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The safety profile and the actual known adverse effects of COVID-19 vaccines in at-risk and healthy individuals – News-Medical.Net

  1. The safety profile and the actual known adverse effects of COVID-19 vaccines in at-risk and healthy individuals News-Medical.Net
  2. Hearing About COVID-19-Related Experiences Increases Vaccination Rates | Weather.com The Weather Channel
  3. COVID-19 is a leading cause of death among children, but that doesn’t stop some of my colleagues from arguing against vaccinating them Science Based Medicine
  4. The nature of the immune responses induced by various COVID-19 vaccines developed using different platforms and formulations News-Medical.Net
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Hormone Replacement Therapy Could Ward off Alzheimer’s Among At-Risk Women

Summary: Hormone replacement therapy (HRT) use was associated with better cognition, memory, and larger brain volume in women who carry the Alzheimer’s associated APOE4 genetic variant.

Source: University of East Anglia

Hormone Replacement Therapy (HRT) could help prevent Alzheimer’s Dementia among women at risk of developing the disease—according to University of East Anglia research.

The study shows that HRT use is associated with better memory, cognition and larger brain volumes in later life among women carrying the APOE4 gene—the strongest risk factor gene for Alzheimer’s disease.

The research team found that HRT was most effective when introduced early in the menopause journey during perimenopause.

Prof Anne-Marie Minihane, from UEA’s Norwich Medical School and director of the Norwich Institute for Healthy Aging at UEA, led the study in collaboration with Prof Craig Ritchie at the University of Edinburgh.

Prof Minihane said, “We know that 25 percent of women in the UK are carriers of the APOE4 gene and that almost two thirds of Alzheimer’s patients are women.

“In addition to living longer, the reason behind the higher female prevalence is thought to be related to the effects of menopause and the impact of the APOE4 genetic risk factor being greater in women.

“We wanted to find out whether HRT could prevent cognitive decline in at-risk APOE4 carriers.”

The research team studied data from 1,178 women participating in the European Prevention of Alzheimer’s Dementia initiative—which was set up to study participants’ brain health over time.

The project spanned 10 countries and tracked participants’ brains from ‘healthy’ to a diagnosis of dementia in some. Participants were included if they were over 50 and dementia-free.

The research team studied their results to analyse the impact of HRT on women carrying the APOE4 genotype.

Dr. Rasha Saleh, also from UEA’s Norwich Medical School, said, “We found that HRT use is associated with better memory and larger brain volumes among at-risk APOE4 gene carriers. The associations were particularly evident when HRT was introduced early—during the transition to menopause, known as perimenopause.

“This is really important because there have been very limited drug options for Alzheimer’s disease for 20 years and there is an urgent need for new treatments.

“The effects of HRT in this observation study, if confirmed in an intervention trial, would equate to a brain age that is several years younger.”

The study shows that HRT use is associated with better memory, cognition and larger brain volumes in later life among women carrying the APOE4 gene—the strongest risk factor gene for Alzheimer’s disease. Image is in the public domain

Prof Anne Marie Minihane said, “Our research looked at associations with cognition and brain volumes using MRI scans. We did not look at dementia cases, but cognitive performance and lower brain volumes are predictive of future dementia risk.

Prof Michael Hornberger, from UEA’s Norwich Medical School, said, : “It’s too early to say for sure that HRT reduces dementia risk in women, but our results highlight the potential importance of HRT and personalised medicine in reducing Alzheimer’s risk.

“The next stage of this research will be to carry out an intervention trial to confirm the impact of starting HRT early on cognition and brain health. It will also be important to analyse which types of HRT are most beneficial,” he added.

Prof Craig Ritchie, from the University of Edinburgh, said, “This important finding from the EPAD Cohort highlights the need to challenge many assumptions about early Alzheimer’s disease and its treatment, especially when considering women’s brain health.

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“An effect on both cognition and brain changes on MRI supports the notion that HRT has tangible benefit. These initial findings need replication however in other populations.”

About this genetics and Alzheimer’s disease research news

Author: Press Office
Source: University of East Anglia
Contact: Press Office – University of East Anglia
Image: The image is in the public domain

Original Research: Open access.
“Hormone Replacement Therapy is associated with improved cognition and larger brain volumes in at risk APOE4 women: results from the European Prevention of Alzheimer’s Disease (EPAD) cohort” by Anne Marie Minihane et al. Alzheimer’s Research & Therapy


Abstract

Hormone Replacement Therapy is associated with improved cognition and larger brain volumes in at risk APOE4 women: results from the European Prevention of Alzheimer’s Disease (EPAD) cohort

Background

The risk of dementia is higher in women than men. The metabolic consequences of estrogen decline during menopause accelerate neuropathology in women. The use of hormone replacement therapy (HRT) in the prevention of cognitive decline has shown conflicting results. Here we investigate the modulating role of APOE genotype and age at HRT initiation on the heterogeneity in cognitive response to HRT.

Methods

The analysis used baseline data from participants in the European Prevention of Alzheimer’s Dementia (EPAD) cohort (total n= 1906, women= 1178, 61.8%). Analysis of covariate (ANCOVA) models were employed to test the independent and interactive impact of APOE genotype and HRT on select cognitive tests, such as MMSE, RBANS, dot counting, Four Mountain Test (FMT), and the supermarket trolley test (SMT), together with volumes of the medial temporal lobe (MTL) regions by MRI. Multiple linear regression models were used to examine the impact of age of HRT initiation according to APOE4 carrier status on these cognitive and MRI outcomes.

Results

APOE4 HRT users had the highest RBANS delayed memory index score (P-APOE*HRT interaction = 0.009) compared to APOE4 non-users and to non-APOE4 carriers, with 6–10% larger entorhinal (left) and amygdala (right and left) volumes (P-interaction= 0.002, 0.003, and 0.005 respectively). Earlier introduction of HRT was associated with larger right (standardized β= −0.555, p=0.035) and left hippocampal volumes (standardized β= −0.577, p=0.028) only in APOE4 carriers.

Conclusion

HRT introduction is associated with improved delayed memory and larger entorhinal and amygdala volumes in APOE4 carriers only. This may represent an effective targeted strategy to mitigate the higher life-time risk of AD in this large at-risk population subgroup. Confirmation of findings in a fit for purpose RCT with prospective recruitment based on APOE genotype is needed to establish causality.

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A Monkeypox Vaccine Is Available for At-Risk New Yorkers

Facing a growing outbreak of the monkeypox virus, New York City health officials expanded access to a monkeypox vaccine on Thursday, offering it to a new group of people who may be at higher risk: men who have had multiple or anonymous male sexual partners over the last two weeks.

New York City is the first American jurisdiction to broaden access to the vaccine beyond close contacts of people infected, following similar moves in the United Kingdom and Canada.

Public health officials globally have been scrambling to craft an effective response to the outbreak, which has been spreading in dozens of countries since mid-May, particularly among networks of gay, bisexual and other men who have sex with men.

New York City reported 30 cases of the monkeypox virus as of Thursday. Nationally, 173 cases had been reported by the Centers for Disease Control and Prevention. Globally, there were more than 3,300 cases of the disease reported in 42 countries outside of the African regions where it is endemic, in the largest ever global outbreak of the disease.

No deaths have yet been reported in the outbreak outside of Africa, but 72 deaths have been reported since the start of the year in the endemic African regions.

The opening of the first clinic to offer the vaccine in New York City on Thursday was not announced publicly beforehand. Instead, after a news release went out at 11:30 a.m. Thursday, the news spread on social media and through word of mouth about the vaccine’s sudden availability.

By early afternoon, a line of more than 100 men had formed outside the city-run Chelsea Sexual Health Clinic, which is the only place in the city offering the shots.

By about 1:30 p.m., workers at the clinic began to turn away new people, asking them to make appointments online for next week.

There is a limited supply of the preferred vaccine to fight monkeypox, which has been approved by the Food and Drug Administration. It is manufactured in Denmark and is known as Jynneos in the United States. Though the federal government owns about 1.4 million doses, Mark Levine, the Manhattan borough president, said that there were only about 1,000 doses of vaccine on hand for the city’s residents.

“The demand we’re seeing today is further proof of how proactive the L.G.B.T.Q.+ community — and all New Yorkers — are when it comes to their health and seeking health care,” the city’s Department of Health said in a statement. “We are in talks with the C.D.C. to obtain more doses and are looking into how we can boost our capacity citywide.”

Gay men’s health advocates have been calling for expanded access to the vaccine for weeks. Until Thursday, it was being offered primarily only to known contacts of people infected and some health care workers. Particularly with the Pride parade and related celebrations happening this weekend, it appeared that the city had far underestimated demand.

James Krellenstein, a co-founder of PrEP4All, a health advocacy group, was among the first in line at the clinic at about noon. He got his dose by 12:30 p.m., and said he felt relieved to have at least some protection before Pride parties go into full swing.

“I think it was really bizarre to do this without prior consultation with the community,” he said, but the clinic’s opening “is the correct move. We do need to be deploying the vaccine at this point to the broader population.”

There is a great desire, he said, to get at least one dose of the two-dose vaccine before this weekend, which will provide at least some protection against spread, even among people not planning to have sexual experiences. The disease can transmit from skin-to-skin contact with infected lesions anywhere on the body, and does not require sexual contact.

“At parties, often times people take their shirts off and dance close to each other,” he said. “This is enabling us to feel a little more comfortable.”

Vaccines will be available at the clinic from 11 a.m. to 7 p.m. on Mondays, Tuesdays, Thursdays, Fridays and Sundays, the city announced. The web appointment system should also have more appointments beginning Sunday, officials said.

The monkeypox virus, so named because it was discovered in captive monkeys in 1958, typically begins with flulike symptoms, such as a fever and swollen lymph nodes, and then progresses to a painful rash with pus-filled lesions on the face and body.

While far less lethal than its relative, smallpox, it can be fatal, with a fatality rate of between 3 to 6 percent in the African regions where it is endemic. It mostly spreads by skin-to-skin contact, but can also be spread by respiratory droplets from prolonged close contact or contact with shared objects like towels.

In this global outbreak, the disease has sometimes presented differently, as only a few lesions in the genital area or internally. As a result, there is a risk of it being confused with other sexually transmitted illnesses, such as syphilis and herpes, the C.D.C. warned in a recent health alert.

Testing in the United States is done at one of about 70 public health laboratories around the country, but the C.D.C. recently announced that it was expanding access to some commercial laboratories to make the tests easier for health providers to order. The pace of testing is still at a relatively low level, however, and some people who suspect they have monkeypox have been struggling to find providers to test them.

As of Wednesday, there had been a total 1,058 tests nationwide for the orthopoxvirus, the family of viruses to which monkeypox belongs, the C.D.C. said.

Joseph Osmundson, a microbiologist at New York University who is among a group of activists pushing for more access to testing and vaccination, said that there was “immense frustration in the community” about access to the vaccine, and he hoped that other cities would follow in New York’s footsteps and open clinics soon.

At the same time, he said, health officials should make sure to better communicate the launch of clinics ahead of time to ensure broader access to the doses.

“We completely understand that we are flying the airplane as we build it and not everything is going to be perfect,” he said. “But we are also worried about equity and communication, and the people who got vaccinated first were those who were super connected to information.”

Luck and happenstance also figured into who got the first shots.

David Polk, who lives in Hell’s Kitchen, said he arrived at the Chelsea clinic at about 12:15 p.m., but not to get vaccinated. He saw people setting up a table and a tent near the front door.

“I thought it was a giveaway,” Mr. Polk, 39, said. It turned out to be a sign-up for the vaccine, and Mr. Polk was one of the first to arrive.

“I’m pretty sure they were not expecting all these people,” Mr. Polk said, “because when I got here there was nobody here, and I had to wait a little while because the appointments system wasn’t working.”

But within a half-hour, scores of vaccine seekers started arriving, and a long line quickly formed, he said. “I think the staff here was as shocked as I was,” Mr. Polk said.

Sean Piccoli contributed reporting.

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Starting later this week, some at-risk Americans become eligible for a 4th Covid shot.

For immunocompromised people who received a single shot of the coronavirus vaccine made by Johnson & Johnson, the C.D.C. does not recommend additional primary doses, but advises that they get a booster shot of the Moderna or Pfizer-BioNTech vaccines two months after the first dose.

Some people are born with absent or faulty immune systems, and in others, treatments for some diseases like cancer diminish the potency of immune defenses. The C.D.C. estimates there are about seven million immunocompromised individuals in the country.

Many of them produce few to no antibodies in response to a vaccine or an infection, leaving them susceptible to the virus. When they do become infected, they may suffer prolonged illness, with death rates as high as 55 percent.

It is unclear what proportion of those people are protected by additional doses. Still, with the Omicron variant surging in the country, some immunocompromised people sought out fourth or even fifth shots of the vaccines even before the C.D.C. changed its guidelines. While receiving multiple doses of vaccines in a short period is unlikely to be harmful, it may produce diminishing returns, according to some experts.

The C.D.C. has said that any American 12 and older can receive a Pfizer-BioNTech booster — those 18 and older can alternatively receive a Moderna booster — five months after completing their initial shots with those vaccines. Israel has already begun offering fourth doses to high-risk groups including older adults. But the Biden administration has not yet said whether it plans to follow suit.

When asked on Friday about the possibility of a fourth shot for the general population, Dr. Rochelle Walensky, director of the C.D.C., said that focus remained on Americans eligible for their third shots.

She added that U.S. officials remained in close touch with Israel experts about their data. “We will be following our own data carefully as well, to see how these boosters are working in terms of waning effectiveness, not just for infection but, importantly, for severe disease,” she said.

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In world first, Israel set to give 4th COVID shot to over 60s, at-risk groups

Israel is set to begin offering a fourth COVID-19 vaccine shot for over 60s, some at-risk groups and medical personnel, in line with a recommendation Tuesday from a panel of health experts.

Prime Minister Naftali Bennett welcomed the recommendation and ordered that officials prepare a campaign to distribute the vaccines, meaning Israel is likely to become the first country in the world to roll out a fourth dose for certain groups.

The experts, a government body called the Pandemic Treatment Staff, recommended that medical personnel, adults over the age of 60 and other at-risk groups get the fourth dose, after waiting at least four months since the third dose.

Eight-six percent of experts in the group favored the move.

The decision needs final approval from Health Ministry Director-General Nachman Ash before it goes into effect.

“This is wonderful news that will assist us in getting through the Omicron wave that is engulfing the world,” Bennett said in a statement.

Bennett said the additional shot would also be administered to health care workers.

“The citizens of Israel were the first in the world to receive the third dose of the COVID-19 vaccine, and we are continuing to pioneer with the fourth dose as well,” the prime minister said.

Israel previously pioneered a third booster shot, rolling it out for at-risk groups before expanding the program to the general population weeks later, before much of the rest of the world. Over four million Israelis have received the third dose, out of 9.3 million people.

Research on a fourth vaccine dose is being carried out at the Sheba Medical Center but has not yet been published.

Sheba said that it is conducting a study of the feasibility of a 4th shot in a trial among some 200 volunteers, examining the effect of antibody levels. The hospital said it was the first such trial in the world and would be carried out in cooperation with the Health Ministry.

Prof. Galia Rahav, who heads Sheba’s infectious diseases unit and is on the expert panel, said the decision to recommend the extra boosters was “not simple” given the paucity of data showing that the protection offered by the third shot was waning. “But at the same time. there are terribly frightening numbers from what is happening in the wider world,” she told Army Radio, referring to the fast-spreading Omicron strain.

Scientists don’t know everything about Omicron yet, but they say vaccination should offer strong protections against severe illness and death. Initial figures have also shown the strain to be even more contagious than the Delta strain.

Bennett and Health Minister Nitzan Horowitz have raised the possibility of a fourth dose for weeks, but Health Ministry experts had advised against the move, including in a decision last week. Bennett earlier said he was waiting “impatiently” for the fourth dose to be approved, predicting a new wave of infections was unstoppable.

The Omicron threat has spurred new calls for Israelis to get vaccinated, including children, by health officials and government leaders.

The Health Ministry said Tuesday that 170 new cases of the Omicron variant of the coronavirus had been confirmed in Israel, doubling the number of infections.

There have been 341 verified Omicron cases in Israel to date, the Health Ministry said in a statement. Another 807 infections were “highly suspected” to be Omicron cases, but were awaiting verification.

Lawmakers have renewed restrictions to curb infections in recent days, including bans on international travel and public workplace capacity.

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Countries partner with US to help transport and relocate Americans, at-risk Afghans

State Department spokesperson Ned Price said on Friday that a number of countries are working with the United States to help transit and relocate Americans and at-risk Afghan fleeing Afghanistan.

Price noted that Bahrain, Denmark, Germany, Italy, Kazakhstan, Kuwait, Qatar, Tajikistan, Turkey, the United Arab Emirates, the United Kingdom and Uzbekistan have already or will start “transiting Americans, or in some circumstances others, through their territories to safety.”

He also said that a number of countries had “made generous offers regarding the relocation efforts for at-risk Afghans.” Those countries include Albania, Canada, Colombia, Costa Rica, Chile, Kosovo, North Macedonia, Mexico, Poland, Qatar, Rwanda, Ukraine and Uganda.

The UAE announced on Friday that it would also be hosting 5,000 Afghans on a temporary basis following a request by the U.S.

“The UAE is always seeking peaceful, multilateral solutions, and is keen to continue its work alongside its international partners to advance efforts to assist the Afghan people during this time of uncertainty,” Sultan Mohammed Al Shamsi with the UAE’s Ministry of Foreign Affairs and International Cooperation said in a statement.

Price said that around 13,000 people have been evacuated by the U.S. since Saturday, with the military evacuating 5,700 people within the last 24 hours. 

Evacuation flights had been temporarily paused on Friday as the processing center in Qatar which was receiving evacuees had reached capacity, though the flights were later resumed after eight hours as officials sought to find countries that might receive evacuation flights from Afghanistan.

Afghans and Americans are seeking to leave the country quickly as anxieties grow amid newly minted rule by the Taliban. Harrowing footage from earlier this week showed Afghans clinging to a U.S. military plane in an effort to leave the country.

President BidenJoe BidenTexas House Dems end standoff, paving way for election overhaul Taliban calls on Afghan Muslim leaders to urge unity amid protests, fleeing citizens State Dept. will not charge for evacuation flights from Afghanistan MORE acknowledged on Friday during an address that the evacuation process out of Afghanistan posed challenges, and he said he could not guarantee the results of the U.S. effort.

“Make no mistake, this evacuation mission is dangerous. It involves risks to our armed forces, and is being conducted under difficult circumstances. I cannot promise what the final outcome will be, or that it will be without risk of loss,” Biden said.

However, the president vowed that the evacuation flights would not stop until Americans and Afghans holding special immigrant visas were out of the country. 



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Israel offers Covid vaccine booster shots to at-risk adults | Israel

Israel has said it will begin to offer a booster shot of Pfizer’s coronavirus vaccine to adults with weak immune systems, but that it was still weighing up whether they should be given to the general public.

The rapid spread of the Delta variant has fuelled a rise in the number of new infections from single digits a month ago to around 450 a day, and the country has moved to fast-track its next Pfizer shipment.

The health minister, Nitzan Horowitz, said on Sunday that adults with impaired immune systems who had received two doses of the Pfizer vaccine could get an immediate booster shot, with a decision pending on wider distribution.

Pfizer and its partner, BioNTech, the main suppliers in a swift Israeli vaccination rollout that began in December, said on Thursday they will ask US and European regulators within weeks to authorise booster shots.

The two companies cited an increased risk of infection after six months in seeking permission for a third shot. Drawing criticism from some scientists and officials, the companies did not share the data showing that risk, but said it would soon be made public.

“We are examining this issue and we still do not have a final answer,” Horowitz said about a booster for the general population in Israel.

“In any case we are administering as of now a third shot to people suffering from immunodeficiency. These are for instance people who have undergone organ transplants or suffer from a medical condition which causes a drop in immunity.”

About half of the 46 patients currently in a severe condition in Israeli hospitals have been vaccinated, according to health ministry data. Israel’s coronavirus pandemic response coordinator, Nachman Ash, said on Wednesday that the overwhelming majority of them were from high-risk groups, over the age of 60 and had prior health problems.

Horowitz also said the health ministry would plug a Pfizer supply gap for ongoing two-dose inoculations of the general adult population by using Moderna vaccines already in stock.

Israel’s prime minister, Naftali Bennett, said in broadcast remarks to his cabinet on Sunday that he had agreed with Pfizer to bring forward the next delivery of doses to 1 August. The shipment had been widely expected to arrive in September.

Israel hopes earlier deliveries will enable more youngsters to be vaccinated before the start of the school year in September. Under health ministry regulations, Israeli youths can receive Pfizer shots but not yet those produced by Moderna.

Israel has almost exclusively administered Pfizer shots to around 60% of its 9.3 million population. A batch of 700,000 doses due to expire at the end of July was sent to South Korea, as a recent slowdown in the pace of vaccinations would likely have meant them going to waste.

Under the deal, Seoul will return the same number of shots, already on order from Pfizer, in September and October.

“We have Moderna vaccines and adults who want to vaccinate can do so from this morning, or maybe tomorrow, with the Moderna vaccines,” Horowitz said.

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More vaccines going to rich than at-risk

SAN FRANCISCO (AP) — Teresa Parada is exactly the kind of person equity-minded California officials say they want to vaccinate: She’s a retired factory worker who speaks little English and lives in a hard-hit part of Los Angeles County.

But Parada, 70, has waited weeks while others her age flock to Dodger Stadium or get the coronavirus shot through large hospital networks. The place where she normally gets medical care, AltaMed, is just now receiving enough supply to vaccinate her later this month.

Parada said TV reports show people lining up to get shots, but “I see only vaccines going to Anglos.”

“It’s rare that I see a Latino there for the vaccine. When will it be our turn?” she said.

Gov. Gavin Newsom has repeatedly called equity his “North Star” for vaccinating a diverse state of nearly 40 million. He partnered with the federal government to set up mass vaccination sites in working-class neighborhoods in Oakland and Los Angeles. And it’s a big part of why he tasked insurer Blue Shield with centralizing California’s patchwork vaccine system, asking the hospital chain Kaiser Permanente to assist.

Yet officials at community health centers that are considered the backbone of the safety net for the poor in the U.S., focused on health equity, say they are not receiving enough doses for their patients — the very at-risk residents the state needs to vaccinate.

In California, nearly 1,400 such centers offer free or low-cost services to about 7 million people, many in communities with a higher concentration of low-income families and few providers who take Medicaid, which is known in California as Medi-Cal. Many of their clients speak a language other than English, work long hours, lack transportation and want to go to the medical care professionals they trust.

Dr. Efrain Talamantes, chief operating officer for AltaMed Health Services, said it was disheartening to watch initial doses go elsewhere while his patients continued to test positive for the virus.

“There is a clear disparity every single time there’s a resource that’s limited,” he said.

Most states are grasping for ways to distribute limited vaccine supply, resulting in a hodgepodge of methods in the absence of a federal plan. Tennessee is among the states dispensing doses based on county populations, while California allocates them by eligible groups including teachers and farmworkers. The free-for-all has allowed people with the most resources to score scarce vaccinations.

Dr. Kirsten Bibbins-Domingo, chair of the Department of Epidemiology and Biostatistics at the University of California, San Francisco, said it seems obvious that the best strategy to get vaccines to hard-hit communities is to turn to the places where residents already get care. But big-box administrators tend to think of community health centers as less efficient because of their smaller size, she said.

“We’re not very imaginative in the way we deliver vaccine efficiently. Our only creative solutions are to build mass vaccination sites, and maybe give people preferential access to those sites,” she said.

As California has ramped up vaccination efforts through mobile and pop-up clinics at churches, work sites and schools, state data show how relatively few shots have gone to Latinos and Blacks compared to their populations.

African Americans have received 3% of vaccine doses while they make up 6% of the state. Latinos, who make up 39% of the state, have received 17% of doses.

Blue Shield officials say they plan to keep open health centers that are already administering vaccines, but the clinics worry they won’t get enough doses.

State vaccine spokesman Darrel Ng said the governor’s plan for equitable vaccination includes setting aside vaccines for “disproportionately impacted communities and ensuring that providers who serve these communities are part of the network.” He said in a statement that it includes sending mobile clinics to places like Black churches.

Andie Martinez Patterson, vice president of government affairs at the California Primary Care Association, said while large-scale health systems can vaccinate people quickly, they likely won’t reach the targeted residents.

Community health centers have worked hard to persuade their patients to take the shot, said Alexander Rossel, chief executive of Families Together of Orange County, adding his center has inoculated 95 percent of its patients age 65 and over.

Health centers watched in dismay as vaccine for health care workers initially went to larger hospitals in December. Then they watched as more affluent, internet-savvy English speakers with time to navigate web portals and drive long distances for appointments flocked to inoculation arenas.

When Orange County started opening large-scale vaccination sites in mid-January, community health centers asked for doses too, said Isabel Becerra, chief executive of the Coalition of Orange County Community Health Centers.

“We don’t have transportation. We don’t speak English. We don’t understand the technology you’re asking us to use to register and get in line. So, can we vaccinate the 65 and older population in the comfort of their own facilities?” she said.

Jodie Wingo, interim president of the community health association for Riverside and San Bernardino counties, said member clinics were scaling up to inoculate more of their 500,000 patients. But now they’re receiving only a few dozen doses at a time.

“Everybody is working toward equity, yet it doesn’t look equitable. At all,” she said.

AltaMed, in Los Angeles and Orange counties, recently started receiving 3,000 doses a week from the two counties. The supply should allow clients like Parada, who is originally from Mexico, to receive her vaccine this month.

AltaMed will send a vehicle to take her to a clinic for the shot that will protect her when she heads out, double-masked, to shop for the family.

“I’m the one who has to go out. I have to protect myself,” she said.

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