The CDC issued an urgent health advisory for those currently pregnant, planning a pregnancy or breastfeeding on Sept. 29, 2021. The statement reiterated the importance of vaccination in preventing severe illness and death resulting from COVID-19. It also highlighted the wide gap in vaccination rates with pregnant people who are less than half as likely to have been vaccinated than a member of the general public.
The CDC advisory also brought attention to the widening racial gaps in vaccination during pregnancy, with less than 16% of Black pregnant females reporting having been vaccinated.
As an immunologist who has been studying immune responses to COVID-19 since the beginning of the pandemic, I know the reason for the agency’s urgency is clear. Pregnancy is a significant risk factor for serious illness and death from COVID-19 – both for the mother and the child. Detailed research into pregnancy during the pandemic has shown that mothers who contract COVID-19 are five times more likely to be admitted to an ICU and 22 times more likely to die than their noninfected counterparts.
The same study found that mothers infected with COVID-19 during pregnancy are twice as likely to require ICU care for their newborns, or to lose their children shortly after birth.
As a father of two, with a third expected in December, I understand the intense stress that health decisions can bring on during pregnancy. In dealing with our own high-risk pregnancy, my wife – who is a health care worker – was recently given the go-ahead to receive a Pfizer booster following its recent FDA/CDC approval. Even with high medical competency and my own expertise as an immunologist, I would be lying if I said the decision was an easy one.
Data is hard to listen to when it conflicts with our gut feelings, but that can be when people need it the most. In this case, the data is clear: COVID-19 poses a significant threat to both the mother and child, and vaccination can help mitigate that risk.
The immunology of pregnancy is complicated
Pregnancy is an immunological tightrope. At the most basic level, a maternal immune system’s job is to welcome a foreign organism that is consuming considerable resources, and allow it to grow unmolested for months. This doesn’t come naturally – to prevent the identification and rejection of a growing fetus as a parasitic invader, maternal immune systems undergo an overhaul that fundamentally alters their responses to infection in order to support the pregnancy.
But those changes don’t shut down immune responses completely. Compromising immune function to a point where infections are allowed to run rampant would not be a successful survival strategy for mother or child.
Instead, a new partnership is struck. The maternal immune systems selectively chooses not to react to foreign tissues and cells associated with the growing fetus, and instead enters into a coordinated dance. Over the course of nine months, it will guide the attachment of the placenta to the uterine wall, promote growth and development of the fetus and ultimately initiate labor to kickoff the delivery.
This is complicated work and requires a measure of immuno-zen: An environment of calm and balance is carefully maintained around the uterus. But inflammation – a catch-all term used to describe the physical manifestations of intense immune activation – is a threat to that balance. Researchers have long understood that serious infectious diseases, which frequently trigger intense inflammatory immune responses throughout the body, pose a serious threat to the mother-fetus duo. The list of infectious diseases capable of complicating a pregnancy is long.
Vaccination protects both mother and child
This balancing act that the immune system undergoes during pregnancy is precisely why vaccination is so important. While there is no doubt that getting a vaccine activates the immune system – that’s exactly what it is supposed to do – this mild immune response to the vaccine is nowhere close to the risks that the pregnancy faces if the mother contracts COVID-19.
When your body meets a harmless lookalike of SARS-CoV-2 in the form of the vaccine, the immune system is trained to recognize the virus in a safe and controlled environment – without the threat of an actual COVID-19 infection. This way, if you encounter the real virus, your immune system is much more prepared and capable of fending it off. As a result, your immune system will be less likely to need to resort to the high-inflammation, high-risk tactics that it would have to deploy against severe infection.
Even with a vaccine that is not 100% effective due to waning antibodies or the emergence of the delta variant, studies have shown that the reduction of symptoms associated with partial protection is enough to lower the risk of poor outcomes in both mother and child.
COVID-19 vaccines protect the baby too
In addition to the maternal protection that vaccines offer, a new study has revealed that antibodies created in response to COVID-19 vaccination can also be effectively passed to the baby through umbilical cord blood. This finding is critical because while COVID-19 infections have not been shown to directly infect the fetus in utero, an infection can be passed from mother to child during birth.
In one study, nearly 15% of children delivered by Cesarean section to COVID-19-infected mothers tested positive for the virus after birth. In this early stage of life, newborns do not yet possess the ability to produce antibodies effectively on their own. Instead, they are entirely reliant on mom – holding onto antibodies that were shared between them in the blood before birth, and getting new ones transferred through breastmilk.
Medical decisions around pregnancy are hard, and the urge to protect the pregnancy by just leaving it alone is a strong one. It can feel like the small risks associated with vaccination are avoidable – so why take the chance? The problem, of course, is that the virus does not allow you to choose. Opting not to vaccinate is, unfortunately, a choice to roll the dice with a virus that has killed millions and has led to catastrophic outcomes for both mother and child.
COVID-19 vaccines have been shown to be safe and effective during pregnancy. And now, research has made it clear that they can be an ally to the maternal immune system, helping it to maintain a healthy and balanced environment for a thriving pregnancy.
[Research into coronavirus and other news from science Subscribe to The Conversation’s new science newsletter.]
Matthew Woodruff's research is supported by the National Institute of Health. He is a co-founder of Jefferson's Electorate.cdc pandemic coronavirus covid-19 vaccine fda antibodies
‘Build Back… You Know, The Thing’: Americans Have No Idea What’s In Biden’s Economic Plan
‘Build Back… You Know, The Thing’: Americans Have No Idea What’s In Biden’s Economic Plan
While Congressional Democrats spar over the ultimate size of President Biden’s "Build Back Better" economic plan, Bloomberg astutely points out that..
While Congressional Democrats spar over the ultimate size of President Biden's "Build Back Better" economic plan, Bloomberg astutely points out that Americans have no clue what they're signing up for with their tax dollars. In fact, according to a CBS News poll published Oct. 10, just 10% of Americans say they know the specifics of the bill, while only 1/3 think it would benefit them directly.
What's more, "Not even Congress knows what the bill would accomplish, with the contents of the plan changing day-by-day as Democrats squabble over how much it should spend, who it should benefit and who should pay for it."
For example, on Tuesday, the White House suggested it would jettison free community college. The next day, Democrats were focused on proposed tax hikes after moderate Sen. Kyrsten Sinema (D-AZ) put her foot down over corporate and personal tax rates.
In an attempt to provide some clarity (don't hold your breath), Biden on Thursday night held a CNN town hall-style event (on the same night as Dune's US release).
In short, their messaging sucks.
"I will state the obvious, but they need to shift the focus away from process to policy. So far, the coverage around their proposal is all around Democratic divisions, which inevitably makes it impossible to sell," said former Marco Rubio communications director, Alex Conant. "Frankly, they need to talk about what their goals are," he added. "Why is this necessary?"
Republicans, on the other hand, are clear on their messaging; "Massive government spending leads to massive tax hikes," according to GOP strategist Ron Bonjean. "When you have a shifting number and shifting programs, it becomes confusing to follow."
Instead of focusing on the legislation’s new investments in child care, the elderly, education, healthcare and climate change, Democratic lawmakers have openly haggled over the price tag. A standoff between the party’s progressive and centrist factions has created cable news-ready drama.
“Given how much is wrapped up in this package, it was always going to be a long and intense negotiation,” said Ben LaBolt, a former spokesperson for President Barack Obama. “One way to start is to build the case for the way this will help middle class families and focus the public on those conversations, while at the same time preserving room for the closed-door negotiations to bring all of the elements of the party together for the biggest, most comprehensive approach possible.” -Bloomberg
In a Wednesday speech in Scranton, PA, Biden tried - and failed - to convey how his economic agenda would help working class families - by intermingling stories about growing up in the area and programs contained in the legislation.
"Frankly, they’re about more than giving working families a break; they’re about positioning our country to compete in the long haul," said Biden, doing his usual poor job of reading a teleprompter. "Economists left, right, and center agree."
Meanwhile, Biden - let's face it, Biden's 'advisers' have failed to ink a final compromise between warring factions of Democrats. For the Build Back Better plan to pass, every single Senate Democrat must be on board. As moderates Sinema and Joe Manchin (D-WV) balk on the price tag and demanding deep cuts, progressive House Democrats are sure to similarly balk at passing the smaller, $1.2 trillion infrastructure package that's already passed the Senate.
While advocacy groups have started to spend heavily to promote policies in the plan, most of the discussion remains centered on its cost.
Biden’s advisers are banking on the presumption that ordinary Americans don’t pay much attention to the machinations of everyday Washington. Much as they were during the presidential campaign, the president’s aides are largely dismissive of what they call horse-race stories.
But Biden’s team had a much easier time selling his pandemic relief legislation, the American Rescue Plan, in March, with its convenient focus on three clear issues -- money for vaccines, money to re-open schools and checks sent directly to American households. -Bloomberg
"They haven’t laid out why we need this, other than Democrats are in power now and aren’t going to have it again for a long time," said Conant.
Good luck with that.
Parents were fine with sweeping school vaccination mandates five decades ago – but COVID-19 may be a different story
Public health experts know that schools are likely sites for the spread of disease, and laws tying school attendance to vaccination go back to the 1800s.
The ongoing battles over COVID-19 vaccination in the U.S. are likely to get more heated when the Food and Drug Administration authorizes emergency use of a vaccine for children ages 5 to 11, expected later this fall.
California has announced it will require the vaccine for elementary school attendance once it receives full FDA approval after emergency use authorization, and other states may follow suit. COVID-19 vaccination mandates in workplaces and colleges have sparked controversy, and the possibility that a mandate might extend to younger children is even more contentious.
Kids are already required to get a host of other vaccines to attend school. School vaccination mandates have been around since the 19th century, and they became a fixture in all 50 states in the 1970s. Vaccine requirements are among the most effective means of controlling infectious diseases, but they’re currently under attack by small but vocal minorities of parents who consider them unacceptable intrusions on parental rights.
As a public health historian who studies the evolution of vaccination policies, I see stark differences between the current debates over COVID-19 vaccination and the public response to previous mandates.
Compulsory vaccination in the past
The first legal requirements for vaccination date to the early 1800s, when gruesome and deadly diseases routinely terrorized communities. A loose patchwork of local and state laws were enacted to stop epidemics of smallpox, the era’s only vaccine-preventable disease.
Vaccine mandates initially applied to the general population. But in the 1850s, as universal public education became more common, people recognized that schoolhouses were likely sites for the spread of disease. Some states and localities began enacting laws tying school attendance to vaccination. The smallpox vaccine was crude by today’s standards, and concerns about its safety led to numerous lawsuits over mandates.
The U.S. Supreme Court upheld compulsory vaccination in two decisions. The first, in 1905, affirmed that mandates are constitutional. The second, in 1922, specifically upheld school-based requirements. In spite of these rulings, many states lacked a smallpox vaccination law, and some states that did have one failed to enforce it consistently. Few states updated their laws as new vaccines became available.
School vaccination laws underwent a major overhaul beginning in the 1960s, when health officials grew frustrated that outbreaks of measles were continuing to occur in schools even though a safe and effective vaccine had recently been licensed.
Many parents mistakenly believed that measles was an annoying but mild disease from which most kids quickly recovered. In fact, it often caused serious complications, including potentially fatal pneumonia and swelling of the brain.
With encouragement from the Centers for Disease Control and Prevention, all states updated old laws or enacted new ones, which generally covered all seven childhood vaccines that had been developed by that time: diphtheria, pertussis, tetanus, polio, measles, mumps and rubella. In 1968, just half the states had school vaccination requirements; by 1981, all states did.
Expanding requirements, mid-20th century
What is most surprising about this major expansion of vaccination mandates is how little controversy it provoked.
The laws did draw scattered court challenges, usually over the question of exemptions – which children, if any, should be allowed to opt out. These lawsuits were often brought by chiropractors and other adherents of alternative medicine. In most instances, courts turned away these challenges.
There was scant public protest. In contrast to today’s vocal and well-networked anti-vaccination activists, organized resistance to vaccination remained on the fringes in the 1970s, the period when these school vaccine mandates were largely passed. Unlike today, when fraudulent theories of vaccine-related harm – such as the discredited notion that vaccines cause autism – circulate endlessly on social media, public discussion of the alleged or actual risks of vaccines was largely absent.
Through most of the 20th century, parents were less likely to question pediatricians’ recommendations than they are today. In contrast to the empowered “patient/consumer” of today, an attitude of “doctor knows best” prevailed. All these factors contributed to overwhelmingly positive views of vaccination, with more than 90% of parents in a 1978 poll reporting that they would vaccinate their children even if there were no law requiring them to do so.
Widespread public support for vaccination enabled the laws to be passed easily – but it took more than placing a law on the books to control disease. Vaccination rates continued to lag in the 1970s, not because of opposition, but because of complacency.
Thanks to the success of earlier vaccination programs, most parents of young children lacked firsthand experience with the suffering and death that diseases like polio or whooping cough had caused in previous eras. But public health officials recognized that those diseases were far from eradicated and would continue to threaten children unless higher rates of vaccination were reached. Vaccines were already becoming a victim of their success. The better they worked, the more people thought they were no longer needed.
In response to this lack of urgency, the CDC launched a nationwide push in 1977 to help states enforce the laws they had recently enacted. Around the country, health officials partnered with school districts to audit student records and provide on-site vaccination programs. When push came to shove, they would exclude unvaccinated children from school until they completed the necessary shots.
The lesson learned was that making a law successful requires ongoing effort and commitment – and continually reminding parents about the value of vaccines in keeping schools and entire communities healthy.
Add COVID-19 to vaccine list for school?
Five decades after school mandates became universal in the U.S., support for them remains strong overall. But misinformation spread over the internet and social media has weakened the public consensus about the value of vaccination that allowed these laws to be enacted.
COVID-19 vaccination has become politicized in a way that is unprecedented, with sharp partisan divides over whether COVID-19 is really a threat, and whether the guidance of scientific experts can be trusted. The attention focused on COVID-19 vaccines has given new opportunities for anti-vaccination conspiracy theories to reach wide audiences.
[Over 115,000 readers rely on The Conversation’s newsletter to understand the world. Sign up today.]
Fierce opposition to COVID-19 vaccination, powered by anti-government sentiment and misguided notions of freedom, could undermine support for time-tested school requirements that have protected communities for decades. Although vaccinating school-aged children will be critical to controlling COVID-19, lawmakers will need to proceed with caution.
James Colgrove has received funding from the National Library of Medicine, the Greenwall Foundation, the Milbank Memorial Fund, and the William T. Grant Foundation.cdc disease control emergency use authorization covid-19 vaccine fda spread
2 High Yielding Canadian Dividend Stocks to Add Today
Many investors are looking to achieve financial freedom. Ditching that 9-5 job and being financially free is certainly a lifestyle to get excited about. To achieve this, many buy high-yielding Canadian dividend stocks. But, what many don’t realize is…
Many investors are looking to achieve financial freedom. Ditching that 9-5 job and being financially free is certainly a lifestyle to get excited about.
To achieve this, many buy high-yielding Canadian dividend stocks. But, what many don't realize is that the dividend yield of a company is not the first thing you should be looking at. In fact, a high yield can sometimes be a looming disaster. Look no further than the record-breaking amount of dividend cuts we had during the COVID-19 pandemic.
There's no point in purchasing a high yielding Canadian dividend stock if you're going to watch your capital shrink. So, in this article we're going to highlight a few options that not only present a high dividend yield for investors buying stocks to churn out more passive income, but a reliable dividend yield, one that can stand the test of time.
Reliability found in Enbridge (TSX:ENB)
If you're an income investor, you've likely heard of Enbridge (TSE:ENB). The company has paid a notoriously high yield for decades, and has maintained one of the longest dividend growth streaks in the country, raising consistently for more than 2 and a half decades.
Enbridge is a midstream company with a growing renewable energy portfolio. To give an indication of the company's dominance, it states that it is responsible for shipping more than 20% of the natural gas that is consumed in the United States, and 25% of North America's crude oil.
Enbridge (TSX:ENB) and the renewable future
Its renewable energy portfolio is quite small, accounting for only 3% of 2020 adjusted EBITDA, but it is one that is growing fast, and investors should take note. As we move further into the future, renewables will no doubt play a key role in Enbridge's growth.
There's also a chance you've glanced at Enbridge during a pre-screen and avoided the company due to excessively high payout ratios. Which, is fairly reasonable. The company is currently paying out over 110% of trailing earnings towards its dividend. But, you may be missing a massive opportunity here.
When analyzing pipelines, you want to be looking at something called distributable cash flow, or DCF. This cash flow calculation is produced by the company themselves, and calculations can vary to some degree. Given the complex business structure of a pipeline company, this is the most reliable indicator to use when it comes to dividend safety.
In 2021, Enbridge expects to generate $4.70-5 in distributable cash flow. With a dividend of $3.34 per year, this puts the company's payout ratio at 66.8% on the high end. Of note, Enbridge's target is to keep its payout ratio within this range, and the company has done so for quite some time.
Consistent cash flows in "take or pay" contracts
How has it managed to do so? Cash flow with pipelines is extremely consistent, due to long term take or pay contracts. Regardless of whether or not Enbridge is shipping product, the pipeline space is paid for. And not only this, Enbridge can turn around and charge someone else to utilize that space, even if it has already been paid for and goes unused.
This creates an extremely reliable cash flow stream despite the price of natural gas or oil, and is one of the major reasons why Enbridge and other midstream companies are not as susceptible to volatility in commodity prices.
Yielding 6.47%, Enbridge is a solid option to help you bolster your passive income stream and start generating long-standing wealth.
Beefy distribution in A&W Revenue Royalties Income Fund (TSX:AW.UN)
Royalty funds are often avoided due to their complex and confusing structure. However, many of them provide excellent opportunities for investors looking to generate passive income. A&W Revenue Royalties Income Fund (TSE:AW.UN) is one that does just that.
Many bears will point out that A&W in the United States has been struggling. However, in Canada it is a much different story.
A&W thriving in Canadian space
The company has over 1,000 restaurants in Canada and had system sales of over $1.4B in 2020, despite being in a global pandemic. The company has proven to be exceptionally skilled at marketing its products and has some of the best industry leading growth out of all fast food chains in Canada.
As a royalty company, A&W Royalty collects "top line" cash flows. Which means it is solely dependent on the sales driven through A&W restaurants. This means that its distribution can vary depending on how well the restaurants do, but overall it has been extremely reliable when it comes to payments.
Yes, the chain did suspend its $0.10 monthly distribution because of the pandemic in 2020, however it quickly made up for this by providing 2 special distributions of $0.30 and $0.20 when operations started back up later in the year.
Sales growth through the first 6 months of 2021
Prior to the pandemic, the company had achieved mid to high single digit same store sales growth over the last half decade, and it's off to a roaring start in 2021 as well, with 12.2% sales growth through the first 6 months. Through the first 6 months of the year the company has also added 34 new restaurants. To put this into perspective, the company added 37 in all of Fiscal 2020.
The fund yields 4.77%, and pays out on a monthly basis. Payout ratios will look high, but if you understand the operations of a royalty company, you'll know that it aims to pay out the vast majority of its distributable cash back to shareholders.
Overall, it seems consumers are willing to eat at A&W despite higher costs, which bodes well for the company's growth. It does this with great marketing and higher quality food than similar chains like Burger King and Mcdonalds, and investors are likely to enjoy a beefy (no pun intended) distribution for quite some time.
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