Pfizer booster

As part of my ongoing participation in the Pfizer/BioNTech COVID-19 vaccine phase III trial, yesterday I received a third vaccine injection, seven and a half months after my second. There was a blood draw to test levels of antibodies, T cells, etc. and the blood work will be repeated in a year. I will continue a weekly symptom check through a phone app and have a couple of phone appointments over the next year, too. The data collected will be used to inform on-going decisions about how often boosters may be needed in the future.

I’m fortunate that my side effects have been milder than they were with the second injection. I have a very sore arm, which is obviously from the shot. I’m tired and have a bit of a headache, which could be side effect and could be just life in general these days. Today is the one-month anniversary of Paco’s death, so how I am feeling could be attributable to that rather than to vaccine side effects. When spouse B and daughter T, who are also study participants, received their third doses, they both lost a day to fever, body aches, and fatigue; because I had had a similar reaction to my second dose, I was expecting a similar experience, but apparently have lucked out.

In the United States, a third dose of the Pfizer vaccine is approved for those aged 65 and up, people who have medical risk, and those in certain professions that have close contact with vulnerable populations. It’s possible that the third dose will be recommended more generally in the future as more data become available. It’s also likely that emergency use authorization for children aged 5-11 will come soon, with shots in arms starting in early November.

Recommendations on booster doses for Moderna and Johnson & Johnson are expected soon, as well as the possibility of mixing manufacturers, for example, someone who had the J&J vaccine having a booster from Pfizer. All the companies are continuing to study the vaccines for long-term efficacy and side effects, as well as safety, efficacy, and dosage for children six months through seventeen years. Currently, in the United States, only Pfizer is approved for ages 12-17.

Another helpful development is that Merck has applied for emergency use authorization of molnupiravir, an oral anti-viral to combat COVID. It would be given to patients in the early stages in hopes of keeping their illness from becoming severe. While it is already possible to give treatments by injection or infusion, such as monoclonal antibodies, this medication would be easy to prescribe and administer for home use. A decision by the FDA is expected within weeks.

Meanwhile, over the summer, COVID cases were devastating parts of the US, especially states with low vaccination rates. Total fatalities are over 700,000 with over 44 million cases recorded. In some areas, hospitals were so overwhelmed that they had to send patients out of state to receive care. This applied to COVID patients and also to patients suffering from other serious conditions. Two states, Idaho and Alaska, had to implement crisis standards of care, which means that whether or not an individual receives treatment beyond comfort care is determined by the likelihood of survival as there is not enough capacity to treat everyone that needs help. This resulted in non-COVID deaths from heart attack, stroke, etc. – patients who ordinarily would have been treated successfully but who died because there were not personnel, equipment, and space available to treat them due to intensive care units being filled with COVID patients.

The delta variant was the power behind the summer surge, but, at least, the fear of it encouraged more people to seek vaccination. The increase in vaccination rates is helping the case numbers to fall at this point. Still, the current rate of fully vaccinated people is only 57% with 66% receiving at least one dose. I am hopeful that the Pfizer vaccine being approved for elementary age children in the coming weeks will add significantly to our vaccination totals, at least in states where the vaccination rate among adults is higher.

There are still terrifying amounts of misinformation floating around about the vaccines that are keeping some people from taking them. Unfortunately, this is keeping the pandemic alive, resulting in illness, death, lack of access to medical care, and the possibility of even more dangerous new variants developing.

We are all in this together. Please, everyone, get vaccinated if you are eligible and follow reputable public health guidelines on masking, avoiding crowds, handwashing, etc. Your choices affect your family, friends, neighbors and community directly and your nation and the world, as well. We can’t truly end this pandemic until there’s no population anywhere still vulnerable to COVID-19.

If you won’t do it for yourself, do it for someone you love.

looking back at MASS MoCA

Today is the last full day of the Boiler House Poets Collective reunion residency for 2021. It’s always amazing to be back here at MASS MoCA together but the experience is heightened after having to cancel because of COVID last year.

I am in the same studio as I was in the Tupelo Press workshop/residency that first brought us together in 2015. As I was looking back at my blog to get the exact dates of that residency, I decided to re-visit all the posts from back then. I was surprised that I processed as much as I did at the time, while realizing how much I had downplayed the amount of confusion and fear I was feeling.

If anyone is so moved to join me in this walk down memory lane, the posts start here.

a momentous visit

While my blogging has been haphazard for months due to my father’s declining health, I wanted to share a post about the recent visit of our daughter E, her spouse L, and their daughters, four-year-old ABC and one-year-old JG. As people who check in here at TJCM periodically may recall, they live in London UK and the pandemic left us unable to visit each other. This meant that when they arrived in the US, it was our first chance to meet JG in person.

All the adults are fully vaccinated, but the children are too young to qualify. While our area of upstate New York is not a COVID hot zone, the transmission rate is still high enough due to the delta variant that we were very cautious about taking the girls to indoor public spaces. While I had scaled back my expectations for the visit a lot, I hadn’t scaled them back quite as much as I should have. For example, I had hoped to see a few more friends than we were able to. Unfortunately, Paco, my 96-year-old father, had more health challenges appear and his unit at the nursing home had to go into lockdown due to a couple of COVID cases among vaccinated staff.

In a way, though, it was nice to have them in our home, doing normal, everyday things like we had when E and ABC lived with us for over two years while waiting for E’s spousal visa to be accomplished.

B, with an assist from ABC, got to bake yummy treats for breakfast.

Everyone enjoyed watching the birds at the birdfeeders. ABC especially liked the tufted titmouse and goldfinches, while others were partial to the cardinals.

We enjoyed watching other wildlife, too. ABC even spotted some deer near the back fence. We also spent a lot of time watching the bunnies eating various leaves and flowers in the lawn.

You probably can’t see the bunny, but – trust me – it’s there.

One thing that they don’t have at home in London is rocking chairs. JG especially loved the one that was her size!

JG was an early walker so we missed her being a babe-in-arms, but Auntie T did get a taste of what that phase was like when JG got so tired she actually fell asleep in her arms.

L took the girls on walks. Here is ABC at the 1 mile – or is it 1 smile? – mark on the Rail Trail. Our area, like many others in the US, has re-purposed places where there used to be railroad tracks into recreational trails.

We also got to visit the parks and carousels. Broome County has six vintage carousels and it was very nostalgic to revisit them with ABC and introduce them to JG. ABC made friends everywhere she went.

L and ABC enjoyed rides in the carousel chariot
JG loves being on the swings!
JG also enjoys being on the move!

We got to enjoy a lot of playtime with the girls. ABC, at four, has a great imagination and enjoys making elaborate scenarios. She is also quite operatic! Besides singing songs that she knows, often from Frozen I and II, she likes to make up songs while she is playing. With both her parents being accomplished singers and instrumentalists, she appears to come by music naturally. She is learning to play the piano, so we got to experience her lessons with her daddy.

ABC is also a beginning reader, so sometimes she would read to us and other times we would read to her. It was an honor to be chosen as the final bedtime story reader. Of course, she also requested a bedtime song before going to sleep.

The most important event of the trip, though, was the one visit we were able to make with Paco in the outdoor courtyard of the nursing home. ABC was being her charming self, singing and dancing and clapping for Paco.

The most precious photo is this one of the four generations.

Paco’s health has declined so much in the weeks since we had this visit that he has now been admitted to hospice care. I will be forever grateful that Paco had the opportunity to meet his second great-granddaughter who won’t remember that day and to see his first granddaughter E and first great-granddaughter ABC who certainly will.

SoCS: again with the complications

My life is beyond my control.

The latest wrinkle is that, just as we had worked through the latest set of medical complications with Paco and thought we could arrange another visit with the UK branch of the family before they return to London next week, there were not one but two breakthrough COVID cases discovered in the nursing home staff and the unit is closed to visitors, probably for two weeks.

Because Paco is considered a compassionate care case, we still have limited visitation, but visits need PPE, including N95 masks, and are restricted to no more than two people for about an hour per visit.

Not conducive to visits with a one-year-old and a four-year-old.

We were blessed with an outdoor visit last week and have some pictures to prove it.

That will have to do because I have no control over the situation.

Just hoping that Paco will be able to stay medically stable while we get through this period. He is fully vaccinated, of course, and everyone will be tested multiple times during the lockdown. Fortunately, he was not in close contact with the staff members who tested positive and who were doing the right thing by being fully vaccinated but the delta variant is even more formidable than the original form of the virus.

So, we’ll just keep on doing everything we can.

Even when it’s not ever enough.

I guess “enough” is not a valid concept here.

Even when the best we can do is not close to the best we had hoped for.
*****
Linda’s prompt for Stream of Consciousness Saturday this week is to begin a post with My. Join us! Find out more here: https://lindaghill.com/2021/08/27/the-friday-reminder-and-prompt-for-socs-aug-28-2021/

Pfizer vaccine approval

Today, August 23, 2021, the United States Food and Drug Administration has announced the full approval of the Pfizer/BioNTech vaccine against SARS-CoV2, the virus that causes COVID-19, for people aged 16 and up. People aged 12-15 are still being immunized under the emergency use authorization. It is also expected that, in the coming weeks, Pfizer will apply for emergency use authorization for children aged 5-11. Research is ongoing on children 6 months-4 years. Also, most adults will become eligible for a third dose to boost immunity, given from 8-12 months after the second dose.

Meanwhile, both Moderna and Johnson & Johnson, the other two vaccines available under emergency use authorization in the US, are continuing their research and applications to expand their age ranges and gain full approval, too.

It’s possible that, for some people who have been reluctant to be vaccinated, the full approval of the Pfizer vaccine might be enough to convince them to receive it. The US has seen many more shots being administered in recent weeks as the delta variant has surged and people realize that nearly all the people being hospitalized and dying are those who were unvaccinated. Unfortunately, it takes several weeks to build immunity from the vaccine so the delta surge will likely continue into the coming months.

The other expected impact of the full approval of the Pfizer vaccine is that more employers may mandate that their workers be immunized before returning to in-person work and more businesses may require immunization (or alternatively a recent negative test) for their patrons.

As regular readers may remember, my spouse B, daughter T, and I are all part of the Pfizer Phase III trial for the vaccine. B and T were lucky enough to receive the actual vaccine in August 2020 while I wound up being in the placebo group. When the vaccine received emergency use authorization, the study was unmasked so that people in the placebo group could receive the vaccine, which I did in February 2021. I will continue to be followed as part of the original study through August 2022. B and T, meanwhile, have entered into the third dose phase of the study. They will be providing data for the continued study of how much immunity boost occurs with the third dose and how long it lasts.

I continue to mourn for all those who are suffering as a result of the pandemic. Please, everyone, listen to the public health specialists in your area, receive the vaccine as soon as it is available to you, and mask, distance, and wash hands as directed. Please, do everything you can to protect the health of yourself, your loved ones, and your community.

SoCS: more on covid and vaccines

Here in the US, we are facing another wave of COVID. I think it is considered our fourth wave, but that has become pretty hard to define over the many months of the pandemic. What is different this time is that this wave is almost exclusively confined to the unvaccinated population, at least in terms of serious illness, hospitalizations, and mortality.

In New York State, where I live, the Northeast in general, and a few other states with high vaccination rates, you are seeing case numbers climb somewhat, largely because the delta variant is causing more breakthrough infections among the vaccinated, but you aren’t seeing extreme impacts on hospitals being overwhelmed and lots of serious illness and deaths.

In states like Missouri and Mississippi, with low vaccination rates, we are seeing conditions that look like the early days of the pandemic in New York, with hospitals overflowing with very sick patients, more than they have space, equipment, and personnel to handle. While in the first-wave, most of the very ill were elderly, now we are seeing that most of the very ill are younger adults. Even in these low-vaccination-rate states, the elderly are the ones most likely to have been vaccinated, so they are less impacted by this current wave, even with the delta variant making up a larger and larger share of infections.

As people who read Top of JC’s Mind from time to time may recall, I, spouse B, and daughter T are all part of the Phase III trial of the Pfizer/BioNTech vaccine. B and T both were in the original vaccine group and were vaccinated last August. They are now both enrolled in the follow-on study of booster shots and their efficacy. Like the original study, it is double-blind, so neither the participants nor the researchers know who received the actual booster and who received the placebo injection.

However, B and T are both having side effects similar to their other doses of the vaccine, so we are pretty sure that they got real booster shots, not placebos. For the record, last August, I got placebo shots. When the study was unmasked after the emergency use authorization was approved, I was offered the real vaccine, which I got in February. I remain in the study as part of the design to follow participants for at least two years. I don’t know if I might, in the future, wind up participating in a follow-on study for boosters as well. It will depend on how the results of the booster study that B and T are now in play out and whether more data is needed. It’s also possible that Pfizer may re-formulate in response to current and future variants and need a pool of test subjects for that. My family will continue to participate as long as we can be of use to help advance the science and protect public health.

It is so very sad to know how many people are suffering from COVID, especially now that we do have good vaccines available. I’m sad for people in countries or regions that don’t have access to the vaccine. I’m upset that there are so many who do have access but still remain unvaccinated, often because of misinformation about COVID and about the vaccines. Choosing to remain unvaccinated doesn’t just impact the individual’s health if they get infected. It also impacts public health, giving the virus more opportunities to mutate and create new variants. It also can spread the virus to others, which is especially dangerous if those people are also unvaccinated. Sadly, we are seeing an increase in hospitalizations of children, who aren’t yet eligible for vaccination, and teens, who are eligible but still have low vaccination rates in many states. Earlier this week, the state of Tennessee announced that it is ending all vaccine outreach to teens. It would be bad enough if this was just COVID vaccine but they are also ending outreach for other vaccines, like TDaP, HPV, hepatitis, and MMR boosters.

It’s appalling.

Please, everyone, remember that we are still in a pandemic – and will be until we can get COVID under control globally. If you have access to vaccines, please take them for your own good and for the good of others. Everyone needs to be vigilant to following public health and infection prevention measures recommended by public health professionals in your region.

COVID doesn’t care about your political views or whether or not you believe it exists. It is a virus that is just looking for a host to make it possible for it to replicate as many copies of itself as possible. If you are infected, you might be lucky and have mild symptoms, but you could pass it on to someone who might become seriously ill or even die. Or you might be unlucky and become seriously ill or die yourself.

The virus won’t care.

Your loved ones will.

*****
Linda’s prompt for Stream of Consciousness Saturday this week was to base your post on your least favorite word. I don’t often think of having a favorite or least favorite word, but I thought that COVID definitely qualified as being my least favorite entity at the moment. If you’d like to join in with SoCS, you can find out more here: https://lindaghill.com/2021/07/16/the-friday-reminder-and-prompt-for-socs-july-17-2021/

SoCS: hope

I have long said that hope is the virtue that I struggle with.

Or maybe it is that I struggle with the intersection of hope and reality.

I do try to keep my hopes realistic, not veering off into fantasy, but lately, it seems, even my realistic hopes get dashed on a regular basis.

On a personal level, my biggest struggle to maintain hope has been with my father’s health condition after a fall four weeks ago. I keep hoping that the medical team will be able to figure out what is causing his increased confusion, disorientation, and fatigue, so that we can make him more comfortable, but we don’t seem to be able to. I am not hoping for a miracle. Paco is 96 and has several underlying health conditions. I know the time we have left with him is limited. I just want to help make things as comfortable and stress-free as possible. I didn’t think this was an unrealistic hope, but perhaps it is.

Even with this personal struggle, there is always an awareness of what is going around us here in the US. I had hoped that, with several effective vaccines widely available, we could tamp down the pandemic, including the newer and more contagious variants. Instead, we are seeing some areas with very low vaccination rates experiencing spikes in COVID cases. Another realistic hope dashed.

Equally or perhaps even more alarming is the increasingly bizarre behavior of the Republican party. I had hoped that, after what even Republican election officials knew was a fair election, and especially after the horror of the January 6th insurrection and attack on the Capitol, the Republicans would fulfill their Constitutional duties and govern, at this point as the minority party. But they are not. In states that have a Republican legislature, especially if there is a Republican governor, too, we are seeing rafts of legislation that try to suppress votes of people who are less likely to choose Republican candidates. This isn’t just another dashed hope. It feels dystopian.

Of course, some hopes are more mundane. I had hoped to get an SoCS post written before I fell asleep and I have managed that.

I hope that Paco will have a decent day tomorrow.

And a decent week.

I hope that isn’t too much to hope for.

*****
Linda’s prompt for Stream of Consciousness Saturday this week is “hope.” Join us! Find out more here: https://lindaghill.com/2021/07/09/the-friday-reminder-and-prompt-for-socs-july-10-2021/

Paco update

Linda’s prompt for Stream of Consciousness Saturday last week was to base the post around a word that contained -igh. My thought was to write a post beginning with “Sigh” about my father’s continuing health struggles, following up on two previous SoCS posts.

The day after I wrote the post linked above, Paco’s condition deteriorated and I made the decision to send him to the emergency room. After the initial check-in, I was allowed to be with him. The ER team was very thorough and found that he was dehydrated and had three new fractures in his lumbar vertebrae. After some IV fluids, he went back to the rehab facility by ambulance at 3 AM.

I caught a nap and was very grateful to learn that my older sister had moved up a planned visit and would arrive that afternoon. She spent a lot of time with Paco on compassionate care visits while I worked out a lot of logistics. It turned out that a rehab room opened up within his senior community; the place where he currently was in rehab was a sister facility in a nearby city. Paco was set to move back on Friday and I spent a lot of time packing up things in his assisted living unit, some to send up to his rehab room there and some to bring back to our house as we had decided to give up his place in assisted, as we know he won’t be well enough to return there any time soon – and may never recover to that point.

The plan on Friday had been that our family would finish clearing out his place in assisted and help Paco to get settled into rehab, but we arrived to find that someone in the assisted wing had tested positive for COVID, so it had to go into lockdown. Fortunately, this didn’t affect Paco’s move and he arrived safely via medivan. I signed yet another cache of documents and was allowed a short visit to help him get settled.

Unfortunately, our hard-won rights to expanded compassionate care visits got lost in the bureaucracy with the impending holiday weekend adding another layer of complications with so many staff away on vacation. I was able to get permission for some extra visiting time over the weekend but face another round of changing personnel, location, rules, etc. this coming week.

Meanwhile, Paco is confused and exhausted. The silver lining is that his pain level is generally low.

The big question mark remains how much recovery is possible in regards to daily living functions. I don’t know if the rehab team will be able to make a valid prediction or not.

It may be a situation of wait and watch and work and hope and pray and see where we end up.

Granddaughter congratulations

Congratulations to granddaughter ABC who is turning four years old! She is a few weeks away from completing nursery school and will be entering Reception, the UK equivalent of US kindergarten, in September. She is reveling in the return to full-time in-person school, loves the parks and the garden, is learning to read, has a vivid imagination, inherited her parents’ musicality, and loves being a big sister, at least most of the time.

Congratulations also to granddaughter JG, who at not quite ten months old, is walking on her own. Watching the videos of her toddling reminds me of her mother, my firstborn E, who also stuck her tongue out when she was first walking on her own. I’m not sure if it is a sign of concentration or if it somehow helps with balance, but it certainly seems to be an inherited inclination. Also, adorable.

When we visited London in December 2019, we had planned to return in the spring, perhaps for Easter, and then for ABC’s third birthday, and in late summer for the birth of the new baby. E and her family planned to come visit us in the US for Christmas.

Due to the pandemic, none of that happened.

So, here we are, all fully vaccinated in upstate New York, but still not cleared for travel to the UK, missing another birthday. We’ve missed the entirety of JG’s babe-in-arms phase as she is now officially a toddler. And we still don’t know when we will be able to travel to the UK. They have been planning another easing of restrictions in mid-June, but now the even more virulent strain from India is spreading in the UK, so…

We don’t know about travel in person.

We do know that our love reaches them, even if our arms cannot.

Trinity Sunday 2021

Today is the Sunday after Pentecost which is celebrated in the Roman Catholic tradition as Trinity Sunday. It is also the name day of a close family member, so it holds additional significance for me.

While I had attended mass in person a few times during Lent and Holy Week after I was fully vaccinated, I had not attended since because space was so limited and advance reservations were required. Now, though, with the new guidance from the CDC and our diocese, fully vaccinated people may attend unmasked and capacity restrictions have been eased, so I decided to attend to celebrate Trinity Sunday in person instead of via broadcast.

We still had temperature checks as we entered, but the ropes that had blocked every other pew have been removed. People still maintained some distance from each other, especially important for families with children too young to be vaccinated or teens who haven’t had time to complete their vaccination series yet. Some adults were masked because they haven’t yet been fully vaccinated or because they chose to wear masks because they are medically vulnerable or feel safer masked while indoors in close quarters. People are also masked when fulfilling certain roles in the liturgy, such as distributing communion. It was nice to see the octet able to stand unmasked in pairs singing the same voice part, rather than scattered about by household as they had to be under full pandemic protocol.

This week, we still used the pandemic protocol of distributing communion after the concluding rite, so that people were distanced as they exited immediately after receiving, avoiding large crowds in the gathering space. Next week, though, when we celebrate Corpus Christi, communion will be distributed at the normal time before the concluding rite, so we will get to have a proper closing hymn again. Our bishop has also rescinded the dispensation of the obligation to attend mass in person as of next week, although, as always, people who are too frail or medically vulnerable are exempt.

I’m not sure what will happen. Many churches, including the one I attend, cut back on the number of masses each weekend due to cleaning protocols. Will there now be too many people trying to fit into fewer masses? Will some people who have been accustomed to participating virtually continue to do so because it feels safer or easier or more convenient?

I admit that, for me, being back in person is difficult and saddening. Perhaps, it will be less so as we are able to resume talking to other congregants; it’s lonelier to me being in the midst of people with whom I can’t interact than being alone participating in mass via television. The bigger problem, though, is my discomfort with many of the clergy and bishops in the United States over the last several years. Too many of them are mired in clericalism that fails to acknowledge the decades/centuries of abuse, misogyny, racism, and injustice in which the hierarchy was either perpetrating or complicit. Too many of them are more enamored with their personal power over others than with following the servant-leadership of Christ. Somehow, for me, it feels safer with a priest on a screen than a priest in the same room, even a large room like a church.

I was just looking back at this post, which I wrote after my first Lenten mass in person. At the end of it, I write about the struggles of living through a lot of pain to remain in the church and questioning if I can go back to being confronted with that every week.

The answer may well become evident in the coming weeks.

Postscript: One of the online resources that I use is catholicwomenpreach.org. Their Trinity Sunday 2021 homily is powerful. If this was the preaching I heard in person at mass, it would be a cause for joy rather than pain.