Daily-Dose

Contents

From New Yorker

From Vox

  1. August 14, 2021

The Covid-19 booster shot approved by U.S. health agencies is not a new vaccine. It is simply a third dose of the vaccine that is given to a person who has already been fully vaccinated. As NPR reported, the CDC recommends that a person get the same vaccine they received for their first two doses. So, for example, if you received the Pfizer vaccine for your first two shots, then you should also get the Pfizer vaccine for your booster shot. If it is not possible to get the same vaccine for your booster shot, an additional dose of the other mRNA vaccine (Pfizer-BioNTech or Moderna) is allowed.

Covid-19 booster shots work in conjunction with how our bodies build protection against threats. Biologically, our bodies contain helper T-cells that stimulate other cells called B-cells, which are crucial in producing antibodies. Certain types of B-cells act as memory cells that store the instructions needed for our bodies to produce a particular antibody. However, these memory cells aren’t activated; they’re waiting for a signal that triggers them to produce antibodies. As Sigal Samuel previously explained for Vox:

When you get a booster shot, it gives your memory B-cells that crucial signal to reengage. This can be useful whether the booster contains the original vaccine recipe or something different. If it contains the original recipe, it’ll amplify the signal, increasing the number of antibodies produced. If it contains a tweaked recipe, it’ll retrain the cells to recognize new features of the virus and produce antibodies, should you be exposed to the variant.

Studies have shown the initial two-dose regimen for the Covid-19 vaccination has lower efficacy in those with weakened immune systems, so another “boost” of the vaccine will likely help immunocompromised people build better protection against the coronavirus.

Currently, the Covid-19 booster shot is only recommended for “moderately to severely immunocompromised people.” While there are many kinds of people who may consider themselves at higher risk of serious illness from Covid-19, such as those having a pre-existing health condition, it is important to note that they are not necessarily the same as those who are immunocompromised.

According to the CDC, this category of people includes organ transplant recipients who are taking medicine to suppress the immune system, those undergoing cancer treatment, and people who are HIV positive, among other criteria. The New York Times reported that about 3 percent of Americans are estimated to have weakened immune systems and studies show initial vaccine doses have been less effective for immunocompromised people. The vaccine efficacy rate for people with weakened immune systems is somewhere between 59% to 72%, which is much lower compared to those with a stronger immune system showing 90% to 94% efficacy. Further studies revealed people who are immunocompromised benefitted immensely from receiving a third dose of the Covid-19 vaccine, which is why it’s so important for them to receive a booster shot.

Despite the good news, the FDA also said they were unable to extend the authorization for a booster shot of the Johnson & Johnson vaccine due to insufficient data. It is unclear whether immunocompromised people who received the Johnson & Johnson vaccine will be eligible in the near future.

Does this mean we are closer to booster shots for everyone?

A close-up of the hand of a masked health worker as she inserts a needle into a vial of the Pfizer-BioNtech COVID-19 vaccine to prepare a dose for use. Ahmad Gharabli/AFP via Getty Images

An Israeli health worker prepares a dose of the Pfizer-BioNtech COVID-19 vaccine on August 13, 2021, at the Maccabi Health Service in the Israeli town of Rishon Lezion.

In her statement last week, Dr. Woodcock reiterated that people who are not immunocompromised and are fully vaccinated are considered “adequately protected” and, as such, will not need a booster shot at this time. However, she emphasized that her team was continuing to work with agency partners to determine whether an additional dose for the general public is needed in the future.

But FDA and CDC approval on booster shots for immunocompromised people has reasonably spurred questions over whether we will soon get the go-ahead for booster shots to the general public, especially as Covid-19 infections and hospitalizations surge nationwide due to the much more contagious delta variant.

Most concerning are reports that the delta variant may be more successful against the Covid-19 vaccines, causing “breakthrough infections” or infections in people who are fully vaccinated. For these people, getting infected after being vaccinated can be overwhelmingly emotional.

“I was pretty shocked to learn I’d tested positive,” Daniele Selby, a writer based in New York City, told Vox. “I am fully vaccinated and have continued to wear masks … so to do all that and still get Covid-19 and feel ill has been pretty upsetting.” Others who have suffered breakthrough infections have had their circumstance politicized, like André Gonzales, who traveled between states for a funeral in early June after being fully vaccinated, and tested positive. “There have definitely been some that have tried to use [my] experience to discount the efficacy of the vaccines or to push unfounded cures on social media,” Gonzales said.

There is still much to be learned about Covid-19 breakthrough infections but preliminary studies suggest there may be varying levels of risk to re-infection based on different vaccines. A recent study by Mayo Clinic suggests people who received the Moderna vaccine may be at a much lower risk of contracting a breakthrough Covid-19 infection than those who received the Pfizer-BioNTech vaccine. The study, however, has yet to go through a full review. It’s important to remember that breakthrough cases among people who are fully vaccinated are still uncommon, and even when they are infected data shows that these infections are at low risk of resulting in severe illness and/or hospitalization, underlining the benefits of getting vaccinated in spite of risks of re-infection.

With upticks in Covid-19 cases across the globe due to the more aggressive delta variant, experts say we may have to learn to live with the virus. The closest comparison is the flu disease, which continues to cause tens of thousands of deaths each year in the U.S. alone. But, over time, our society has largely managed to adapt to a world with the flu, thanks to the existence of an effective flu vaccine.

As German Lopez wrote for Vox:

While we still have to get more people vaccinated, at a certain point we’ll have to acknowledge we’ve done what we can. It might not be ideal, but we can learn to live with a vaccine-weakened version of Covid-19 — hopefully not too unlike how we’ve long dealt with the flu.

Booster shot policies have exposed the world’s ongoing vaccine inequities

WHO Director-General Tedros Adhanom Ghebreyesus in a suit and tie speaking behind a podium desk with his hands in motion. Jaber Abdulkhaleg/Anadolu Agency via Getty Images
WHO Director-General Tedros Adhanom Ghebreyesus at a joint press conference in Kuwait City, Kuwait, on July 28, 2021.

Globally, the United States is the latest country to allow booster shots for people with weakened immune systems, following countries like France, Germany, and Hungary. Some countries have already begun announcing plans to expand their booster shot policies beyond those with weakened immune systems. The U.K., France, and Germany have announced they will begin administering third Covid-19 doses to the elderly as soon as next month. Israel, which has also approved booster shots for those above 60 years old, has gone a step further, reportedly making plans to offer it to younger people, too. Israel was among the first to open up after lockdowns thanks to a strong vaccination program early on, but it is now experiencing another wave of Covid-19 infections, despite the country’s high vaccination rates.

The move to expand additional Covid-19 shots to the wider public in some countries has sparked criticism from World Health Organization officials since the vast majority of poorer countries are still struggling to get residents vaccinated, even with first shots.

“I understand the concern of all governments to protect their people from the Delta variant. But we cannot accept countries that have already used most of the global supply of vaccines using even more of it,” said WHO chief Tedros Adhanom Ghebreyesus. He urged governments to hold off on expanding booster shot programs until the end of September.

Officials from countries preparing to administer additional Covid-19 shots to the wider public have pushed back at the WHO’s criticism. Israeli Prime Minister Naftali Bennett argued that the results of the country’s distribution of booster doses among the elderly could be useful data for future booster programs across the world.

In any case, many countries are still lagging in vaccinations, partly due to a lack of access to vaccine supplies and because of poor infrastructure to distribute them quickly. According to Reuters’s world Covid-19 vaccination tracker, which uses data only from countries that report their vaccination figures, about 40% of people who have received at least one dose of a coronavirus vaccine were from high-income countries. Moreover, at least 34% of these vaccine recipients were from Europe and North America.

As some wealthier countries begin moving toward distributing additional Covid-19 vaccine doses to their populations while other poorer nations still lag behind, and governments struggle to determine the best health protocols to keep people safe, the likelihood of disparities will continue.

Empty seats are seen in the House Chamber at the Texas Capitol in Austin on July 13 as Texas Democrats left the state to block sweeping new election laws.

It is now on track to enact one of the most restrictive voting laws in the country after an effort that has literally rendered the legislature unable to govern: Democrats fled the state to deprive the legislature of the quorum it needs to operate to protest the bill, leaving Texans without a representative governing body. In response, the Republican House speaker did not offer to negotiate a policy compromise, but has tried to arrest the Democrats who fled.

Republican Gov. Greg Abbott, meanwhile, has become a prominent national right-wing figure on both immigration and the pandemic.

He has waded into battles with the Biden administration over the US- Mexico border, setting off on a misleading quest to construct a wall on his own (the taxpayer funds he’ll use for the effort are enough for only a few miles of wall, at most) and falsely claiming that migrants are behind Covid-19 surges. And as the delta variant is infecting almost 12,000 Texans a day in reported tests, he has also refused to reinstate mask mandates at the state level, banned local governments from doing so, and sued those that defy him.

Tamir Kalifa/Getty Images
Texas Gov. Greg Abbott holds a border security briefing with sheriffs from border communities in Austin on July 10.

It’s all a bid to keep the GOP base happy in the lead-up to next year’s midterm elections, as Republicans in the state are more concerned about potential primary challenges from the right than any serious offensive from Democrats. But with their focus on raising their political profiles and defeating potential rivals, they have forgotten to actually govern amid several statewide crises in recent months: the winter storm that left tens of thousands without power and in the cold, the arrival of increasing numbers of migrants at the border, and the recent resurgence of Covid-19 cases due to the delta variant.

According to Brendan Steinhauser, a GOP strategist based in Austin who ran Texas Sen. John Cornyn’s 2014 reelection campaign, Republicans are just doing their job by responding to what Texas Republican voters want: “The voters are driving Republican policies,” Steinhauser said.

But at some point, elected officials have a responsibility to protect the health and safety of their constituents and the basic human rights of anyone who passes through their state, even if it’s not what their base wants. Few Texas Republicans have embraced that sense of duty; state Rep. Lyle Larson, a Republican from San Antonio, has been a lone dissenting voice calling on his colleagues to “do the right thing with no expectation of getting re-elected” on issues like Covid-19, Medicaid expansion, and election law.

“We’ve come to a point where Republican elected officials in Texas treat their jobs like they’re Fox News contributors as opposed to people with responsibilities to their constituents,” said Zack Malitz, co-founder of the progressive Real Justice PAC and a former adviser on Democrat Beto O’Rourke’s 2018 Texas Senate campaign.

Malitz’s view reflects the general frustration of Democrats. But there is a limited amount they — or anyone concerned about Texas government — can do. The reality of how districts are drawn, as well as Texas Republicans’ push to restrict voting, means many of those GOP lawmakers with little interest in lawmaking are likely to hang on to their seats next year. And that means the problems Texans have faced due to their government’s neglect are likely to continue.

The Texas legislature is scoring political points at the expense of addressing the most pressing issues

For a while after the 2018 elections, Texas Republicans were focused on bread and butter issues like property taxes and school finance that wouldn’t offend many independents and Democrats. Democrats made some major inroads that year, not just retaking the US House, but also picking up 12 seats in the Texas House and two in the Texas Senate. That shook Republicans’ confidence a bit, and left them looking to play it safe.

But after Democrats’ predictions that they would turn Texas blue in 2020 failed to come to fruition, Republicans felt that they were given a mandate, marking the return of culture war-type issues that most energize their base in the Texas legislature.

“In Texas, Republicans still win statewide and have done so in the last couple of election cycles, even though we had some narrower races in 2018,” Steinhauser said. “If you’re a Republican running statewide, you still have to speak to the Republican Party first, not only to get the nomination, but to turn them out and win in November.”

That pressure has manifested in what Steinhauser described as the most conservative session of the state legislature in his memory. The governor has already signed legislation that removed permit requirements to carry a handgun and also established an effective ban on abortion that is currently facing legal challenges.

But there is also a special session of the state legislature underway where lawmakers are supposed to work on legislation that would prevent schools from teaching critical race theory or mandating masks or Covid-19 vaccines, and to provide funding for border security, among other Republican causes.

All the while, the failure of the Texas power grid during the winter storm — a statewide crisis that impacted Texans regardless of political party — has been glossed over. Though the governor signed laws to prepare the electrical grid to withstand future extreme weather events, the legislature hasn’t passed any bills delivering direct relief for consumers who were slammed with huge electricity bills as a result of the blackouts or making the kind of forward-looking structural changes to Texas’s electricity market that many experts have called for. 

    <img alt=" " src="https://cdn.vox-

cdn.com/thumbor/0FnAMTtHJMrvrNGBrtlaK-n3y-8=/800x0/filters:no_upscale()/cdn.vox- cdn.com/uploads/chorus_asset/file/22781221/AP21194749783455_copy.jpg" /> Eric Gay/AP

Wendy Rodriguez (right) joins a rally to protest proposed voting bills on the steps of the Texas state Capitol on July 13.
Mark Felix/Bloomberg via Getty Images
Former Texas Rep. Beto O’Rourke (right) marches with Luci Baines Johnson (center), the daughter of former President Lyndon B. Johnson, during a voting rights rally near the Texas State Capitol on July 31.

Nor did the legislature, in either their regular or special sessions, find time to address many other pressing concerns in Texas, like Medicaid expansion and police reforms that were proposed in the aftermath of former Houston resident George Floyd’s death.

“These cultural war issues get people to hunker down in the trenches that they’re used to being in around elections and refocus voters’ attention on how much they hate the other side,” Malitz said. “These issues are being deliberately used as a distraction from really widely felt stuff in Texas right now: Covid, economic recovery, the blackouts, baseline bad governance.”

Republicans are also trying to strip Texans of the only tool they have to demand good governance with a bill that would make the state’s already very restrictive voting laws even more so. It passed the state Senate on Thursday despite a more than 15-hour filibuster from an Austin Democrat, but still needs to pass the House and be signed by the governor.

As my colleague Ian Millhiser notes, the bill would strengthen constraints on absentee voting; ban drive-through polling sites; introduce new limitations and paperwork requirements on people who help disabled voters and non-English speakers cast a ballot; make it harder to remove partisan poll watchers who harass voters or otherwise disrupt an election; and impose harsh new penalties on people who commit even minor violations of Texas election law.

Steinhauser said that Texas Republicans are more unified behind that agenda than they have been in a long time.

“Part of that is probably the party being out of power nationally and having a common political enemy, if you will — to have the White House and Nancy Pelosi and Chuck Schumer to point to,” he said. “Also having Trump be a little less front and center in the party has allowed them to focus their critiques on national Democrats.”

But for Texas Democrats, there isn’t room for compromise on the Republican agenda. House Democrats had fled the state en masse last month in an effort to prevent votes on the voting bill in particular. But after Republican Speaker Dade Phelan signed civil arrest warrants for absent Democrats on Tuesday night with a green light from the Texas Supreme Court, nearly enough of them have returned to form a quorum, a two-thirds majority of the chamber required to conduct business, giving the Republican majority a chance to move forward with their agenda.

Though Republicans have decried Democrats’ actions as breaking relationships in a chamber that has historically sought to give the minority party a seat at the table, Republicans had already drawn battle lines with a legislative agenda designed to exploit partisan divisions.

Gov. Abbott has tried to pass off his failures on the Covid-19 resurgence on migrants

Beyond the problems with the legislature, Texas is in the middle of another statewide crisis: a third wave of Covid-19, this time brought on by the highly contagious delta variant. It has left hospitals with dwindling numbers of ICU beds and delaying non-emergency medical procedures while the governor calls in out-of-state medical staff to come to the rescue.

Nevertheless, Abbott hasn’t budged in refusing to use his gubernatorial powers to try to get rising case — and death — numbers under control. He could, for instance, implement statewide mask or vaccine mandates, but will not, saying that curbing the epidemic now comes down to “personal responsibility.”

He has instead actively worked against the interests of public health, issuing an executive order that prohibits any government entity from issuing its own mask mandates, effectively hamstringing local governments that are bearing the brunt of Covid-19 surge in keeping Texans safe. Several counties have gone ahead and implemented mask mandates anyway, but Abbott is going to court in an effort to reverse them.

Though he has praised the vaccine and has gotten the jab himself, Abbott is focused on protecting the rights of the unvaccinated.

Callaghan O’Hare/Bloomberg via Getty Images
A Coivd-19 test drive-thru testing site in Houston, Texas. Gov. Abbott issued an executive order prohibiting any government entity from issuing mask mandates.

“They have the individual right and responsibility to decide for themselves and their children whether they will wear masks, open their businesses and engage in leisure activities,” Abbott told the Dallas Morning News. “Vaccines, which remain in abundant supply, are the most effective defense against the virus, and they will always remain voluntary — never forced — in the State of Texas.”

Steinhauser said that Abbott is trying to balance the desire of millions of Texans not to return to the shutdowns of last year with the real immediate need to get millions more Texans vaccinated. Democrats, however, see it as an abdication of the governor’s responsibility to protect public health.

“This is beyond inaction — this is the governor tying the hands of health experts who are trying to keep Texans healthy as cases and hospitalizations increase,” Texas state Rep. Donna Howard, a former critical care nurse, said in a statement.

What’s more, Abbott has sought to blame the recent delta surge on migrants arriving on the southern border — playing into a false, nativist, and damaging right-wing narrative that might be particularly attractive to Republican voters in the state, who have long identified immigration and border security as top priorities in public opinion polling.

At a national level, a recent Axios poll found that nearly 37 percent of unvaccinated Americans blame “foreign travelers in the US” for the rise in Covid-19 cases. Abbott has played no small part in creating that perception.

They’re “allowing free pass into the United States of people with a high probability of Covid, and then spreading that Covid in our communities,” he said in an interview last month on Fox News.

But available data hasn’t shown migrants on the border to be any more likely to test positive for Covid-19. In March, the acting head of the Federal Emergency Management Agency (FEMA) told Congress that less than 6 percent of migrants at the border had tested positive for Covid-19, a lower percentage than the Texas positivity rate at that time.

Scapegoating migrants serves two purposes for Abbott: It obscures his role in failing to prevent the current Covid-19 surge and provides him with an excuse to pursue the kind of restrictive immigration policies that former President Donald Trump both popularized and made a priority.

Sergio Flores/AFP via Getty Images
Former President Trump is joined by Gov. Greg Abbott, during a visit to the border wall near Pharr, Texas, on June 30, 2021.

He recently issued an executive order allowing public safety officers to stop and reroute vehicles suspected of transporting migrants with Covid-19, though the measure has been blocked in federal court for now.

He has told Texas child care regulators to revoke the licenses of facilities that house migrant children and state troopers to jail migrants for state crimes, such as trespassing on private property when they cross the border.

And he is trying to finish the wall along the Texas border, putting forth a $250 million “down payment” drawn from state disaster relief funds — money that could have gone to the aid of those still recovering from last winter’s storms, or those struggling under the burden of the pandemic — and crowdfunding almost another $500,000 as of June 23. That’s still a drop in the bucket of what he might need to finish the project, which the federal government estimated could cost as much as $46 million per mile in some sectors of the border.

But it doesn’t really matter if Abbott finishes the wall or whether his executive order is ever allowed to go into effect. The policies have generated news cycles that boost his profile nationally, which will be important if he pursues a 2024 presidential bid as rumored.

“It’s a fantastic talking point for his primary electorate, both next year and in 2024,” Malitz said. “It’s government by theater. The things that they are doing with government in Texas are, by and large, for the purpose of introducing a message into the right wing media machine with obviously catastrophic humanitarian results.”

Abbott and his fellow Texas Republicans have been very successful at controlling messaging, and have had many wins in energizing state conservatives. Their party is poised to retain control of Texas. But these victories have come at a great cost, carried by the people of Texas.

(Facebook and Apple have been at odds since Apple introduced its anti-tracking feature to its mobile operating system, which Apple framed as a way to protect its users’ privacy from companies that track their activity across apps, particularly Facebook. So you can imagine that a Facebook executive was quite happy for a chance to weigh in on Apple’s own privacy issues.)

And Edward Snowden expressed his thoughts in meme form:

pic.twitter.com/yN9DcTsBNT

— Edward Snowden (@Snowden) August 6, 2021

Some experts think Apple’s move could be a good one — or at least, not as bad as it’s been made to seem. Tech blogger John Gruber wondered if this could give Apple a way to fully encrypt iCloud backups from government surveillance while also being able to say it is monitoring its users’ content for CSAM.

“If these features work as described and only as described, there’s almost no cause for concern,” Gruber wrote, acknowledging that there are still “completely legitimate concerns from trustworthy experts about how the features could be abused or misused in the future.”

Ben Thompson of Stratechery pointed out that this could be Apple’s way of getting out ahead of potential laws in Europe requiring internet service providers to look for CSAM on their platforms. Stateside, American lawmakers have tried to pass their own legislation that would supposedly require internet services to monitor their platforms for CSAM or else lose their Section 230 protections. It’s not inconceivable that they’ll reintroduce that bill or something similar this Congress.

Or maybe Apple’s motives are simpler. Two years ago, the New York Times criticized Apple, along with several other tech companies, for not doing as much as they could to scan their services for CSAM and for implementing measures, such as encryption, that made such scans impossible and CSAM harder to detect. The internet was now “overrun” with CSAM, the Times said.

Apple’s attempt to re-explain its child protection measures

On Friday, Reuters reported that Apple’s internal Slack had hundreds of messages from Apple employees who were concerned that the CSAM scanner could be exploited by other governments as well as how its reputation for privacy was being damaged. A new PR push from Apple followed. Craig Federighi, Apple’s chief of software engineering, talked to the Wall Street Journal in a slickly produced video, and then Apple released a security threat model review of its child safety features that included some new details about the process and how Apple was ensuring it would only be used for its intended purpose.

So here we go: The databases will be provided by at least two separate, non-government child safety agencies to prevent governments from inserting images that are not CSAM but that they might want to scan their citizens’ phones for. Apple thinks that this, combined with its refusal to abide by any government’s demands that this system be used for anything except CSAM as well as the fact that matches will be reviewed by an Apple employee before being reported to anyone else, will be sufficient protection against users being scanned and punished for anything but CSAM.

Apple also wanted to make clear there will be a public list of the database hashes, or strings of numbers, that device owners can check to make sure those are the databases placed on their devices if they’re concerned a bad actor has planted a different database on their phone. That will let independent third parties audit the database hashes as well. As for the source of the databases, Apple says the database must be provided by two separate child safety organizations that are in two separate sovereign jurisdictions, and only the images that both agencies have will go into the database. This, it believes, will prevent one child safety organization from supplying non-CSAM images.

Apple has not yet said exactly when the CSAM feature will be released, so it’s not on your device yet. As for how many CSAM matches its technology will make before passing that along to a human reviewer (the “threshold”), the company is pretty sure that will be 30, but this number could still change.

This all seems reassuring, and Apple seems to have thought out the ways that on-device photo scans could be abused and ways to prevent them. It’s just too bad the company didn’t better anticipate how its initial announcement would be received.

But the one thing Apple still hasn’t addressed — probably because it can’t — is that a lot of people simply are not comfortable with the idea that a company can decide, one day, to just insert technology into their devices that scans data they consider to be private and sensitive. Yes, other services scan their users’ photos for CSAM, too, but doing it on the device is a line that a lot of customers didn’t want or expect Apple to cross. After all, Apple spent years convincing them that it never would.

Update, August 13, 4:55 pm: Updated to include new information about Apple’s messaging around its CSAM scanning technology.

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