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Covid-19 Sentry

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Contents

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From Preprints

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From Clinical Trials

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From PubMed

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From Patent Search

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Daily-Dose

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Contents

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From New Yorker

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From Vox

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+From time-crunched employees to unfinished content and accidentally exposed genitals, Cyberpunk 2077 has faced a litany of issues. +

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+It’s rare that anything lives up to its hype. And yet the often astronomically high expectations that consumers set still persist, and sometimes even appear warranted. That seemed to be the case with Cyberpunk 2077, a video game released on PlayStation 4, Xbox One, and Windows PC on December 10 after many years of buildup. +

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+Inspired by a cult-favorite tabletop role-playing game, Cyberpunk 2077 seemed tailor-made for success. It’s the first new console game from Polish studio CD Projekt Red since The Witcher 3: Wild Hunt, a massively successful game that won numerous awards and end-of-year accolades after its 2015 launch. Cyberpunk 2077 stars Keanu Reeves in a major role that bears his likeness as an on-the-run rocker-turned-military-veteran-turned-cybernetic terrorist. The game’s heaps of trailers and previews and marketing materials seemed to promise a slinky, sexy, neon-tinged world of futuristic action — catnip for many gamers craving escapism. +

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+But these surefire bets were not so surefire after all. Cyberpunk 2077 has, since its release, been roundly criticized across the gaming community by consumers, game designers, and industry insiders alike. An already toxic fanbase has bounced from harassing reviewers who offered tepid praise to roasting the company for the game’s many problems. Initially positive reviews have added caveats as more time with the game reveals more loose threads. To many observers in and outside of the gaming world, Cyberpunk 2077 has proven to be a stunning failure: a video game with such promise and ballyhoo that it did not, and perhaps could never, live up to. +

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+The story of Cyberpunk 2077’s botched release and ongoing controversy is one that illuminates several problems within the world of video games. Developer CD Projekt Red — Europe’s most successful video game company — first announced that it was working on the project in 2012. It was a tantalizing announcement: The game would draw on a popular tabletop RPG released in the late 1980s, Cyberpunk, and a teaser released in 2013 showed that the developer had translated that world into an appealingly gritty cybernetic environment. It would be an expansive world, developers teased, aesthetically akin to the dystopian environs of Mad Max: Fury Road and Akira. +

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+Cyberpunk 2077 is the story of a California city set in an alternate timeline, where a handful of megalomaniac corporations own the streets, everyone modifies their body with illegal tech, and much of the state is still reeling from a major nuclear attack years prior. You, the player, get to be a particularly badass cyber-enhanced human, fighting against psychological and physical threats to your survival. (This is where Keanu Reeves, as your begrudging sidekick, comes in; his involvement was revealed in 2019 to resounding cheers.) +

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+Although no release date was in sight at the time of its 2013 teaser, excitement only grew after The Witcher 3: Wild Hunt launched in 2015 to overwhelming praise. Its popularity helped increase hype for Cyberpunk 2077, already a game that many fans of the original property were champing at the bit for. And with work on The Witcher 3 winding down, the developer was committed to seeing Cyberpunk 2077 through. +

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+Thus began a lengthy period of pre-release hype. CD Projekt Red taunted fans with a glimpse of the game in 2018, five years after that initial teaser appeared. +

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+At the game’s 2018 showing, held at the industry trade show Electronic Entertainment Expo (E3), journalists pumped it up based on early, closed-door impressions. The developer gained positive attention for insisting that its game would not include some of the most common, most maligned features of other big adventure games at the time. CD Projekt Red would not lock any game content behind a paywall, it said. Anything added to the game after launch would be available for free. And the game would only come out when it was “ready.” +

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+“We do realize you’ve been impatiently waiting for a very long time, and we wouldn’t like anyone to feel that we’re taking this for granted,” the developer wrote after the game’s E3 2018 presentation. “On the contrary — it gives us a lot of extra motivation. The hype is real, so the sweat and tears need to be real, too :)” That now feels like ominous foreshadowing. +

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+The game, announced as an April 2020 release, was delayed several times due to the Covid-19 pandemic and, crucially, quality problems. Each rescheduled release date engendered more concern and pushback, in part because it called for more patience than many Cyberpunk fans were willing to dredge up. +

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+And the company’s claims eventually proved untrue: Despite stating in 2019 that it would not require developers to work overtime to finish the game, CD Projekt Red entered a months-long crunch period, a labor issue that has gained more attention in gaming circles in recent years. Bloomberg reported in September that the studio had instituted six-day workweeks for the final development stretch; at that time, the game was set for a November release. A month later, in late October, Cyberpunk 2077 was delayed again until December. +

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+Gaming fans have raised concerns about crunch as more and more developers speak out about it. Unionization efforts are mounting in the gaming industry. Advocating for fair labor practices is becoming important to games makers and the people who play them, and if developers have to crunch on a game, the prevailing attitude among those anticipating it is hope that the end product is at least as “worth it” as possible. +

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+That was not the case for Cyberpunk 2077, it would seem. “Despite the months of crunch that went into developing the game, even though the company promised not to go that route, the game launched with several technical issues,” Jeff Ramos, who writes for Polygon, told me. “So many in fact, the company offered refunds to players disappointed with the end product. We have even gone as far as updating our review of the game discouraging readers from playing the game on consoles until the game gets improved.” +

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+When the game’s first reviews came out just before its December 10 release, they were mostly positive. It turned out, however, that this was because reviewers were only given early access to the Windows PC version, the one best optimized and representative of the expansive, graphically intensive game’s potential. Once the game was released on consoles as well (PlayStation 4 and Xbox One), players discovered a litany of technical issues. Characters’ faces were obscured, some environments were unsightly. The game would make consoles crash repeatedly, sacrificing players’ progress. One glitch even exposed characters’ detailed penises and breasts, which would poke out of their clothes. The memes and mockery were relentless and swift. +

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+Another issue arose out of lack of oversight: A feature of the game recreates the tests that doctors use to discern whether a patient has epilepsy but offers no epileptic seizure warnings in advance of their appearance. One games critic reported that she suffered grand mal seizures as a result; the developer has now added warnings. +

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+When CD Projekt Red announced that it would offer full refunds for unhappy console buyers a week after release, people quickly discovered that this was a make-good in name only. Retailers redirected those seeking their money back to speak to the company, which only reiterated that it was up to retailers to make the refunds. On December 17, Sony announced that it would grant refunds to all owners of Cyberpunk 2077 on PlayStation 4 — as well as completely remove the game from sale on the digital PlayStation marketplace until it’s in a more functional state. That’s an unprecedented move from a console manufacturer, and a sign of how dire the situation is around Cyberpunk 2077’s release. +

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+CD Projekt Red courted controversy even before Cyberpunk 2077’s rocky release period. The studio has made news in the past for posting transphobic material on social media, misappropriating queer-themed hashtags, and making jokes about gender identities. In 2019, when footage from the game showed a hypersexualized trans character on a billboard, the studio failed to offer a nuanced explanation as to its placement, raising eyebrows. (In the finished game, this ad appears on vending machines basically everywhere.) +

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+Cyberpunk 2077’s extensive character creator is meant to allow players to become whoever they want with no regard to gender. But the company’s history has cast a shadow over those options and the game itself, especially when there are options to intricately customize a penis but no such attention paid to vaginas; transgender characters in the game are used for provocation and little more; and there are few characters of color, most of whom are presented stereotypically. +

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+All of this has led to consumer rage of the highest order. It’s the kind of outrage that saw a (young, female) reviewer from one prominent gaming website face severe harassment for offering criticism of the game, which diehard fans maintained must be perfect after all of this time and struggle and crunch. Yet upon its release, they backtracked, redirecting their viciousness toward the studio itself. +

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+The question remains: Would Cyberpunk 2077 have been subject to such intense debate had it not come saddled with the indulgent hype that it had enjoyed? Much of this is owed to its marketing, said Ramos, which portrayed the game as something different from what it actually is. +

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+“Fans still got a steady feed of promotional videos detailing the game’s vast open world, the various inhabitants of Night City, and the promise of exciting combat we’d get to experience once the game was in hand,” Ramos said. “While I had assumed the game would cater more to the action-orientated themes that came across in the marketing, what I found after 40 hours of gameplay is that it plays more like its role-playing, tabletop roots.” +

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+To some who, like Ramos, are able to play the game in a more functional capacity, this isn’t a bad thing. He’s enjoying the game for exactly the reason why many others aren’t: It’s not all posturing, stylized edge and murder under seedy neon lights. The game does spend time expanding upon its lore, fleshing out its characters and setting, and for some folks, the fashion and cultural references are a big success. Even if the story can be campy and the dialogue wooden, there is the potential for fun to be had. +

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+“As a game about its characters, flawed as some of them are, that’s where Cyberpunk shines,” Ramos said. “Unclear marketing and bad bugs don’t affect those much.” +

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+Cyberpunk 2077 will receive updates that the studio hopes will improve its performance so that console players will find it more workable. There will also be more playable content in the future, as the studio initially teased years ago, and there are versions in the works for the most recently released consoles, the PlayStation 5 and Xbox Series X, which should be tempting for owners of those currently hard-to-find systems. +

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+Video games with such intense fanbases cultivated before their actual release often face an uphill battle. Many games in the past have undergone the same cycle of intense excitement and even stronger disappointment; with latent toxicity still alive in many corners of the gaming world, those situations have often featured severe online bullying at the expense of hardworking developers or dissenting reviewers. +

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+Games that have survived that initial period of persistent hate are those that are refined over time, eventually finding new, loving, dedicated fanbases. Perhaps the same will be true for this video game — or perhaps all this baggage will weigh it down, leaving little but a cautionary tale in its wake. Maybe even Keanu Reeves won’t be enough to save this one. +

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+The side effects of the Pfizer/BioNTech and Moderna vaccines, explained. +

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+After months of waiting, we finally have detailed information on the safety and efficacy of the first Covid-19 vaccines that will be distributed in America. +

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+On Thursday, a committee that advises the Food and Drug Administration voted to recommend the Moderna vaccine for an emergency use authorization for people ages 18 and over. Ahead of the decision, the agency shared the most comprehensive data to date on what we know about the shot. The same process happened last week with the Pfizer/BioNTech vaccine, which is now being rolled out across America following an EUA Friday night. +

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+While both vaccines had already been shown to be highly effective, the new data provides a much more granular picture of their side effects and safety profiles. +

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+
    <img alt=" " src="https://cdn.vox-cdn.com/thumbor/3PkOm2g20JsnEsp5u4iyRsE869o=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22179970/GettyImages_1229551927.jpg" />
+  <cite>Kena Betancur/AFP via Getty Images</cite>
+  <figcaption>People walk by the Pfizer headquarters in New York City on November 9.</figcaption>
+
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+What’s now clear: An injection with either vaccine, both of which use mRNA technology, can feel more intense than other routine vaccinations (such as the flu shot) — with side effects for some recipients such as pain, headache, and fatigue. And this may be especially true for Moderna’s vaccine: About 16 percent of people who got the shot in clinical trials experienced a “severe” systemic adverse reaction, a classification the FDA uses to refer to side effects, like fever or fatigue, that require medical attention and prevent people from going about their daily activities. +

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+“We should anticipate that if you got vaccinated that day, you may not want to go to work,” Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College, said of the vaccines. That’s why health systems are being warned to stagger immunizing their workforces, to avoid “potential clustering of worker absenteeism,” as the vaccine expert group advising the Centers for Disease Control and Prevention (CDC) put it. +

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+These side effects are known as reactogenicity, and vaccine developers and regulators allow for some level of reactogenicity in all approved vaccines. They can be a sign of the body’s immune response kicking into gear, said Saad Omer, director of the Yale Institute for Global Health. +

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+I think it will be very important to communicate to the population that these vaccines have more reactogenicity (injection site pain, transient fatigue, headache, elev temp) than most other licensed vaccines. Not dangerous but unpleasant. People need to know what to expect. https://t.co/51R1J8vRKQ +

+— Florian Krammer (@florian_krammer) December 2, 2020 +
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+“Think about [reactogenicity] as mouthwash — it’s hurting while it’s working,” Omer said. “The key is to prepare people to know this will happen — this may hurt a little, give you a bit of fever — but these are short-term, known side effects that you need to be aware of.” +

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+The stakes for clearly communicating information about each vaccine’s risks and benefits are high: More than a quarter of Americans reported that they would probably or definitely refuse to take a Covid-19 vaccine, according to a late-summer survey by the Kaiser Family Foundation, even if it were freely available and deemed safe by regulators. And with the virus spreading farther and faster in America than just about anywhere else in the world, it’s critical that people don’t feel caught off guard by the side effects or spread misinformation about the vaccine. +

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+To achieve that, transparency is key, said Brendan Nyhan, a Dartmouth professor of political science who has been thinking about how to build confidence in the Covid-19 vaccines. “Millions of people are going to get this vaccine, and we know huge numbers of people are going to have normal side effects, which are often indicating that the vaccine is working. We want to build trust with people so there are no surprises when that happens.” +

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+In that spirit, here’s what we know about the side effects of these two shots and how to think about them. +

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+What mild and moderate side effects really mean +

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+Before we get into the weeds, it’s helpful to understand how these companies classify side effects in the first place. In general, vaccine developers seeking approval in the US market use the FDA’s “toxicity assessment scale” to grade side effects and other adverse events from 1 to 4, from mild and moderate to severe and life-threatening. +

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+Grade 1 “mild” side effects are generally easily tolerated and don’t interfere with a person’s regular activities. Grade 2 “moderate” effects may interfere with regular activities, grade 3 “severe” effects are incapacitating and need medical attention, and grade 4 are “potentially life-threatening,” usually requiring an emergency room visit or hospitalization. Let’s use the example of headache following vaccination. Here’s how the FDA would classify it: +

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                                                                                                                                                                                                                                                                      So a mild side effect is one you’d notice but doesn’t require any special care or keep you from living your life; a moderate side effect can keep you home from work but doesn’t warrant medical intervention; severe adverse events require medical care and definitely interfere with your normal life; and potentially life-threatening is just what it sounds like and usually involves a visit to or stay in the hospital. </p>
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+In vaccine studies, these events are broken down into “local” reactions (meaning they’re specific to one part of the body, like pain or tenderness where the vaccine is injected) and “systemic,” whole-body reactions (like fever or fatigue). +

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+For a vaccine to win FDA approval, any reactions people have during clinical trials have to be mostly mild and moderate. And that’s because the safety bar for vaccines is really high, even compared to medicines. +

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    <img alt=" " src="https://cdn.vox-cdn.com/thumbor/Cv8zDsRt26bLAWC-6V4heWJJ0CU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22179978/GettyImages_1228042510.jpg" />
+  <cite>Chandan Khanna/AFP via Getty Images</cite>
+  <figcaption>Moderna Covid-19 vaccine files kept at a research center in Hollywood, Florida.</figcaption>
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+Vaccines “are given to healthy people who have in many cases absolutely nothing wrong with them. And we are talking about [giving them] to literally billions of people. Even rare side effects if they’re serious matter enormously,” said Charles Weijer, a professor of medicine and an ethicist at Western University in Canada. “We’re more willing to accept adverse effects [with drugs], provided those are counterbalanced by benefits to the patient.” +

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+Mostly mild and moderate side effects are the safety profiles of both the Moderna and Pfizer/BioNTech vaccines — and that’s why the FDA in the US and drug regulators in other countries around the world are rushing to bring them to market. But there are important differences between the two vaccines. +

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+What we know about Moderna and Pfizer/BioNTech side effects +

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+Now let’s look at the best data we’ve got on the vaccines. It comes from the FDA’s analyses of phase 2 and 3 clinical trials ahead of their emergency use authorization meetings on December 10 for Pfizer/BioNTech and December 17 for Moderna. (The companies also released their own data for the meeting, but we focused on the agency’s independent reviews here.) +

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+The reviews show the vaccines are both safe and that they’re extremely good at preventing Covid-19 infections (with around a 95 percent efficacy rate). That’s hugely important at a time when more than 3,000 Americans are dying from Covid-19 each day on average. +

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+They also give a sense of what side effects we might expect when these vaccines are rolled out. The Pfizer/BioNTech vaccine caused mild or moderate reactions in most people, and severe reactions were rare. Moderna didn’t share the details of its vaccine trial’s mild and moderate side effects, but the FDA said mild and moderate is how they’d characterize the bulk of them. A key difference with the Moderna vaccine, however, is that we know severe reactions were more common in the trials. +

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+Let’s get into what this means, but with a couple of caveats first. Because we have no head-to-head study of the two vaccines and the companies haven’t reported side effect data in the same way, doing apples-to-apples comparisons is tricky, said Hilda Bastian, an expert in reading medical evidence who has been analyzing the coronavirus vaccine data. The vaccines also come in different doses: 30µg in the case of Pfizer/BioNTech and 100µg with Moderna. While they’re supposed to be delivered in two shots per person, the time intervals are different: The Pfizer/BioNTech shots are three weeks apart, and Moderna’s are four weeks. +

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+Pfizer/BioNTech and Moderna also tested their products on different populations. “Some of the differences affect risks and so could be affecting outcomes,” said Bastian. For example, there were more people of Hispanic/Latino background and with chronic lung disease in the Pfizer/BioNTech trial than the Moderna trial, she added. And in the real world, when the vaccines roll out to millions, the side effects may again look different. +

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+With all that in mind, here’s what we know about each shot. For Pfizer/BioNTech the most common side effects overall, according to the FDA’s analysis of the data, were local reactions at the site of injection (including pain, redness, swelling), fatigue, headache, muscle pain, chills, joint pain, and fever. Again, these were mostly classified as mild or moderate. Severe reactions, meanwhile, were rare — occurring in 0 to 4.6 percent of participants, depending on the specific side effect. +

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+In general, side effects popped up more after the second dose than the first. They also happened less frequently in people 55 and younger, the FDA said. You can see the breakdown of adverse events data in younger adults (18-55) in the chart below following dose 1 and, if you click through, following dose 2. (Note: Pfizer/BioNTech found no potentially life-threatening (grade 4) adverse reactions linked to the vaccine in the population they analyzed for safety.) +

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+Now let’s look at the FDA’s Moderna data. Again, the company didn’t share the details of their mild and moderate adverse events — and revealed fewer details than Pfizer/BioNTech generally. But we know the most common reactions were injection site pain, fatigue, headache, muscle pain, joint pain, and chills. +

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+Though the FDA said these were mostly mild and moderate, we only have the specific figures for total events and the more severe reactions. For example, 83 percent of study participants experienced a systemic adverse reaction of any level of severity while 15.7 percent experienced a severe “systemic” adverse reaction and 7 percent, a severe “local” reaction. Depending on the type, these severe events ranged in frequency from 0.2 to 9.7 percent. +

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+Like the Pfizer/BioNTech shot, side effects were more frequent after the second dose and less common overall in adults 65 and older. Side effects that required hospitalization or emergency room visit were extremely rare. According to FDA analysis, “Across groups and doses, <0.1% reported a Grade 4 systemic reaction.” You can see that below, in a chart focusing on safety data in the younger adults in the study. +

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+So what can we take away from all this? +

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+“We know neither of these vaccines carries a high risk of serious adverse events. And we can expect them to cause typical reactions to vaccines,” said Bastian. But there are important differences. At least in these trials, all side effects and especially severe side effects were more common with the Moderna vaccine. +

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+“The overall picture is that almost everyone has systemic adverse events with Moderna’s vaccine, and we don’t know how often they were only mild,” Bastian said. “For Pfizer/BioNTech, most people had at least mild reactions, but moderate reactions were common too.” So, at least for now, it seems reactions to the Pfizer/BioNTech vaccine “are considerably less severe.” +

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+The vaccines “are on the fairly reactive side compared to most vaccines we commonly use,” said Jesse Goodman, a professor of medicine and infectious diseases at Georgetown University and a former FDA chief scientist. “It’s hard to compare between the two, but you do get the feeling these systemic reactions like muscle and joint aches are maybe more common in the Moderna vaccine than Pfizer.” Goodman also noted that rates of adverse reactions in Moderna’s placebo groups were higher, and side effects were generally less severe in people who had already been infected with Covid-19. +

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+For the general population, though, there isn’t anything to fear with either vaccine. Again, side effects, if they do pop up, will be mostly moderate or mild. And this doesn’t come as a surprise to vaccine researchers. “The side effects [we’re seeing] are symptoms associated with products of the immune system — cytokines — that are recruited when fighting an infection or responding to a vaccine,” said Paul Offit, director of the Vaccine Education Center and professor of pediatrics at Children’s Hospital of Philadelphia. “That’s why people over 65 have a lesser rate of these side effects than younger people — just evidence of a more senescent immune system.” +

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+There’s still a lot to learn about these vaccines +

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+Even with all the available data, there are still unknowns about the two vaccines. We may not see additional rare side effects or severe reactions that will emerge until millions of people get them, for example. +

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+Bell’s palsy, a form of temporary facial paralysis, showed up in three people who got the Moderna vaccine and four people who got the Pfizer/BioNTech shot in the companies’ late-stage trials. It’s not yet clear whether these cases are actually linked with the vaccines — since Bell’s palsy can occur in the general population irrespective of vaccination — but because “we see a similar imbalance in two different studies, it pricks my ears up a bit,” Goodman said, and it’s something we’ll learn more about as the vaccines are rolled out. +

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+There are also groups the vaccines weren’t tested in, like pregnant women and people with HIV. In the cases of anaphylaxis in the UK following vaccination with the Pfizer/BioNTech shot, two people with a history of severe allergies — the kind that force them to carry around EpiPen-type devices — had a potentially life-threatening allergic reaction, were treated, and recovered. Allergic reactions were very rare in the Pfizer/BioNTech trial (affecting only 0.63 of people who got the vaccine, according to the FDA’s analysis). And people with severe allergies were also excluded from the study. +

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+Clinical trials are not the real world of people; they all have inclusion/exclusion criteria.
Like no history of anaphylaxis (protocol ).
The same day @Pfizer vaccine rolled out, 2 cases of severe allergic reactions in healthcare workers.
There will be more safety issues ahead. pic.twitter.com/9SRrWyPPDu +

+— Eric Topol (@EricTopol) December 9, 2020 +
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+The CDC is now advising that people with a history of severe allergic reactions to vaccines can still get the Pfizer/BioNTech shot but should be counseled about the risks and be monitored for 30 minutes afterward, while those with an allergy to a specific vaccine ingredient shouldn’t get the shot. +

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+Long-term Covid-19 vaccine side effects are “not really a thing” +

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+But, again, there’s some reassurance to be taken here: Severe allergic reactions to vaccines are extremely rare generally. Most serious vaccine reactions — such as the rare neurological disorder Guillain-Barré syndrome — tend to happen within six weeks of getting immunized, said Colleen Kelley, associate professor of medicine at Emory University, who is also a principal investigator in the Moderna trial. And we already have more than six weeks of data on safety and side effects in the two shots. +

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+“People worry about late or long-term side effects occurring a year or two later — that’s not really a thing with vaccination,” Kelley said. +

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+Instead of taking a large dose of medication for many years, where a side effect may surface only after lots of exposure, with vaccines, Bastian said, you’re getting a small dose to stimulate an immune reaction once or a few times. So it makes sense that the longer-term risks aren’t a major problem. +

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+Again, though, this doesn’t mean all coronavirus vaccines are entirely safe or that there’s not more to learn about these two. And as other Covid-19 vaccines hit the market, clarity and transparency about what we know will be paramount if we want people to trust and take the vaccines, Bastian said. “The evidence says treat people like adults. Tell people the truth. Anything else is manipulation and that’s a form of lying.” +

+ +

+Biden is expected to nominate Michael Regan to lead the agency, which must be rebuilt and strengthened in the new administration. +

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+President-elect Joe Biden will nominate Michael Regan, secretary of the North Carolina Department of Environmental Quality, to head the Environmental Protection Agency, according to multiple news reports. Regan has two decades of experience in environmental policy and positions at the Environmental Defense Fund as well as the EPA, and would be the first Black man to run the agency in its 50-year history if confirmed. +

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+Regan and the Biden administration will need to not only restore our nation’s premier environmental regulator but also to remake it, adapting it to tackle mounting environmental problems against which it has long faltered, from climate change to rampant environmental injustice to toxic pollutants old and new. +

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+It might seem like an impossible task, given that climate-linked disasters keep multiplying, many curbs on greenhouse gas emissions have vanished, and environmental enforcement has plummeted. But our new leaders and all Americans can take inspiration from how we have done it before. +

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+Fifty years ago, our rivers were on fire, smog choked our urban centers, and state and local governments struggled to respond. In the single month of December 1970, President Nixon opened the EPA, its new head William Ruckelshaus came out swinging against water polluters and industry-dominated state pollution boards, and Congress finalized the Clean Air Act, which Nixon then signed into law. +

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+Since then, the EPA has brought substantial improvements in our air, water, and dealings with hazardous waste, benefitting not just our health but also our economy. Over the last four years, however, EPA political appointees tied to industries regulated by the agency have set about stripping this vital agency of its power to act. Tragically, they’ve done so even as environmental pollution still contributes substantially to premature mortality, cancer, and heart disease, as its effects still weigh most heavily on our society’s most vulnerable and exploited, and as climate disasters impose ever more unmistakable impacts on Americans’ health and well-being. +

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+What can be done to reverse the EPA’s systematic weakening under Trump, while retooling it to meet today’s challenges? The wisdom of staffers as gathered from the Environmental Data and Governance Initiative’s EPA oral history project and interwoven with our own analysis suggests there’s much that a Biden administration and the EPA itself can do. +

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+Here are 10 things the new leadership should do to fix the EPA. +

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  1. Take quick climate action +

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+As the world’s largest historical emitter of greenhouse gases and still the second-largest annual contributor, the US has for too long shirked its global duty in helping alleviate the climate crisis. +

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+The first step to rectifying this will be rejoining the Paris climate agreement and then translating our Paris commitments into policies that speed emissions reductions, a job that the Clean Air Act and the courts have placed largely in EPA’s hands. To make up for four years of EPA inaction under Trump, the Biden EPA must reverse the Trump administration’s rollback of Obama-era policies for curbing greenhouse gases and strengthen them in durable ways including possible legislation, and improve emissions reporting so that everyone can easily follow policies’ impacts. +

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  1. Restore the budget and staff +

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+The EPA’s staff has declined 22 percent since 1999, and its inflation-adjusted budget is now less than in 1979. Its budget has shrunk despite added responsibilities, limiting its ability to carry out long-standing work such as enforcing the Clean Air and Water Acts and ensuring clean drinking water nationwide, while impeding its response to newer challenges, from tracking and lowering greenhouse gas emissions to preparing for and responding to the heatwaves, wildfires, superstorms, and other threats posed by climate change. +

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+To start fixing that, President-elect Biden should propose — and Congress should approve — a 10 percent or more increase to the agency’s funding. This would allow the EPA to hire adequate staff to meet its current responsibilities and decisively tackle climate change. +

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+EPA”u2019s Andrew Wheeler Outlines Priorities Under Trump Leonard Ortiz/MediaNews Group/Orange County Register via Getty Images +
+EPA Administrator Andrew Wheeler at the Richard Nixon Library and Museum in Yorba Linda on September 3, 2020. +
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  1. Keep industry out +

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+In the Trump EPA, political appointees — as well as scientific advisers — have had extensive ties to industries regulated by the agency (such as the fossil fuel and chemical industries). But the agency’s decisions must be based on science and the public’s health, rather than an industry’s bottom line. The federal government needs to create better ways to prevent these sorts of conflicts of interest that undermine sound science and public confidence. +

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  1. Make environmental justice a priority +

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+The EPA has long struggled with how much more people of color are exposed to pollution. To better rectify this, the Biden administration should prioritize environmental justice not just through agency-wide administrative actions (which can be backpedaled later), but by advocating for greater legislative authority in this arena. +

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+Among the promising recent legislative proposals, a proposed Public Health Air Quality Act mandating more fenceline monitoring would greatly aid the agency’s ability to recognize and respond to these communities’ dilemmas. An environmental justice bill passed in New Jersey as well as a similar federal bill introduced by Sen. Cory Booker (D-NJ) would also give the agency stronger legal tools to limit pollution in overburdened communities. +

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  1. Tackle toxic chemicals +

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+The EPA has had limited success ensuring the safety of chemicals used in everyday products, guarding against lead contamination of drinking water, and banning chemicals like asbestos that cause deadly diseases. +

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+To tackle these toxics, the agency should improve implementation of the 2016 Frank R. Lautenberg Chemical Safety for the 21st Century Act. It should also strengthen air quality and other standards to prioritize protection of pregnant women, infants, and children from hazardous chemicals. And it should do more to protect children from lead — one way to do this is to dedicate funding to rapidly replace the millions of lead service lines that still carry drinking water in many parts of the country. +

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  1. Reinvigorate science +

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+The EPA’s ability to protect human health and enforce environmental laws hinges on science and scientists. But during the Trump administration, scientists were sidelined from top-level decision-making, and hundreds left the agency, weakening its expertise. To make the EPA a place where top scientists want to work means improving the hiring system, providing them with sufficient resources for their work, and also heeding their knowledge and recommendations. The EPA must reinvigorate its scientific workforce, advisory system, and research to ensure that environmental decision-making is grounded in science. +

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  1. Enforce the law +

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+The EPA’s power and willingness to enforce environmental laws has undergone long-term erosion but dropped off precipitously under Trump — even as noncompliance remains frequent. To increase pressure on polluters on behalf of the public, the EPA needs to step up enforcement, especially when and where the states do not. To do so, its enforcement capacity needs rebuilding (environmental and compliance staff fell 23 percent under Trump), and from the outset, the new Administrator and his team need to announce and pursue a serious commitment to taking on violators. +

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  1. Upgrade data +

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+Much of the federal government’s existing environmental data infrastructure remains fragmented, partial, and outmoded. The EPA should update technology for measuring and monitoring pollution and better integrate its data systems across programs. This promises to improve the agency’s work by, for one, enabling more prompt targeting of violators. It should also strive to help people and advocacy groups better understand what is going on. +

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+Even EPA’s best current digital interfaces pose challenges for ordinary citizens seeking to learn about nearby facilities, from unfamiliar acronyms to unexplained numbers. EPA data on polluters as well as its own actions or inaction needs to be made more transparent, accessible, and interpretable to the public, so as to better inform communities about the environmental risks surrounding them. Making it easier to analyze environmental justice impacts at the community level should be an agency priority. +

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  1. Be a better steward of information +

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+The EPA should be a national force for educating the public about the science that grounds our environmental laws. Under Trump, this agency slid in the opposite direction, removing not just references to climate change but much other scientific information from its websites, abandoning many environmental education efforts, and even turning its press office into a megaphone for conservative op-eds by its political appointees. The incoming leadership should ensure not just that the agency provide factual, technically accurate, and user-friendly information, but that it actively promotes environmental science literacy. +

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  1. Partner with the American public +

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+To accomplish many of these goals, the agency needs support from advocacy groups, educators, and other environmentally concerned citizens. These partnerships will provide new avenues for communicating accurate information about environmental problems, including more “citizen science” to enhance the agency’s work. They will also fortify efforts to push for local, state, and federal actions to improve environmental health and address climate change, and to further strengthen EPA’s abilities. +

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+For 50 years, the EPA has played a critical role in making our air cleaner, providing safe drinking water, and ensuring that rivers no longer spontaneously catch fire. Let’s rebuild and strengthen the agency so that it is equipped to prevent the fires, both literal and figurative, of our present and future. +

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+Marianne Sullivan is a professor of public health at the William Paterson University of New Jersey and a member of the Environmental Data and Governance Initiative (EDGI). +

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+Christopher Sellers is a professor of history at Stony Brook University, a research fellow at the Institute for Historical Studies at the University of Texas-Austin, and on the coordinating committee of EDGI. He is the author of Crabgrass Crucible: Suburban Nature and the Rise of Environmentalism in 20th-Century America, and forthcoming books on the history of environmental politics in Atlanta, Texas, and Mexico. +

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