s all about company choice in Texas, except now it’s come to something that they don’t like what the companies are choosing,” Vladeck said. “It puts a big burden on employers.”

See here for the background. So far, businesses that are also federal contractors, including airlines and companies like IBM, will ignore Abbott’s order, while others are awaiting the OSHA rules before making a decision. Multiple business groups, the same organizations that often turn to the state for a legislative solution to local ordinances they don’t like, harshly criticized Abbott’s order for making their lives more difficult. Harris County Attorney Christian Menefee released a statement encouraging businesses that want to be able to get their employees vaccinated to file a lawsuit against Abbott over the order. And in the end, even wingnut talk radio hosts weren’t impressed by Abbott’s order. It’s almost as if he were a weak, gutless leader.

More on the San Antonio ISD vaccination mandate litigation

I’m a little confused at this point, but I’ll cope.

Judge Mary Lou Alvarez of the 45th District Court denied the state of Texas’ request for a temporary injunction Friday, allowing the San Antonio Independent School District to continue requiring its employees to be vaccinated against the coronavirus.

Former SAISD Superintendent Pedro Martinez, who has since left the district to take a job in Chicago, issued the vaccine mandate on Aug. 16, requiring all staff members to be vaccinated by Oct. 15. SAISD board President Christina Martinez said Thursday that about 90% of SAISD staff has been vaccinated.

Alvarez’s decision came after a hearing on the state’s request for temporary relief against the vaccine mandate was delayed. Another state district judge denied the school district’s challenge on Sept. 23 that the state and Gov. Greg Abbott did not have jurisdiction to sue. SAISD then appealed that ruling, pushing back the original hearing for the state’s lawsuit; the appeal was dropped earlier this week.

After Alvarez’s ruling, the state’s legal team said they planned to appeal. A trial for the lawsuit is set for Jan. 19, 2022.

[…]

Attorney Steve Chiscano, who represented SAISD, dismissed the state’s lawsuit as a political ploy.

“We are sitting in an injunction hearing that the AG is hoping to win so he can spin off another press release on how proud he is that he beat up on this district,” Chiscano said. “It is so obvious and so clear that this is happening that I believe at the end of the day, you’ll see that what the governor is doing is not supported by any law.”

See here and here for the background. I’ve decided that we had a motion by SAISD to dismiss the lawsuit, which was denied, and then the state asked for a temporary restraining order against SAISD, which was also denied. The source of my initial confusion was the change in judges between the two, but I think that may just be how Bexar County rolls. In any event, true to form and as the story notes, Paxton – who was not present for the hearing – did indeed tweet about it and how he’s fighting for the freedom of people who want to get sick and die and take others with them. Ultimately, this judge did not buy the state’s argument that the Abbott executive order was enough on its own to prevent SAISD from responding to the pandemic in this fashion. A higher court may intervene before the hearing for an injunction, but in the meantime I sure hope that SAISD is making progress in getting shots into arms. That is what really matters. The Current has more.

SAISD vaccine mandate update

Still in place for now, but clearly on shaky ground.

Best mugshot ever

San Antonio Independent School District can continue requiring its staff to get vaccinated against COVID-19, despite a judge ruling against the district Thursday in a case filed by the Texas attorney general.

Judge Angelica Jimenez of the 408th District Court denied SAISD’s plea on Thursday that state Attorney General Ken Paxton lacks the legal authority to enforce Gov. Greg Abbott’s Aug. 25 executive order, which banned public entities, such as school districts, from mandating COVID-19 vaccines. Steve Chiscano, the attorney representing SAISD, immediately appealed the ruling.

Appealing Jimenez’s jurisdiction ruling delayed a hearing requested by the state to stop SAISD’s vaccine mandate with a temporary restraining order. The school district and attorney general’s office will make their arguments again before the 4th Court of Appeals. Case information is due at the court Oct. 4, according to online court records. The lawyers will file briefs, and justices will make a decision at an undetermined date.

[…]

In a statement, the district said Jimenez’s ruling does not enforce Abbott’s executive order prohibiting vaccine mandates and that SAISD would continue its vaccine protocols.

“We do not believe the Governor and Attorney General have the legal authority to continue this lawsuit, and we respectfully disagree with the judge’s ruling,” the district said in the statement. “We know that following the executive order and not requiring vaccination of our employees is potentially deadly, and we will do what is necessary to protect the children and staff of the district.”

See here for the previous update. I’ve always thought that the vaccine mandate was a heavier lift than the mask mandates, so I won’t be surprised if Paxton eventually wins this one. But as long as that mandate remains in place, SAISD can move closer to a goal of maximizing the number of its employees who have been vaccinated. No matter the odds, that’s worth fighting for.

The COVID shot for kids is coming

Not a moment too soon.

On Monday, Pfizer released the initial trial results, showing that its vaccine is safe and effective for the 5-11 age group. The findings are a key step toward inoculating a younger population that so far has been unprotected from the virus.

“It’s good to hear the studies are paying off,” García said. “We are happy to be part of the process to help other people get more trust in the vaccine, so we can start getting back to normal as soon as possible.”

The announcement summarized results from 2,268 trial participants. The findings show that children develop an antibody response similar to the 16- to 25-year-old age group when given a lower dosage of the vaccine.

Pfizer and BioNTech, the company’s German partner, plan to include the data in a “near-term submission for Emergency Use Authorization” while safety research is ongoing. Dr. Bill Gruber, a Pfizer senior vice president, told The Associated Press that the company plans to apply for emergency use by the end of the month.

My kids are thankfully old enough to already be vaccinated, but I know a lot of people who have been eagerly awaiting this announcement. I expect there will be a surge of new vaccinations in the weeks following the emergency use grant, and while it will surely fall well short of the full total of eligible kids, it will make a decent dent in the overall vaccination rate. We’re going to need every bit of this. The 19th and Daily Kos have more.

Paxton sues again over SAISD’s vaccine mandate

Yes, vaccine mandate. For teachers and staff.

Best mugshot ever

For the second time in a month, Texas Attorney General Ken Paxton sued San Antonio Independent School District and Superintendent Pedro Martinez for requiring all staff to be vaccinated against COVID-19.

Martinez issued a staff vaccine mandate and mask mandate Aug. 16 for everyone inside school buildings. Three days later, Paxton sued Martinez and SAISD over both mandates, stating in the lawsuit that the superintendent and the district were “deliberately violating state law,” as a July executive order from Gov. Greg Abbott prohibits any entity that receives public funds from mandating COVID-19 vaccines that had received only emergency approval from the federal government.

But the federal Food and Drug Administration granted full approval for the Pfizer COVID-19 vaccine on Aug. 23, and the lawsuit was dropped. Two days later, Abbott issued a new executive order, banning governmental entities from requiring any COVID-19 vaccine, regardless of FDA approval status.

Paxton filed the second lawsuit against SAISD in Bexar County on Sept. 9, seeking a temporary restraining order barring the school district from mandating vaccines. In the petition, Paxton claims SAISD and Martinez are again violating state law by “flouting” the August executive order.

“The decision to openly violate state law and devote district resources to defending Superintendent Martinez’s unlawful actions is irresponsible,” Paxton said in a statement. “But if school districts decide to use their limited funding to try to get away with breaking the law, my office will oppose them and uphold the rule of law in Texas.”

See here and here for some background. My reaction when Paxton filed the first lawsuit was that he was likely to prevail, and despite the FDA approval and Biden mandate (which has been announced but not yet fully implemented), I don’t see any reason why that would change. I will of course be happy to be wrong, and if it is the case that some people have gotten vaccinated as a result of the SAISD mandate then it’s a win no matter what happens in court. The main thing to remember here is that Ken Paxton, like Greg Abbott, is objectively pro-COVID, and we need to make them pay at the ballot box for it.

Hospital systems have no excuse for not mandating COVID vaccines now

So get on with it already.

Local hospitals reacted Friday to President Joseph Biden’s sweeping vaccine mandates directed at the health care workers, who make up much of the Houston workforce.

In a move that overrides Gov. Greg Abbott’s executive order barring public institutions from issuing their own COVID-19 restrictions, the administration said it would require vaccinations for employees at health care facilities that accept Medicare and Medicaid reimbursement.

Baylor College of Medicine’s dean of clinical affairs, Dr. James McDeavitt, said Thursday he supported the new measures.

“It is the right thing to do,” he said.

Still, he wished the plan had come sooner. “It is not going to help us with the current delta surge,” he added.

[…]

Five Houston hospital systems already require a vaccine. In June, Houston Methodist became the first hospital in the nation to announce it would require its staff to be fully vaccinated, a move that met months of resistance, including a lawsuit by some employees. Memorial Hermann and Baylor College of Medicine enacted their own vaccine mandates in July; St. Luke’s Health and Texas Children’s Hospital announced similar plans in August.

Thursday’s executive order will bring similar mandates to the city’s remaining health systems.

Until now, Harris Health System and UTHealth had encouraged worker vaccinations but were unable to require it under the governor’s order.

But on Friday, Harris Health System said it “fully intends to embrace the vaccine mandate” for workers at its two hospitals, 18 community health centers and 10 clinics serving the greater Houston area. The system has not yet set a date.

UT Health said it would wait for guidance from the Centers for Medicare & Medicaid Service, expected in October. It had not instituted a mandate as of Friday afternoon.

St. Joseph Medical Center and UTMB Galveston said they are still evaluating Biden’s plan.

While Kelsey-Seybold Clinic said in August it was waiting for full vaccine approval from the U.S. Food and Drug Administration before asking employees to provide proof of immunization, the clinic has not announced a mandate since the Pfizer-BioNTech vaccine gained full U.S. Food and Drug Administration approval late last month.

See here for the background. I agree that the mandate coming out now will have little to no effect on the current surge, given that it takes a few weeks to get both shots and the full effect of them, and that it will take time for these hospital systems to get their programs going. It would still be nice if some of them had more of a sense of urgency about it. This is still by far the best thing we can do for the medium to longer term, and at the very least these hospital systems should be setting a better example. Get it done already, y’all. The Trib has more.

The legal situation with the heartbeat bill

I’m writing this at eight PM, and will very likely be asleep before SCOTUS takes any action, if they do take action. So let’s start with what we have as of now:

That was in reply to this:

See here for the previous entry. If I see that SCOTUS has taken action when I get up in the morning, I’ll update this post. If not, you can assume that there’s basically no such thing as abortion in Texas until further notice. And that will include medical abortion.

Two days before one of the strictest abortion laws in the country is set to go into effect in Texas, the state Legislature tentatively approved another bill Monday evening that would restrict the procedure during the first term of pregnancy.

Senate Bill 4 remains identical to the version of the bill passed by the Texas Senate. Texas Democrats were unable to attach amendments to the bill, despite more than a dozen attempts, which means the bill will head straight to Gov. Greg Abbott’s desk if it is finally approved with no changes.

The legislation would limit patients’ access to abortion-inducing pills, preventing physicians or providers from giving abortion-inducing medication to patients who are more than seven weeks pregnant. Current law allows practitioners to give these pills to patients who are up to 10 weeks pregnant.

Notably, the U.S. Food and Drug Administration set its guidelines in 2016 advising that abortion-inducing pills are safe to use up to 70 days, or 10 weeks, after initial conception.

These pills have increasingly become the most common method for women to terminate a pregnancy if they are aware of their pregnancy early enough. According to the Guttmacher Institute, a reproductive health research institute that supports abortion rights, 60% of women elect to take a pill over having surgery.

It’s grim. This bill might have a chance of being knocked down by litigation, but who can even say at this point.

It should be noted that there is some state litigation happening, but that will not have the effect of blocking SB8.

Travis County District Judge Amy Clark Meachum issued a temporary restraining order barring the anti-abortion organization Texas Right To Life; John Seago, its legislative director, and others from “instituting any private enforcement lawsuits” under SB 8 against the plaintiff, a Dallas attorney, according to the order.

But the full scope of the order was narrow, and does not apply to a majority of providers or Texans.

“While the temporary restraining order issued by the Texas state court in Austin provides some relief to the two individuals and one nonprofit organization against lawsuits from the Texas Right to Life, it does not provide the full relief needed to ensure all Texans can access their constitutional right to an abortion,” said Julie Murray, staff attorney for Planned Parenthood Federation of America.

Here’s a bit more on that litigation from KXAN:

District Judge Amy Clark Meachum considered three cases on Tuesday morning: one, brought by an attorney and sexual assault victim’s advocate named Michelle Tuegel; another brought by Bridge Collective, a resource group for people seeking an abortion; and another brought by Allie Van Stean, a woman who regularly donates to women’s health clinics.

On Tuesday morning, the judge granted temporary restraining orders (TROs) in all three instances, against the group Texas Right to Life. According to attorneys for these three plaintiffs, the TRO’s prevent Texas Right to Life from filing lawsuits under the new fetal heartbeat law, until the court can conduct a full-scale temporary injunction hearing later in September.

Their attorneys say the ruling is significant for their clients because they had to prove “probable right to relief” to get the TRO — meaning they were able to show the judge evidence supporting their challenge to the law’s constitutionality.

KXAN spoke to Van Stean earlier this month, who explained, “Simply donating to places like Planned Parenthood count as aiding and abetting an abortion… If I’m donating to Planned Parenthood, I’m not necessarily giving with the intent to assist women in getting an abortion. Planned Parenthood and other places provide necessary and needed services like birth control at a lower cost, affordable option for women who can’t afford it.”

A spokesperson for Texas Right to Life told KXAN on Tuesday, the judge’s ruling was “narrow” and does not block the Texas Heartbeat Act from being broadly enforced at midnight.

Rewire wrote a story about Michelle Tuegel, who had filed a lawsuit in Dallas. In that one she sued a whole lot of people, mostly legislators. I don’t know what happened to that suit or if it is related in some way to this one. You should read that story, which links to this one about how Tuegel won a big judgment against US Gymnastics over the Larry Nassar case. If nothing else, I’m glad to have someone like that fighting the good fight.

And that’s all I know right now. If there’s any news in the morning, I’ll include it here. Daily Kos has more.

UPDATE: No word from SCOTUS, so SB8 officially became law at midnight last night. They can – and some people think they will – still act today. But SB8 is in effect until and unless they do.

The financial incentive

At this point, whatever works.

A week after public health officials in Texas’ most populous county started handing out $100 cash cards to locals getting their first COVID-19 shot, the number of daily vaccinations has shot up to six times its previous rate, Harris County Judge Lina Hidalgo said Tuesday.

“We had an inkling that something was going right when I started my announcement [about the incentive] at noon, and by the time I was done, 30 minutes later, there was a line of cars waiting to receive the vaccine,” Hidalgo said. “We haven’t seen those lines for months.”

To accommodate and encourage the increased demand, the county will be opening an additional mass vaccination site and expanding its mobile vaccine program, Hidalgo said.

“You have to be creative, and we’re seeing the results and we’re doubling down on it,” Hidalgo said.

Harris County officials began the incentive program last Tuesday in a bid to jumpstart stalled vaccinations in Houston and surrounding areas, and to provide relief to the region’s stressed hospitals during what health officials say is the worst surge of infections the area has seen since the pandemic began last year.

For the three weeks before the program started, Hidalgo said, Harris County Public Health was administering an average of 431 first doses per day. The day the announcement was made, the number jumped to 914. The next day, 1,596 people sought the first doses from public health providers.

On Saturday, four days into the program, some 2,700 people got their first injection, Hidalgo said.

“This is an incredible achievement,” she said.

As the story notes, more vaccination sites are being opened to accommodate what I hope will be a sharp uptick in demand. The FDA approval of the Pfizer shot, and more companies telling their employees to get vaxxed may help push the numbers up as well. I honestly don’t care what the cause is, as long as it happens. And it needs to happen at a higher rate than this – even with the uptick statewide, we’re at less than 30% of the shots-per-day peak in April. Let’s get closer to that, and then we’ll really have something.

Greg Abbott remains COVID’s best friend

It’s hard to even know what to say.

Gov. Greg Abbott on Wednesday announced an executive order banning COVID-19 vaccine mandates regardless of a vaccine’s approval status with the U.S. Food and Drug Administration.

He also said he was adding the issue to the agenda for the current special session of the Texas Legislature.

The order comes two days after the FDA granted full approval to the Pfizer vaccine. That raised questions about the fate of a previous Abbott order that prohibited vaccine mandates, but only for those under emergency authorization.

Abbott’s latest order is simple, saying “no governmental entity can compel any individual to receive a COVID-19 vaccine.” The order preserves exceptions for places like nursing homes and state-supported living centers.

At the same time, Abbott asked lawmakers to consider legislation addressing whether state or local governments could issue vaccine mandates and, if so, which exemptions should apply.

“Vaccine requirements and exemptions have historically been determined by the legislature, and their involvement is particularly important to avoid a patchwork of vaccine mandates across Texas,” Abbott said in a statement.

[…]

There specifically appeared to be the fresh potential for cities, counties and school districts to require their employees to get vaccinated against COVID-19. San Antonio Independent School District had already announced mandatory employee vaccinations, prompting a lawsuit from Attorney General Ken Paxton.

District officials said Wednesday they will move forward with the mandate — despite Abbott’s latest order.

“We strongly believe that the safest path forward as a school district is for all staff to become vaccinated against COVID-19,” the district said in a statement.

See here for some background, and here for a copy of the order. As the story notes, this would prevent government entities from ordering their employees from getting COVID shots, though as you can see that’s already being challenged. Private employers are not affected by this, so if you work for one of the increasing number of them that are imposing COVID vax mandates, you’re out of luck. A bill passed during the regular session forbids businesses from requiring proof of vaccination from their customers, though that doesn’t take effect until September 1 so Harry Styles can still do what he wants.

I don’t think this is anywhere near the end of it. The same arguments being made about mask mandate bans – successfully, so far – by multiple counties and school districts is that the Disaster Act of 1975 doesn’t actually give Abbott this power. That would be equally true for vaccine mandate bans, I would think. That doesn’t mean the courts, by which I mostly mean the Supreme Court, will eventually accept that argument, just that these same entities will give it a try. The federal government will have a say as well, and let’s not forget the federal lawsuit, too. We’re also going to have an election next year, and we have the option of electing a Governor who wants to fight against the COVID virus instead of fighting for it. There’s a lot more of this story to be written. The Current and the Chron have more.

The approval and the mandates

As I’m sure you’ve heard by now, the FDA has given its final approval to the Pfizer vaccine for COVID-19. That should mean a lot of good things, but among them it should mean broader vaccine mandates are now in play.

The U.S. Food and Drug Administration’s full approval of the Pfizer vaccine Monday is cracking open the door for Texas cities, counties and school districts to compel their employees to get vaccinated against COVID-19 — moves previously blocked by Gov. Greg Abbott.

Abbott had banned public schools and local governments from enacting their own vaccine mandates. But the governor’s executive order specifies that the ban on mandates applies to COVID-19 vaccines that are under emergency authorization — a designation that no longer applies to the Pfizer two-dose vaccination.

Already, one major school district is pressing forward with its plan to require vaccinations for teachers and staff.

Pedro Martinez, superintendent for San Antonio Independent School District, called for mandatory employee vaccinations last week — drawing a lawsuit from Attorney General Ken Paxton, who accused the district and Martinez of breaching Abbott’s ban on vaccine mandates.

But with the FDA’s approval, San Antonio school officials are moving forward with their vaccine requirement for district employees.

In a statement, Martinez called the FDA approval “a positive step forward in the fight against COVID-19 nationwide and a step forward in helping keep schools safe for learning here at home.”

Here’s Superintendent Martinez on CNN discussing his fight against Greg Abbott over this. Most of the fights so far have been about mask mandates, but as we noted recently, San Antonio ISD has notified its employees that they must get vaccinated, which has drawn a lawsuit from Ken Paxton. Which, apparently, has been withdrawn now, as the executive order against vaccine mandates only covered “vaccines administered under an emergency use authorization”.

Here’s more from the Chron.

The Pfizer vaccine’s change in status appears to give cities, school districts and universities a way around the governor’s ban.

“Receiving a COVID-19 vaccine under an emergency use authorization is always voluntary in Texas and will never be mandated by the government, but it is strongly encouraged for those eligible to receive one,” Abbott’s most recent executive order reads.

A spokeswoman for Abbott did not immediately respond to a request for comment on Monday.

The update means San Antonio Independent School District, which was sued by the state after requiring its employees to get the shots by Oct. 15, is still moving forward with its mandate. The district had clarified late last week that it would not compel workers to get a vaccine that wasn’t fully approved by the FDA.

Attorney General Ken Paxton touted that as a win in a news release Monday, distributed less than an hour after the FDA granted full approval.

“State law could not be clearer: ‘No governmental entity can compel any individual to receive a COVID-19 vaccine administered under an emergency use authorization,’” Paxton said in the release. “But San Antonio ISD tried to play by its own set of rules. Thankfully, we stopped them.”

San Antonio school officials say the full authorization now allows the district to go ahead with its requirement that all employees get the shots by mid-October, they say. In his clarification statement last week, Superintendent Pedro Martinez had stipulated that the timeline would only change if the FDA hadn’t fully authorized the vaccine by Sept. 10.

Hey, if you want to declare victory while you’re surrendering and retreating, it’s fine by me. Just keep on surrendering and retreating, that’s all I ask.

The remaining questions are 1) What about Moderna and J&J; 2) What will other government entities do about this new ability; and 3) What about the mask mandates? In short,

1) “In May, Pfizer and BioNTech submitted their license application. Moderna began its application in June, and Johnson & Johnson said it will begin the process later this year.” As such, I’d assume the Moderna approval will come sometime in September or October, and J&J will be later than that. But most people have Pfizer or Moderna shots, so that’s the main thing.

2) My guess is they will move more slowly, but once the first domino falls I’d expect others to follow quickly. Note that this will be about mandates for local government employees, not residents. It’ll help, but it won’t apply to everyone.

3) Not the same thing, so we’re still waiting for the lawsuits to play out.

In the meantime, go tell all your vax-hesitant family, friends, neighbors, co-workers, acquaintances, and whoever else that now is the time for them to get their shots. It’s all officially approved, there’s no need to wait any longer.

“Universal masking” for school children recommended

Seems like a sensible idea, especially given that children under the age of 12 can’t get the vaccine yet.

The American Academy of Pediatrics on Monday recommended that all children over the age of 2 wear masks when returning to school this year, regardless of vaccination status.

The AAP, which said its important for children to return to in-person learning this year, recommends that school staff also wear masks. The AAP is calling the new guidance a “layered approach.”

“We need to prioritize getting children back into schools alongside their friends and their teachers — and we all play a role in making sure it happens safely,” said Sonja O’Leary, chair of the AAP Council on School Health. “Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone.”

The AAP said universal masking is necessary because much of the student population is not vaccinated, and it’s hard for schools to determine who is as new variants emerge that might spread more easily among children.

Children 12 and over are eligible for Covid-19 vaccinations in the U.S. And the FDA said last week that emergency authorization for vaccines for children under 12 could come in early to midwinter.

[…]

Universal masking will also protect students and staff from other respiratory illnesses that could keep kids out of school, the AAP said.

The Centers for Disease Control and Prevention recommended this month that vaccinated students do not have to wear masks in classrooms.

Dr. Francis Collins, director of the National Institutes of Health, said on MSNBC that the CDC may have been trying to be a little more lenient, allowing people to make judgment calls “depending on the circumstances in your school and your community.”

But he said he understands where the AAP is coming from.

“They will not be popular amongst parents and kids who are sick of masks, but you know what? The virus doesn’t care that we’re sick of masks,” Collins said. “The virus is having another version of its wonderful party for itself. And to the degree that we can squash that by doing something that maybe is a little uncomfortable, a little inconvenient … if it looks like it’s going to help, put the mask back on for a while.”

That was from last week. Yesterday, the CDC caught up.

To prevent further spread of the Delta variant, the US Centers for Disease Control and Prevention updated its mask guidance on Tuesday to recommend that fully vaccinated people wear masks indoors when in areas with “substantial” and “high” transmission of Covid-19, which includes nearly two-thirds of all US counties.

“In recent days I have seen new scientific data from recent outbreak investigations showing that the Delta variant behaves uniquely differently from past strains of the virus that cause Covid-19,” CDC Director Dr. Rochelle Walensky told a media briefing on Tuesday.

“This new science is worrisome and unfortunately warrants an update to our recommendations,” she said. “This is not a decision that we or CDC has made lightly.”

[…]

Earlier this month, the CDC’s Covid-19 school guidance noted that fully vaccinated people do not need to wear masks, and then about a week later the American Academy of Pediatrics issued stricter guidance recommending that everyone older than 2 wear a mask in schools, regardless of vaccination their status.

Now the updated CDC guidance recommends everyone in schools wear masks.

“CDC recommends that everyone in K through 12 schools wear a mask indoors, including teachers, staff, students and visitors, regardless of vaccination status. Children should return to full-time, in-person learning in the fall with proper prevention strategies in place,” Walensky said. “Finally, CDC recommends community leaders encourage vaccination and universal masking to prevent further outbreaks in areas of substantial and high transmission. With the Delta variant, vaccinating more Americans now is more urgent than ever.”

The updated CDC guidance makes “excellent sense,” Dr. David Weber, professor at the University of North Carolina School of Medicine in Chapel Hill and board member of the Society of Healthcare Epidemiology, told CNN on Tuesday.

“Breakthrough disease clearly occurs, and for those cases, we know they’re much more mild in vaccinated people, but we don’t know how infectious vaccinated people are,” he said. “But clearly, if you want to protect your children under 12 or grandchildren, or protect immunocompromised people, as well as protect your own health — from even mild disease — then you should be wearing a mask, particularly in areas of high transmission when indoors.”

My kids have been vaccinated, but they’re still regular mask-wearers, especially the younger one. I fully expect them to continue to do so in school, at least for the fall. I’ve been wearing a mask again for indoor spaces as well. I will admit it’s kind of annoying, as we have been vaccinated for months now and have been pretty damn careful all along, but it is what it is. That said, I have a lot of sympathy for this position:

Some of that is happening in other states, but who knows, maybe we’ll get it for federal buildings and air travel, too. And who knows, maybe this will work.

As leaders in other parts of the country require government employees to get COVID-19 vaccinations, San Antonio and Bexar County are considering following suit, the Express-News reports.

Such a step would come as vaccination rates plateau and the highly contagious delta variant leads to a rise in infections, hospitalizations and deaths in Texas. California and New York City this week said they will make employees get the vaccine or submit to weekly coronavirus tests. Veterans Affairs became the first federal agency to mandate COVID vaccinations for frontline staff.

“We are supportive of the efforts of New York and California,” San Antonio Mayor Ron Nirenberg and County Judge Nelson Wolff said in a joint statement supplied to Express-News. “We will be reviewing the legalities and practicalities of requiring a COVID-19 vaccine and/or weekly testing in conformity with CDC guidelines in order to protect the health and well-being of city/county workforce.”

A city and county vaccine mandate would apply to roughly 18,000 workers, according to the daily, which reports that both Nirenberg and Wolff are unsure whether the requirement would be allowable under state law.

I think we can say with extreme confidence that the state would bring all its fight against such a move. That doesn’t mean it’s not worth the effort, but it’s not a move to be made lightly. Be prepared to hire a bunch of expensive lawyers, and have a solid communication strategy in place, that would be my advice.

As for masks in schools, well…

What did you expect? Greg Abbott has already said there won’t be any mask mandate in schools, and it’s impossible to imagine him changing his mind. It’s all up to the parents and school staff. I would not feel safe having my not-yet-vaccinated kids in school without a full-mask situation, which by the way is what we did in this past spring semester. I don’t even know what the argument against is. Doesn’t much matter when the power is on that side. The Trib and Daily Kos have more.

Pfizer shot approved for younger kids

Yes!

The Food and Drug Administration cleared the first coronavirus vaccine for emergency use in children as young as 12 on Monday, expanding access to the Pfizer-BioNTech shot to adolescents ahead of the next school year and marking another milestone in the nation’s battle with the virus.

The decision that the two-shot regimen is safe and effective for younger adolescents had been highly anticipated by many parents and pediatricians, particularly with the growing gap between what vaccinated and unvaccinated people may do safely. Evidence suggests that schools can function at low risk with prevention measures, such as masks and social distancing. But vaccines are poised to increase confidence in resuming in-person activities and are regarded as pivotal to returning to normalcy.

“Adolescents, especially, have suffered tremendously from the covid pandemic. Even though they’re less likely than adults to be hospitalized or have severe illness, their lives really have been curtailed in many parts of the country,” said Kawsar R. Talaat, an assistant professor of international health at the Johns Hopkins Bloomberg School of Public Health. “A vaccine gives them an extra layer of protection and allows them to go back to being kids.”

Expert advisers to the Centers for Disease Control and Prevention are scheduled to meet Wednesday to recommend how the vaccine should be used in that age group, and the vaccine can be administered as soon as the CDC director signs off on the recommendation.

In a news briefing Monday evening after the announcement, FDA officials said the Pfizer authorization for 12- to 15-year-olds was a straightforward decision because the data showed that the vaccine was safe and that the response to the vaccine was even better than among the 18- to 25-year-olds who got the shots.

Our almost-17-year-old has had her shots. We’ll be getting the 14-year-old signed up as soon as we can. “Herd immunity” may never be a thing we achieve with COVID, but having a greater share of the population vaxed is a good thing, and adding this group to the eligible list moves towards that goal. I’m ready for this.

More vaccines coming

Bring ’em.

The Food and Drug Administration approved Johnson & Johnson’s COVID-19 vaccine on Saturday for use in the U.S., the third vaccine to be approved since the pandemic began.

Texas could initially receive more than 200,000 doses, according to the Texas Department of State Health Services, but the agency hasn’t received a timeline for when they would arrive. The company has said it plans to ship 20 million shots in the U.S. by the end of March and an additional 80 million doses before the end of June.

Texas received about 1.5 million vaccine doses by Pfizer and Moderna this week, including doses that had been undelivered earlier in the month because of the winter storm.

Unlike those vaccines, Johnson & Johnson’s formulation is the first to only require one dose, and it can be stored at regular refrigeration temperatures. The others require two doses, and Pfizer doses must be stored at below-freezing temperatures.

[…]

Five million vaccine doses have been administered overall in Texas as of Feb. 25. That equals about 5.8% of the state’s population — a long way from the 70% to 80% that experts estimate is necessary to achieve herd immunity. It would require nearly 100% of adults to be vaccinated to reach those figures, according to census numbers.

Scientists are still monitoring how well vaccines prevent the spread of the coronavirus, and health officials advise those who are vaccinated to continue wearing masks, social distance and follow other COVID-19 safety guidelines.

Hopefully, the J&J vaccine will really kick this up a notch, since it only requires the one shot. But as always, it’s first a matter of supply, and just having another supplier should help. If J&J is delivering 80 million doses nationally by the end of June, that should be six or seven million for Texas. It’s all about the numbers.

Vaccination progress

Making progress.

One in eight Harris County residents 16 and older have received at least one dose of the COVID-19 vaccines, according to state and local data.

A Chronicle analysis found that the first dose of the Pfizer-BioNTech or Moderna vaccines have gone to 12.4 percent of the county’s population in that age range, or 447,861 people.

That number is expected to rise as the Federal Emergency Management Agency opens a vaccine supersite in Houston at NRG Park. The site can vaccinate 42,000 people per week, targeting residents in high-risk ZIP codes.

Federal regulators are also likely to authorize the Johnson & Johnson COVID-19 vaccine, boosting vaccine supply at a critical time, when some say the inventory does not match demand. On Wednesday, the U.S. Food and Drug Administration said it had reviewed the pharmaceutical giant’s trial data and determined it was consistent with the recommendations of the emergency use guidelines.

That’s about nine percent of the total population in Harris County, and a bit less than half of these people have gotten both dose. With the one-shot Johnson and Johnson vaccine on its way, we should really make a dent in the numbers quickly.

The super sites should help, too, even if people had to wait longer than they expected on the first day.

Lauren Lefebvre, regional director for the Federal Emergency Management Agency, said late Wednesday that there were a variety of reasons for the delays. Some people had issues with the electronic codes required to check in for appointments, and officials may tweak some of their procedures to decrease the amount of paperwork required to enter.

Traffic issues were further exacerbated by cars arriving early or late. Lefebvre said FEMA expects to add more workers in the coming days, and some of the traffic routes could change around the stadium to ease the flow of cars trying to enter.

The city and county have made vulnerable populations — including the unhoused, and those without Internet or the ability to travel — a focal point of their pandemic response. The NRG site is drive-in only, which has raised concerns about equitable access.

Houston Health Department Director Stephen Williams added that the NRG site is only one part of the city’s broader vaccination efforts, and will open up availability for “other providers, many of which are located in hard-hit areas but have been unable to keep up with demand.

“Of course we’re trying to target those individuals who are most vulnerable, but (NRG) is not exclusively for individuals that are most vulnerable,” he said. “Having an additional 6,000 slots to see people is a really good thing for Houston and Harris County — and we don’t want to minimize the value of that — but it isn’t everything.”

Yes, more is still needed. But we’re way ahead of where we were in January, and the curve is sloping upward.

Mutant mosquito update

Keeping you informed on the news you can really use.

Four years ago, the Zika virus became an issue. More than 300 people were infected in Texas. Zika can cause birth defects and fetal neurodevelopmental abnormalities in pregnant women.

The vector is Aedes (rhymes with ladies) aegypti and Aedes albopictus mosquitoes. The Aedes mosquitoes transmit Zika, chikungunya, dengue and yellow fever, which prompted state and county health officials to discuss actionable solutions to control the mosquito.

Talks about releasing genetically modified mosquitoes in Houston began in 2018 between Harris County and Oxitec, a United Kingdom-based company that produces sustainable technologies or transgenic methodologies to stem the impact of disease-spreading insects. Talk also began about a similar action in Monroe County, Fla.

However, ecological concerns have been raised about the use of these mosquitoes.

“We had stakeholders there who wanted to use it,” said Kevin Gorman, head of field operations at Oxitec. “We had vector control authorities who were keen to try the technology.”

The Environmental Protection Agency stated in a May 2020 press release that it approved an experimental use permit to Oxitec to field-test its genetically engineered mosquito in the United States.

The genetically modified Aedes aegypti mosquitoes are males that mate with wild female Aedes aegypti, essentially causing the offspring to die before they can reproduce due to a genetic variation.

Oxitec had two successful years of controlling the Aedes aegypti in Brazil with its current generation of mosquito and had several years of efficacy in Brazil with its first-generation, Gorman said.

[…]

A release in Florida seems imminent, but not in Texas. Despite an established relationship and much communication, it looks like the Florida Keys will be going solo.

“Although we really enjoyed a sort of really great relationship with Houston at the moment we’re in a holding pattern with Houston,” Gorman said. “And we’re unlikely to be releasing there, and there certainly aren’t firm plans to do so in the next year.”

He cited uncertainty due to personnel changes in the county government as the reason for the decision.

A statement sent to Reform Austin by Sam Bissett, a communications specialist with Harris County Public Health, said the choice to not move forward with the release was made last year by both parties.

“At this time, there are no agreements or approval in place for Harris County to work with Oxitec in 2021. While we have had discussions with Oxitec previously about a potential partnership with Harris County Public Health, those discussions were paused last year between both sides.”

See here for my previous post on Oxitec and mutant mosquitoes, from 2017. There’s a lot more to the story and it’s hard to just capture the essence of it, so go read the whole thing. Apparently, the Aedes aegypti mosquito is more abundant in the Rio Grnade Valley than in Harris County, so maybe we’re not the best place to test this out in the US. Harris County also employs mosquito traps and dragonfly armies to control the local skeeter population. Which all seems a whole lot more quaint these days, but Zike and its ilk haven’t gone away just because we’re mostly inside these days. We will be spending more time outside again, and when we do we’d like to not be at significant risk from some other emergent deadly disease, thank you very much. Maybe next time we’ll be able to work something out.

We could have had an excise tax on e-cigarettes

But then Greg Abbott got involved.

At the urging of the nation’s biggest tobacco company, Gov. Greg Abbott launched a late-hour push to change Texas legislation creating a 10% state retail excise tax on e-cigarette and vapor smoking products.

That bill died in House action Thursday night due to a legislative maneuver, known as a point of order, offered by Republican Rep. Jonathan Stickland of Bedford. It has no realistic chance of revival because of legislative deadlines and the mandate that tax measures originate in the House, not the Senate.

Stickland said Friday his aides spotted the technical error and he pointed it out in the House out of concern about ladling taxes on e-cigarettes and vape products.

“A lot of people have used e-cigarettes to quit other bad habits,” Stickland said Friday. “It’s just a freedom issue for me. I think that taxes are theft.”

After the bill’s death, Dallas Democrat Nathan Johnson, the author of the Senate version of the bill, said in a text message: “I’m disappointed, to say the least. This bill would protect kids and save public costs. It had overwhelming support in the House.”

Critics said earlier that Abbott’s late move — targeting a bill touted as deterring youths from buying addictive e-cigs — would effectively ease taxation of products such as Juul pods that concentrate nicotine in not much liquid.

[…]

Abbott’s suggested changes would have scrapped a proposed first-in-the-nation retail tax predicted to generate about $20 million a year for public education. Instead, Texas would tax vape products at the wholesale level at five cents per milliliter of “consumable liquid solution.”

Four states — Delaware, Kansas, Louisiana and North Carolina — tax vape products at five cents per milliliter, according to the Campaign for Tobacco-Free Kids, with New Jersey and West Virginia levying higher rates.

The Abbott-backed changes also would have put a $1 per ounce tax on every initial sale of heated tobacco products, which produce an inhalable aerosol primarily by heating, not burning, tobacco. The FDA authorized U.S. sales of the products, made by Philip Morris International, late last month. Corey Henry of Philip Morris International said in an email that the product will be commercialized by Altria in the U.S. through a licensing agreement.

Proceeds from the double-barreled tax were to help fund public schools.

Rob Crane, an Ohio State University physician who heads the Preventing Tobacco Addiction Foundation, said in an email that the resulting e-cig tax would have been so light, it would make “no difference” to children or adults considering purchases of such nicotine delivery products.

The first link in the story gives some background on the bill, as it was and what it was intended for. I confess, I wasn’t aware of any of this before I read the story, so I don’t have much to add beyond what you can read at the two links. Mostly, this is a reminder of why it’s hard to pass bills in the Lege. Time is against you, there are many veto points, and the closer you get to the end of the session the easier it is kill things. All you can do is note how far you got this time, and vow to try again in two years.

Let’s use mutant mosquitoes to fight Zika

What could possibly go wrong?

The Bayou City’s teeming mosquito population spawns in dark, wet nooks and carries a slew of deadly tropical diseases that could ravage the region.

So Houston is pondering a sneak attack, something akin to a Trojan Horse. Harris County officials are negotiating with a British biotech company, Oxitec, to create and release mutant mosquitoes genetically engineered so that after they’re set loose in the wild, offspring die, and the mosquito population dwindles.

Deric Nimmo, principal scientist at Oxitec, said it is a paradigm shift – “the release of mosquitoes to control mosquitoes.”

If an agreement is finalized, Harris County could become one of the first locations in the United States to use the mosquitoes, going far beyond the chemicals and public-awareness campaigns the county has long relied upon.

[…]

Oxitec spun off from Oxford University 15 years ago to commercialize proprietary strains of insects, namely mosquitoes. The hope is that they can help reduce populations of Aedes aegypti mosquitoes, which carry the Zika virus, dengue fever and chikungunya, among other deadly illnesses. The mosquitoes are common in the Houston region.

Oxitec inserts a “self-limiting gene” into a male mosquito and releases several into the environment. Those mosquitoes then mate with females – Oxitec claims their special males out-compete normal males – and the resulting offspring die before they become adults. Over time, the overall population of the Aedes mosquito declines.

Male mosquitoes do not bite and can’t spread disease.

The company has conducted field trials in Brazil, Panama and the Cayman Islands and says it has reduced the Aedes mosquito populations by up to 90 percent in each location.

“It looks like we’re going to do or plan to do some sort of trial initially to test out the system,” Nimmo said.

Oxitec has yet to try out its technology in the U.S.

[…]

According to the FDA, if Oxitec wanted to conduct a field trial in Harris County, the company would have to submit an environmental assessment to the agency.

Another complication: Regulatory authority over Oxitec’s mosquitoes would then likely shift to the Environmental Protection Agency.

Mustapha Debboun, director of the Harris County Mosquito Control Division, said working with Oxitec could provide another tool in the fight against Zika and other mosquito-borne illnesses.

“We’re not abandoning the tried-and-true” approaches, said Harris County Precinct 4 Commissioner Jack Cagle, who has been leading the efforts. “We’re willing to see – What can we add to the tried-and-true that can make this better, especially considering that the tried-and-true has some flaws?”

Unseasonably warm weather has prompted the division to boost staff during winter months. It has seven investigators now, compared to four, and two additional public education staffers, Debboun said.

In August, officials nearly doubled the number of Aedes mosquito traps across the county to 134. Harris County also continues to partner with Microsoft to develop high-tech traps that will sense and nab only certain species of mosquitoes, like those that carry Zika or dengue, and eventually hopes to utilize drones to find and target hot spots.

After receiving a federal grant, the county hopes by May to start research on whether mosquitoes in the region that could carry Zika are developing resistance to certain pesticides. The county also will use that money to test more mosquitoes for Zika, Debboun said.

“The crucial part of all this is to find out if the mosquito has the virus in it,” he said.

Yes, remember the Microsoft Mosquito Drone story? Nice to hear about it again, even if there isn’t much to report yet. As far as Oxitec goes, their approach is one I’ve heard about as a possible way to limit the growth of the A. aegypti population and the many diseases it helps propagate. Maybe it will work without serious unanticipated side effects, but we would be the US pioneers for such a test. I’m not sure how I feel about that, but as the consequences of doing too little are West Nile and Zika, I’m not sure how wishy washy one can be about this. What do you think?

Use of abortion pill rises

Until the Lege reconvenes, anyway.

Misoprostol

There’s been a sharp increase in the number of Texas women who are using the abortion pill to end their pregnancies now that federal officials have eased restrictions on the drug, according to officials at Planned Parenthood of Greater Texas.

Until recently, the number of women seeking medically induced abortions at Texas’ Planned Parenthood facilities had dipped to about 1 percent because of stringent guidelines put in place by state lawmakers, officials say.

That changed in late March, when the U.S. Food and Drug Administration relaxed guidelinesfor women taking mifepristone, a pill geared to induce abortion early in a pregnancy.

“We have seen a fourfold increase in the number of our patients choosing medication abortion since the FDA updated its protocol,” said Sarah J. Wheat, chief external affairs officer at Planned Parenthood. “From our perspective, it’s restoring options for women.

“It’s putting decisions back in the hands of women instead of politicians at the Capitol.”

No firm numbers are available yet, but Texas researchers and abortion providers say they see the increase and hope to have better estimates in the coming months.

[…]

Planned Parenthood continues to run clinics statewide, including the Southwest Fort Worth Health Center, a privately funded $6.5 million licensed ambulatory surgical center that opened in 2013.

A medical abortion has remained an option for patients at these facilities, but fewer women have used it because Texas law required them to visit the clinic four times for it, said Daniel Grossman, an investigator with the Texas Policy Evaluation Project and a professor at the University of California, San Francisco.

“In the six months after HB 2 went into effect, there was a 70 percent decline in medication abortions performed statewide,” said Grossman, who is working with researchers at the University of Texas at Austin to determine the impact of legislation on abortions. “Interviews with women … [showed they were] incredibly frustrated when they had a preference for medication abortion” and couldn’t get it.

Wheat said some women have had to travel 100 miles or more to reach a Planned Parenthood clinic, which put a hardship on them for multiple visits.

“That requirement alone created huge barriers for our patients,” she said.

Now that the FDA change has loosened restrictions in Texas — requiring a lower dose, 200 milligrams instead of 600 milligrams; fewer doctor visits; and allowing the medication up to 10 weeks in a pregnancy instead of seven weeks — more women are choosing the medical abortion option, Wheat and Grossman say.

Exact numbers won’t be available for weeks or months, but “many of the independent abortion providers who have already started using the new FDA regimen are saying their numbers are back up,” Grossman said. “Many women have a preference and prefer this.”

[…]

Now the question is whether Texas lawmakers will weigh in on the issue when they return to work in January.

Planned Parenthood officials say they hope not.

“The restrictions the Legislature put in place were not based in science,” Wheat said. “The FDA is the national expert in how medications are provided, and they approved these updates.

See here for the background. I’d laugh at the futility of hoping that science and rationality would prevail if it weren’t so painful. The best hope as I see it is for HB2 to be sufficiently gutted by the Supreme Court. That will surely only slow down the zealots, but it’s probably the best we can expect until we start electing different leaders.

FDA makes medical abortion safer

Good news, at least until the Legislature reconvenes.

Misoprostol

Texas women will be able to obtain medical abortions later into their pregnancies under newly approved changes by the federal Food and Drug Administration.

The FDA on Wednesday announced revised rules for drug-induced abortions — a method used early in a pregnancy — that will increase the number of days women can take medication to induce abortions from 49 days of gestation to 70 days. Other revisions to the original FDA label for medication that induces abortions include a lower dosage of the drug, known as mifepristone.

First approved in 2000, mifepristone, when taken with another drug called misoprostol, is used to terminate early pregnancies.

Doctors in many states already followed common, evidence-based protocols that strayed from the FDA’s previous label for the drug, but Texas doctors were prohibited from doing so by state law. Among the provisions of the 2013 abortion law known as House Bill 2, Texas doctors were required to follow the FDA’s protocol for drug-induced abortions rather than evidence-based protocols.

[…]

Abortion providers and representatives of the medical community had long asked for an update to the FDA rules, arguing the original FDA label for mifepristone was based on outdated evidence from the 1990s.

“Today, science has prevailed where the state legislature has failed,” said Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes, the organization’s political arm in the state.

While the medication to end a pregnancy must still be administered in Texas by a physician, the FDA revisions also say the second drug can now be taken “at a location appropriate for the patient.” It’s unclear what that means for Texas women who under state law must take the pill in front of a doctor.

A spokesman for the Texas Medical Board, which regulates physicians, said it was “still in the process of analyzing the FDA’s updated regimen.”

Of course, plenty of women have taken matters into their own hands on this, so this is at least a small step in the direction of safety. Don’t expect the Lege to be deterred by this, of course. They will figure out a way to make this as burdensome and punitive as possible. We may get a favorable ruling from SCOTUS in the HB2 case, but this would be a separate matter that would have to be litigated all over again. So enjoy this while you can, it’s got a limited shelf life. Sorry to be such a drag. Think Progress, the Chron, the Press, Daily Kos, and the AusChron have more.

On e-cigarettes

From the Rivard Report:

After a 2011 ordinance banned indoor smoking in public places around San Antonio, some smokers were left trying to find options to leave tobacco behind. In the ensuing three years, electronic cigarettes and vaporizers have seen exponential growth around the country, with several retail outlets popping up in and around San Antonio.

Monster Vape, co-founded by Christopher Zieg, opened its doors in 2012, and in two years expanded into two more San Antonio stores and a Corpus Christi franchise.

Zieg, a former U.S. Military medic, said he knew the dangers of smoking, but had trouble quitting until he attended a concert and saw the singer vaping onstage. His personal success with quitting smoking after switching to vaping five years ago inspired him to set up shop as he finished his military service in San Antonio.

“Being a medic and seeing what e-cigs have done for me, I wanted to pass that on to other people,” Zieg said, citing a number of benefits, including a lack of tobacco smells on clothing and vehicles, better energy levels, and perhaps most importantly the fewer number of chemicals found in the fluids used in vaporizers.

The health effects of e-cigarettes are currently unknown, and some early reports have mixed news so far. The new smokes are not yet regulated by the FDA, but I strongly suspect they will come under close scrutiny. I also suspect that local governments, which have been very active in banning tobacco use in public spaces, will not wait for a final word from the FDA to act on their own.

While the federal government works out new rules for electronic users, several city governments have started the push to include electronics in existing anti-smoking ordinances. In December, an ordinance passed by New York City Council added vaporizers to the city’s smoking ordinance, treating them as tobacco products and prohibiting their use indoors. Similar ordinances have passed in Chicago, Los Angeles, and King County, Washington, which includes several cities, most notably Seattle.

Cities in Texas have followed suit, including Georgetown, Soccoro, and Frisco, which – like New York – amended previous ordinances, and San Marcos, which made a last-minute inclusion of vaporizers to its first smoking ordinance during its final reading, drawing criticism from shop owners.

“I just don’t think they did their research before making that decision,” said Sharon Teal, owner of Ahh Vapors, LLC in San Marcos. She cited studies released by the Consumer Advocates for Smoke Free Alternatives Association, showing e-cigarettes to be far less harmful than cigarettes.

In cities where the jury is still out on the inclusion of electronics in smoking ordinances, several businesses have introduced their own bans shutting out vaporizers. To Zieg, this will cause vaporizer users to find other businesses where they can vape.

“If you have two coffee shops and one says ‘no’ and one says ‘yes,’ the vapers are going to go where they’re allowed to do what they love,” Zieg says.

That may be true, but it’s as likely that the non-vapers, of whom there are many more, will choose to stay away. Be that as it may, I don’t know how much this is on the radar of Texas cities yet. I admit I don’t get out much, but I think I’ve maybe seen one or two people vaping ever, whereas I still see plenty of the old-fashioned kind of smokers. On the one hand, it would probably be easy enough for most cities to simply amend their existing no-smoking ordinances to include e-cigs – at this time, I doubt there would be that much organized opposition, certainly not as much as there was when the ordinances were first passed. On the other hand, I doubt there’s much of an organized push to get those ordinances updated, either, so for now I’d say most city councils have bigger fish to fry. What do you think about this? Would you like to see Houston or your city act now on e-cigs, or maybe consider the matter later? Would you go even farther than that? Leave a comment and let us know.

There are limits to caffeination after all

No caffeinated gum for you.

Wrigley’s new caffeinated gum, Alert Energy Gum, only lasted a couple of weeks on the shelves of supermarkets, grocery stores and convenient stores after the FDA became concerned about the amount of caffeine each piece of gum offered.

With 40 milligrams of caffeine (equal to half a cup of coffee) in each piece, it’s no shock as to why the FDA was concerned, especially because we live in a world where energy drinks and coffee thrive. Although other gum companies have released their own caffeinated items, like Mentos’s Up2U Gum and Jolt’s energy gum, the FDA has become recently concerned with the amount of added caffeine in foods and drinks.

In fact, the main worry the FDA has about caffeinated beverages and foods is that most of the products are marketed to children, who shouldn’t be consuming energy drinks and coffee throughout the day. The FDA’s limit for caffeine consumed each day is 400 milligrams, the equivalent of four or five cups of coffee. This limit is set for adults, but the FDA discourages the consumption of caffeine or caffeinated items by children and youths.

Gum is an item consumed by people of all ages, so unlike alcohol, it isn’t blocked from being purchased by children or adolescents. In a statement from the FDA, Michael R. Taylor, the deputy commissioner for foods and veterinary medicine at the agency says, “One pack of this gum is like having four cups of coffee in your pocket. Caffeine is even being added to jelly beans, marshmallows, sunflower seeds and other snacks for its stimulant effect.”

So after caffeinated Cracker Jacks, air, beer, soap, doughnuts, and potato chips, we have finally reached a bridge too far. You’ll just have to get juiced by other means. On the bright side, there’s a caffeinated toothbrush coming out soon, so the range of options continues to expand.

Cracker Jack’d

Buy me some peanuts and caffeinated Cracker Jacks

Coming soon to a store near you: Cracker Jack’D, a new twist on the popcorn candy that offers Power Bites with as much caffeine in every serving as a cup of coffee. That could mean kids could get an overdose of caffeine if they consume more than one serving at a time, warns the Center for Science in the Public Interest, a nonprofit nutrition activist group based in Washington, DC.

The addition of caffeine to a growing number of snack foods comes at a time when warning bells have sounded over the hazards of caffeinated energy drinks. US Food and Drug Administration officials told the New York Times on Wednesday that they’ve received reports of 13 deaths linked to 5-Hour Energy shots over the past four years. And the agency is also investigating heart attacks attributed to Monster energy drink, including the death of a 14-year-old Maryland teen.

An excessive amount of caffeine can cause heart palipitations, increased blood pressure, nausea, dizziness, and insomnia — and kids may be particularly sensitive to the chemical’s effects.

The nutrition activist group fired off a protest letter on Wednesday to manufacturer Frito Lay and to the FDA. “Whether or not they are advertised directly to children, it is certain that young children will consume Cracker Jack’d…and sometimes consume it to excess,” wrote the Center’s director Michael Jacobson.

Besides the energy drink craze, caffeine has also been added recently to foods you’d never suspect like the low-calorie beverage Crystal Light, Sport Beans jelly beans, and MiO Liquid Water Enhancer, a flavoring that’s squirted into water.

[…]

Frito-Lay spokesperson Chris Kuechenmeister pointed out in an emailed statement that the new Cracker Jack’D Power Bites line have “two flavors that will contain coffee, a natural source of caffeine.” The company expects each 2-ounce serving to contain about 70 milligrams of caffeine, the FDA limit for a 12-ounce serving of cola.

“Cracker Jack’D is a product line specifically developed for adult consumers and will not be marketed to children,” wrote Kuechenmeister. “The package design and appearance are wholly different from Cracker Jack to ensure there is no confusion among consumers.”

Yes, I’m sure no children will ever consume this product. At the rate we’re going, it’s a matter of what isn’t caffeinated any more, not what is. Via Jezebel.