Need to vent? Turn to real-life support, not social media

social support

Social media may make it easier for people to engage online, but I does not provide certain benefits of real-life human interactions, says a Michigan State University researcher.

“Problematic social media use has been associated with depression, anxiety and social isolation, and having a good social support system helps insulate people from negative mental health,” said Dar Meshi, an assistant professor in the Department of Advertising and Public Relations at MSU. “We wanted to compare the differences between real-life support and support provided over social media to see if the support provided over social media could have beneficial effects.”

The research was published online April 29 in the journal Addictive Behaviors.

While social media support did not negatively impact mental health, it did not positively affect it either.

“Only real-life social support was linked to better overall mental health,” Meshi said. “Typical interactions over social media are limited. We theorize that they don’t allow for more substantial connection, which may be needed to provide the type of support that protects against negative mental health.”

Meshi and Morgan Ellithorpe, an assistant professor in the Department of Communication at the University of Delaware and a co-author on this paper, conducted a survey of 403 university students to identify how problematic their social media use was and their degree of social support in real-life and on social media.

By also using the PROMIS, or Patient-reported Outcomes Measurement Information System, scales for measuring depression, anxiety and social isolation, the researchers could see how the students’ social media use and social support related to their mental health.

Problematic social media use is not a recognized addictive disorder, but there are similarities in the symptoms of someone with a substance use disorder and a person displaying excessive social media use. Examples include preoccupation with social media and signs of withdrawal, such as irritability, when prevented from using social media.

“It appears that the more excessive one’s social media use is, the less social support that person gets in real life, which leads to poor mental health,” Ellithorpe said.

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COVID-19’s parallel pandemic: Why we need a mental health ‘vaccine’

COVID-19’s parallel pandemic: Why we need a mental health 'vaccine'

Younger people are at lower risk of severe health outcomes if they develop COVID-19, and are therefore not a priority group for vaccine rollout. However, a silent mental health pandemic wave is in full force, and this time it is targeting younger age groups.

It is well recognized that older age groups (ages 60+) are at increased risk of severe illness and death if they develop COVID-19. As such, several regions are rolling out vaccines according to age, with priority for older adults.

The pandemic’s mental health impact by age

The pandemic’s impact on mental health throughout our society will likely outlive COVID-19. As clinical psychologists and trauma researchers, our team is interested in understanding mental health risk and resilience factors during COVID-19. In terms of high-risk groups from a mental health perspective, early evidence suggests that the age trends are inverted, where younger people are at the highest risk of poor mental health outcomes.

Our recent study published in the Canadian Journal of Psychiatry looked at early anxiety symptoms during the pandemic. In close to 50,000 Canadians across several age groups, we showed this trend.

There were clinically significant levels of anxiety in 36 percent of younger Canadians (ages 15-34), followed by 27.1 percent of people aged 35 to 54, and finally 14.5 percent of those 55 and older. Younger people also had more COVID-19 worries compared to older groups.

These early trends of age-related differences in mental health symptoms have also been shown in other studies, both COVID-19 specific studies and pre-COVID-19 research. Indeed, our previous research has shown that older adults have lower rates of common mental disorders such as anxiety and depression.

One theory is that older adults have advanced cognitive and behavioral strengths that allow them to have greater emotion regulation. These strengths are developed over time as a result of age-related changes in perspective.

From this viewpoint, older adults may have a learned “antibody” against the COVID-19 mental health impacts. Nonetheless, despite these apparent strengths in older groups, mental health symptoms are elevated across all ages compared to pre-COVID times.

Pandemic mental health ‘vaccination’

As with the development of the vaccine to reduce the physical health impacts of the pandemic, we must also consider how to address the mental health impacts. If we had a mental health “vaccine,” what might that look like? Based on the research related to collective or mass traumas (traumas affecting large groups of people), we are best suited to aim for secondary prevention.

Secondary prevention means reducing the effects of a disease when the disease is already present in its early form. Essentially, it means preventing it from worsening. In the context of mental health, this would mean targeting mental health symptoms early in order to decrease major long-term effects.

Early intervention research suggests that cognitive behavioral therapies (CBTs) can be especially effective at reducing the risk of worsened mental health issues. It may be appropriate to implement a “CBT-vaccine” for those showing early elevated symptoms. If so, younger people would be a high-risk group to target for priority prevention.

Younger people have higher rates of anxiety and other mental health problems. There is also early evidence to suggest that when mental health symptoms are present, younger people may have worse outcomes than older groups (similar to current poorer physical outcomes we are seeing when older adults develop COVID-19), but this research is mixed.

What we do know is that mental health problems, especially when long-lasting, can have a major impact on quality of life, daily functioning and physical health, including illness onset and death, for all ages. Longstanding issues may result in loss of employment and are costly for our health-care system.

Mental health must be a priority across all ages, but may be especially important in younger people. We need to engage in similar efforts toward applying a widely accessible mental health “vaccine” as we are doing for the COVID-19 vaccine if we truly want to get all elements of this pandemic under control.

Unfortunately, for many, receiving scientifically supported treatments delivered by a qualified mental health professional is a luxury. Services are difficult to access, especially during this time when the need is higher. Long term, we must continue investing in mental health professionals to meet the service needs of the population.

The initial dosage is digital

Due to the limited supply of qualified mental health professionals, a good place to start may be providing widely accessible and scientifically supported online CBT programs. This would eliminate difficult decisions regarding prioritizing access to care.

Although people recognize the current need for mental health supports, there has been confusion regarding available resources. Uptake has also been low to moderate for publicly funded online mental health programs. In a nationally representative Canadian study conducted in late May, only two percent of Canadians reported using virtual mental health resources.

Publicly funded programs such as Wellness Together and AbilitiCBT are also limited by the duration and frequency of usage available, and there is little scientific information about understanding how these pandemic-specific programs may reduce mental health symptoms, and who might benefit the most. Internet or app-based CBT programs widely vary in terms of content, level of engagement and how effective they are. In a recent publication on digital advancements in mental health, the authors accurately state: “We applaud investments in virtual mental health services by governments and industry but caution that a thoughtful approach is needed to direct those resources to realize its full potential.”

Providing effective online self-guided programs could potentially keep milder mental health cases out of the queue for one-on-one treatment with a mental health professional. This would create greater opportunities for more complex and severe cases to receive intensive individual treatments. Several existing online programs targeting specific mental health symptoms are supported by large numbers of clinical trials such as This Way Up.

However, they are occasionally costly and it is challenging for consumers to know which programs are scientifically supported and effective, especially with the massive increase of online programs and apps in the past decade. The responsibility should not fall on consumers to figure that out. Think of it this way—we would never ask people to go figure out which COVID-19 vaccine or treatment is best. Health professionals make clear recommendations based on existing well designed clinical trials.

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The Candle Scents You Should Burn If You Need To Relax

Over the past year we’ve spent way more time in our homes than we anticipated, so it’s no surprise that 2020 saw a surge in candle sales. “Home scent has been a strong performer all year,” Larissa Jensen, vice president and beauty industry advisor for market researcher The NPD Group, told CNBC in December. “All of that’s really tied to the fact that we are more homebound than ever.”

Lighting candles before we settle in with a good book or TV show is relaxing in itself. But certain scents are associated with relaxation and even reduced anxiety — so those are the candle scents you’ll want to light when you really need to relax.

Lavender is the perfect example. According to Medical News Today, a recent study found that the scent has calming properties that help ease anxiety. Another scent to light when you’re stressed is rose. A study published in the journal Natural Product Communications found that smelling rose oil decreased the breathing rate and blood pressure of participants.

There are other relaxing candle scents to try

Another scent that promotes relaxation is lemon. In fact, one study found that, in essential oil form, lemon is actually more effective for stress relief than lavender and rose (via Behavioural Brain Research).

Then there’s jasmine. This scent has been touted as the perfect natural remedy for anxiety and depression for years. One study (via Science Daily) even suggested that it could be used as a substitute for prescription valium, which is used to treat anxiety.

A eucalyptus candle also might be just what the doctor ordered after a stressful day. Per Healthline, eucalyptus is known for being a stress and anxiety reducer.

Finally, candles scented with bergamot, a citrus fruit, definitely belong in your relaxing candles collection. According to Medical News Today, studies have found that bergamot aromatherapy reduces anxiety.

It’s also worth noting that all these scents are available as essential oils, which can be used in a variety of ways — in a diffuser, in a steam, simply smelled from the bottle, diluted and applied directly to the skin, and more (Cleveland Clinic).

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Why do we need booster shots, and could we mix and match different COVID vaccines?

Why do we need booster shots, and could we mix and match different COVID vaccines?

The COVID vaccine rollout is now underway in Australia and around the world. It’s incredible we’ve been able to develop and produce safe and effective vaccines so quickly—but the current crop of vaccines might not protect us forever.

Fortunately, researchers are already developing and testing booster shots. So what are booster shots, and when might we need them?

First a prime, then a boost

The first time you give someone a dose of vaccine against a particular infection, it’s called a prime. You’re getting your immune response ready to roll.

Each time you give another dose against that same infection, it’s called a boost. You’re building on immunity you already have from the first dose.

Importantly, giving smaller doses in multiple shots is often better than a large dose of vaccine in a single shot. This is because our immune system builds on our immunity like bricks in a wall; each level needs to be laid before the next layer is built.

Booster shots take advantage of a phenomenon called “immunological memory”. Our immune cells essentially remember vaccines we’ve previously received, and respond much more quickly and vigorously to subsequent shots, building our immunity to levels at which we can be confident we’ll be protected.

When might I need a boost?

There are three different situations in which you might need a boost.

First, several doses of a vaccine can be given relatively quickly, one after another, to rapidly build someone’s immunity against a given infection. A good example is the whooping cough vaccine. It’s initially given at around two, four and six months of age to rapidly build immunity in infants, who are most at risk from whooping cough.

This is also the approach most COVID vaccines use. The first shot gets your immune system going but immunity is unreliable. The second shot leads to more consistent protection.

Second, we can give a booster shot if immunity drops over time, or “wanes,” to restore someone’s immunity to optimal levels. For example, we know immunity to tetanus can drop over time, so we recommend tetanus boosters every ten years.

Immunity appears to be strong three months after the Moderna vaccine and six months after the AstraZeneca vaccine, but we don’t yet have a full picture of how long immunity to COVID-19 lasts after vaccination. Scientists will continue to monitor this to determine if and when we’ll need these type of boosters for COVID.

Third, if the virus “mutates” or changes substantially over time, this can make it challenging for our immune cells to recognize the virus, effectively lowering our immunity again. A good example here is the influenza vaccine. The ‘flu virus can change a lot from year to year so, to make sure immunity remains high, we give annual boosters tailored to new strains.

On the front foot with viral variants

SARS-CoV-2, the virus that causes COVID-19, has already undergone a number of changes. We’re still learning how this might affect the efficacy of different vaccines.

But vaccine manufacturers are already adjusting their COVID vaccines to better target new variants. Moderna, for example, has just administered the first doses of an updated vaccine to volunteers in a new clinical trial. They’re intending to find out how well it works against B.1.351, the variant first identified in South Africa.

The updated vaccines tweak the “antigen”—the molecule used by our immune cells to target a specific virus. But they can use the same basic design and manufacturing processes.

As a result, they probably won’t have to go through the full gamut of clinical testing again. Regulatory hurdles are similarly streamlined with updated ‘flu vaccines.

Rapid development of these updated vaccines will put us on the front foot in our fight against COVID-19.

More of the same, or something a little different?

With boosting, you can end up with a higher level of immunity if you wait longer between doses. This is because our immune cells need a rest before they can respond to additional doses. We’ve seen this with the AstraZeneca vaccine where a longer delay between doses, up to 12 weeks, leads to much better protection.

It’s also possible we could generate greater immunity if we use different vaccines, one after the other, rather than repeating the same vaccine. This is called heterologous prime boosting.

We’re not sure why a mix-and-match approach can be more potent. But it’s possible combining two different vaccines—which give the same antigen target but stimulate the immune system in different ways—could better focus our immune cells’ attention on the right target.

We haven’t really taken advantage of heterologous vaccines in real-world settings yet. The first clinical heterologous vaccine was an Ebola vaccine approved in May 2020, while the Sputnik V COVID vaccine is also a heterologous vaccine.

But that could change. While there are now multiple approved COVID vaccines, vaccine rollout has been challenging. In the United Kingdom, the official policy is to use the same vaccine for both shots. But if the vaccine used for the first shot is not known or not available, people can still receive a booster with what is available.

Meanwhile, a clinical trial in the UK is evaluating the immune response when the Pfizer vaccine is followed by the AstraZeneca vaccine, and vice versa, as compared two doses of the same vaccine.

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Bushfire volunteers need more support after answering the call

bushfire

It’s a largely overlooked aspect of mental health care that needs swift resolution—which is why volunteers are being asked by Flinders University’s Professor Sharon Lawn and David Lawrence from The University of Western Australia to participate in a study that aims to map out a better support solution.

“People I’ve met already are everyday members of communities directly and indirectly affected by the fires who pitched in to support each other—but in many cases that hasn’t been enough,” says Professor Lawn, who specializes in mental health research and is also the lead Mental Health Commissioner for South Australia.

“Often mental health issues develop slowly over a period of months or years. We know that many first responders in need of help often avoid seeking help in a timely fashion or don’t receive enough help for their needs. Volunteers are likely to reach out to family and friends first, and fellow volunteers and others in their communities, rather than reaching out to more formal supports.”

Professor Lawn will be continuing interviews with bushfire volunteers until the end of March 2021.

What has been learnt so far about supporting the wellbeing of emergency services personnel—identified in the report “Answering the Call: the first National Mental Health and Wellbeing Study of Police and Emergency Services”, on behalf of Beyond Blue—is that cumulative exposure to traumatic events can have negative consequences over the course of someone’s career and life, and emergency services personnel are at higher risk of developing mental health issues than the general population.

“The overwhelming majority of volunteers and paid firefighters do what they do because they want to serve their communities and help in times of need,” says Professor Lawn. “They care about their communities—and they are likely to be impacted, as anyone would be, when they witness disasters befalling their communities.

“One critically important factor is recognizing changes in wellbeing early and seeking help when it is needed.”

Following the devastating 2019-20 bushfires, the Australian Government provided additional funding through the Medical Research Future Fund to support continuing research into the ongoing wellbeing of volunteer and paid first responders.

Now, through working with the Bushfire and Natural Hazards Cooperative Research Centre, Professor Lawn and her co-researchers will ensure their new information helps develop strategies and programs to most effectively support the wellbeing of Australia’s first responders.

“A challenge for our future bushfire preparedness is sustaining a volunteer workforce of sufficient size and capacity to be able to respond to large-scale events without overtaxing volunteers to the point where they are at risk of burnout,” says Professor Lawn.

She believes the answer requires two areas of attention—maintaining the existing volunteer workforce through providing necessary support, training and resources, and also recruiting and training new volunteers to meet the increasing demands of more intense fire seasons.

Over the next two years, the researchers will continue to connect with communities, to help understand what is needed to effectively support the long-term wellbeing of volunteer and paid firefighters, and how to foster their ability to cope both now and into the future.

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The Delayed Side Effect Of The Moderna Vaccine You Need To Know About

As of February 11, 2021, Moderna had provided the United States with over 41 million doses of the 300 million it has committed to giving the country. And, according to Moderna, over 22 million Americans had received at least one dose of its vaccine.

If you’re one such vaccine recipient, or if you are about to become one, you may be noticing delayed reactions at the Moderna vaccine where a healthcare professional injected it. In a recent letter to the New England Journal of Medicine, doctors noticed that just under 1 percent of study participants in a phase 3 clinical trial of the Moderna vaccine (244 of 30,420 patients) developed reactions at the vaccine’s injection site, eight or more days after receiving their first vaccine dose. Such reactions included red, inflamed and tender skin. Of all participants, 0.2 percent developed similar reactions after a second vaccine dose.

A total of 12 patients developed skin rashes between 4 and 11 days after the first dose, and, significantly, after “initial local and systemic symptoms associated with vaccination” had already cleared. “For most people who are experiencing this, we believe it’s tied to the body’s immune system going to work,” letter co-writer Esther Freeman said in a statement released by Massachusetts General Hospital.

Should you be worried if you get a rash after a dose of Moderna?

Did you develop a rash after getting your first dose of the Moderna vaccine? Freeman, the director of Global Health Dermatology at Massachusetts General Hospital, doesn’t think that developing a skin irritation should prevent you from getting your second dose of the vaccine. Moreover, says letter co-author Erica Shenoy, associate chief of Mass General Hospital’s Infection Control Unit, such rashes and skin hypersensitivity “could be confused — by clinicians and patients alike — with a skin infection” (via Massachusetts General Hospital). But, in the case of the study reported on in The New England Journal of Medicine, treating the rashes with antibiotics was ineffective. Instead, patients who developed skin reactions to Moderna were treated effectively with ice and antihistamines. More severe cases required corticosteroids. 

There’s more good news. If you develop rash after taking Moderna, Freeman and Shenoy’s research indicates that you probably won’t have to deal with the symptoms in the longterm. The 12 vaccine recipients with skin irritations mentioned in the New England Journal of Medicine saw their symptoms clear up, on average, after “nearly a week.”

You shouldn’t necessarily be alarmed if you develop a skin reaction after your second dose of the Moderna vaccine, either. Six of the 12 patients mentioned in the New England Journal of Medicine letter went on to develop a subsequent reaction after a second vaccine dose. According to a Massachusetts General Hospital’s statement, none of these reactions “was more severe than their dose one reaction.”

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Here’s What You Need To Know Before Using Rose Quartz

Rose Quartz is one of the most beautiful crystals that a person can have in their collection. In addition to its gorgeous color, it is also said to release strong vibrations that can benefit your life in a number of ways. Healing Crystals For You reports that Rose Quartz is available in multiple shades of pink, hence its colorful name. They come in all shapes and sizes, and may even be transparent. These stones hail from deposits in many countries including Brazil, Japan, and South Africa. However, they can also be found in the state of South Dakota.

According to Healthline, the use of the stone dates back to 7,000 BC. Evidence suggests that Egyptian and Roman women alike would use the crystal in their face masks due to its anti-aging properties. Of course, there are plenty of other uses for the gem. The stone is a must-have for anyone looking to use crystal energy in their lives. However, there are a few things that you should know before incorporating Rose Quartz into your routine.

Rose Quartz has many benefits

Rose Quartz is said to be a powerful crystal that includes a multitude of benefits and should be treated as such. The first thing you need to do before using the stone is to cleanse it of all negative energy. The easiest way to do so is by smudging it with the smoke from sage. There are a wide variety of uses for the gem, but the most common is love. The crystal is often called the “love stone,” and can be used in hopes of healing relationship problems, inspiring kindness and understanding, and as a form of self-care.

“Predominantly, rose quartz is a crystal of unconditional love that brings deep healing to the heart by opening the heart chakra. Once achieved, a deeper state of calmness, serenity, and peace is reached, which ultimately results in complete relaxation, encouraging the feelings of happiness and contentment,” owner of KSC Crystals and reiki master, Keith Birch, told Healthline.

Of course, others use the stone to meditate with, and even to clear their complexion. It’s also said that Rose Quartz can help with the power of positivity. “Rose quartz increases blood circulation in the body and is especially powerful when worn close to the heart. Rose quartz wards off negativity, and when carried on your person, helps to replace negative emotions with positive, returning the wearer to that place of pure love and balance,” Birch said.

How to incorporate Rose Quartz into your life

According to Tiny Rituals, there are plenty of ways in which you can incorporate Rose Quartz into your life. Using a Rose Quartz facial tool like Demi Moore could improve your skin. Meanwhile, wearing jewelry such as a necklace, bracelet, or ring made from the stone will help you attract love, joy, and abundance. The gem can also be placed around your home or office to give it good vibes and energy. It’s a popular choice when looking to Feng Shui your space, and could work wonders for opening up your heart chakra. You can even add it to your bath water to give yourself an extra boost.

Sleeping with the crystal under your pillow is another way to gain from its properties. Doing so reportedly helps you feel more energized when you wake up and increases your sense of inner peace and positivity. “Rose Quartz is widely known for its ability to improve sleep and have soothing dreams. When using a Rose Quartz crystal for better sleep and peaceful dreams, it is best advised to focus on what type of feelings you’d like the Rose Quartz to achieve before you actually go to sleep. This will help your subconscious to vibrate this energy to cooperate with the Rose Quartz stone for achieving best effects,” Calming Cosmos reports.

Now that you know all about the benefits of Rose Quartz, it’s time to choose one that best suits your life!

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Will we need COVID-19 booster shots? Study considers more vaccinations

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As people across Maryland and the country seek their first dose of COVID-19 vaccine, Jean Armstrong got her third.

The Baltimore County public school administrator was one of the first people to get a pair of shots of the Pfizer/BioNTech vaccine last May as studies began to test its safety and efficacy. She returned this week to the University of Maryland in Baltimore to help researchers understand whether a booster could continue to keep her from getting seriously sick from the coronavirus.

“I’m a believer in vaccines and think they work, and it’s important to be involved,” Armstrong said of her willingness to be vaccinated again. “It seems like realistically we have to be prepared for boosters and vaccines for variants.”

Researchers and vaccine manufacturers are actively preparing for the possibility that people will need to get another vaccination or regular ones to keep at bay the current coronavirus or a mutated and more nefarious version.

The vaccines now approved for use are considered highly effective at staving off infection, particularly severe infection, but no one knows how long immunity lasts. It’s widely believed that it wanes at least somewhat over time.

And data is beginning to show that the vaccines are at least somewhat less potent against emerging variants. There are several now widely circulating, including ones discovered first in South Africa, Brazil and the United Kingdom. Others with potentially concerning mutations have been logged in the United States in California and most recently in New York.

The research seeks to answer some questions and “grease the wheels” for others, said Dr. Kirsten E. Lyke, who is helping oversee the study at the University of Maryland School of Medicine’s Center for Vaccine Development and Global Health.

Specifically, Lyke, director of the Malaria Vaccine and Challenge Unit, said researchers will look at immunity before and after a booster, which is a regular dose of the Pfizer vaccine. They also will assess how well people tolerate another shot.

Twenty-four hours after her third shot, Armstrong, a Harford County woman in her 40s, said she’s not had side effects except a bit of arm soreness. She had more flu-like symptoms from the first two shots she received last May.

Federal regulators gave the Pfizer vaccine authorization for emergency use in December after a remarkably speedy development period of just months rather than years. It continues to be evaluated for full approvals.

A similar vaccine from Moderna also has been authorized and a third from Johnson & Johnson is expected to get the go-ahead for use within days.

All are considered highly effective against severe disease. Researchers say, however, that the public may need another shot eventually. People may even need to have annual shots, as they do for the flu.

The vaccine makers are preparing for that possibility now, as well as moving quickly to adapt the vaccines for variants.

The U.S. Food and Drug Administration offered guidance this week to assure the public that the adapted vaccines will be tested, but the process won’t be delayed. The vaccine makers will be permitted to do small-scale studies of maybe a few hundred people to test the upgrades, rather than repeat large studies with tens of thousands of people for each vaccine.

“We know the country is eager to return to a new normal and the emergence of the virus variants raises new concerns about the performance of these products,” said Dr. Janet Woodcock, acting FDA commissioner, in a statement. “By issuing these guidances, we want the American public to know that we are using every tool in our toolbox to fight this pandemic, including pivoting as the virus adapts.”

Pfizer and Moderna both said this week that work is underway.

Pfizer said Thursday that it was studying a third dose in its initial phase 1 participants, who include Armstrong, to evaluate the safety and tolerability of a booster shot of the existing vaccine. The vaccine was initially tested at four sites, including Maryland.

That study also will inform efforts to adapt the vaccine to address emerging variants, said officials with the New York-based pharmaceutical giant.

“While we have not seen any evidence that the circulating variants result in a loss of protection provided by our vaccine, we are taking multiple steps to act decisively and be ready in case a strain becomes resistant to the protection afforded by the vaccine,” said Albert Bourla, Pfizer chairman and CEO, in a statement.

“This booster study is critical to understanding the safety of a third dose and immunity against circulating strains,” he said.

Moderna is following a similar path, and its officials said this week that the Massachusetts drugmaker already had sent a vaccine adapted for the variant found in South Africa to the National Institutes of Health for study.

The officials said the company would update its vaccine as many times as necessary.

“As we seek to defeat COVID-19, we must be vigilant and proactive as new variants of SARS-CoV-2 emerge,” said Stéphane Bancel, Moderna CEO, in a statement. “Leveraging the flexibility of our mRNA platform, we are moving quickly to test updates to the vaccines that address emerging variants of the virus in the clinic.”

At the University of Maryland, the first few people out of the hundreds who initially participated in the phase 1 trial got their third dose this week

All of those participants are being followed for more than two years as part of the FDA’s final approval process for the vaccine. Armstrong said she was surprised to be called back already for another shot, but wanted to help researchers as the pandemic evolved.

Despite her discomfort with needles, she had agreed to participate in another study years before, one that produced a vaccine for the H1N1 flu outbreak in 2009. She volunteered again last year.

Scientists don’t know why some people have more adverse reactions than others. The previous COVID-19 shots had given Armstrong chills, body aches and a fever, which are typical and normally short-lived responses.

“I was pleasantly surprised this time,” she said. “It’s 24 hours later and my arm hurts just a little bit. It’s been easy so far.”

Lyke said that as researchers were searching initially for the right vaccine makeup and dose, participants were given any of four versions of the Pfizer vaccine in three different amounts. Others were given a placebo, but they have since been fully vaccinated.

She said all the versions induced an immune response in people, but by June researchers had narrowed the vaccine and dose to the most effective and best-tolerated one.

Messenger RNA vaccines had long been studied for infectious diseases and even cancer, but the technology had never been approved for use. Instead of weakened or dead virus, mRNA vaccines deploy a bit of the virus’ genetic code to instruct cells to produce more of the viral protein, which in turn induces an immune response. The resulting antibodies fight the virus when they later come into contact with it.

All participants getting a booster shot at Maryland are at least six months past their second vaccination. Researchers took blood before and after the latest shots to determine the effects.

“If the immune response waned we’d know they needed a booster,” Lyke said. “And we wanted to see how they would respond to a booster, meaning they tolerated it and had another good immune response.”

She said it’s unknown whether anyone will need a booster, will need seasonal boosters or will need adapted shots for variants.

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Under a Boil Water Advisory? Here’s What You Need to Know—Including What You Can (and Can’t) Do

What-You-Can-and-Can't-Do-During-A-Boil-Water-Advisory-GettyImages-152537775

Millions of Texans remain under a boil-water advisory following a week of freezing temperatures and storms that have pushed state water supplies beyond their limits. More than 700 water supply systems were affected by leaks caused by frozen pipes, reported CNN.

During a press conference on Thursday, Austin Water Director Greg Meszaros said the state capital's water supply lost 325 million gallons of water due to burst pipes. "We know that there are tens of thousands of leaks," he said. "As the fire department indicated they have responded to thousands upon thousands of burst pipes. That is an incredible amount of water. Nothing I've ever seen before."

Lights and heat came back on Friday morning, but some 187,000 customers remain without power and millions still have no water at all or are being told to boil their water to make it safe to drink, reported NPR. According to Houston Mayor Sylvester Turner, the city's residents will probably have to boil water until Sunday or Monday. If you're not familiar with a boil-water advisory, here are some answers to the most common questions.

First: Why are boil water advisories issued?

According to the Centers for Disease Control and Prevention (CDC), local health authorities issue boil water advisories when the community water supply is (or could be) contaminated with germs that can make you sick.

These boil water advisories often result from unplanned events like water line breaks, treatment disruptions, power outages, and floods, per the New York State Department of Health.

How long do you need to boil water during an advisory?

Boiling is the safest method for making water safe for drinking or cooking. "In a large clean pot or kettle, the water should be brought to a rolling boil for one full minute," Tamika Sims, PhD, senior director in food technology communications at the International Food Information Council, tells Health. "Before you drink or expose your skin to the water, be sure to let it cool down to a safe temperature."

Do you have to boil water if you have a filter?

Water filters remove bacteria, hardness, and unwanted impurities from water, such as sediment, taste, and odor, to improve its quality. But a filter can't remove microorganisms or other contaminants from contaminated water, so you should still boil the water, Sims says.

Can you shower during a boil water advisory?

You can, but it's extremely important you but take care not to swallow any of the water. "During times of inclement weather, there can be low water pressure in the pipes. With this, the groundwater, which is generally not treated against harmful bacteria, viruses, and parasites, can seep into older pipes that have cracks in them," Vidya Mony, MD, infectious disease expert at Santa Clara Valley Medical Center in Fruitdale, California, tells Health.

"These harmful pathogens can then be swallowed when the bath or shower is turned on and make you sick," Dr. Mony adds. "This is why it's very important to not swallow any water while taking a bath or shower. It is also important that for children and people with disabilities [to be] supervised during their bath, to ensure that water is not swallowed and to limit the amount of time bathing."

If you need to bathe infants or young children during a boil-water advisory, the CDC suggests giving them a sponge bath to reduce the chance of them swallowing water.

Can you brush your teeth during a boil water advisory?

Not with your tap water, per the CDC. You should use bottled or boiled water for this, since it's so easy to swallow water while brushing your teeth.

Can you wash dishes during a boil water advisory?

The CDC recommends using disposable plates, cups, and utensils whenever possible during a boil-water advisory. If washing dishes is a priority during a boil-water advisory, you can use treated (boiled) water, Sims says. In fact, she adds that all water of uncertain quality should be treated before using it for any purpose where you have the potential of ingesting it, including washing dishes, drinking, food washing/preparation, brushing teeth, or making ice.

Can you wash clothes during a boil water advisory?

Good news here: It's still safe to wash clothes as normal during a boil-water notice, per the CDC—but you have to make sure they're completely dry before you wear them. If you're under a 'Do Not Use' advisory, however, you should not use water for anything, including washing clothes.

I accidentally drank some water that wasn’t boiled—what should I do?

First of all, don't panic. "Generally, the chance of becoming ill after accidentally drinking contaminated water is quite low," Dr. Mony says. However, people who have chronic illnesses, recent skin infections or wounds, or are immunocompromised are at high risk of infection.

"The most frequent signs of an infection after drinking contaminated water are those of the gastrointestinal system," Dr. Mony explains. "You can have abdominal pain, vomiting, diarrhea, and abdominal cramps, with or without fevers. Should you have these types of symptoms, it is important to seek medical care."

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The ACA Marketplace Is Open Again for Insurance Sign-Ups. Here’s What You Need to Know.

For people who’ve been without health insurance during the pandemic, relief is in sight.

In January, President Joe Biden signed an executive order to open up the federal health insurance marketplace for three months as of Monday so uninsured people can buy a plan and those who want to change their marketplace coverage can do so.

Consumer advocates applauded the directive. Since 2016, the number of Americans without health insurance has been on the rise, reaching 30 million in 2019. The economic upheaval caused by the novel coronavirus has made a bad situation worse, throwing millions off their insurance plans.

The move is in stark contrast to the Trump administration’s approach. As covid-19 took hold last spring and the economy imploded, health experts pleaded with the Trump administration to open up the federal marketplace so people could buy insurance to protect themselves during the worst public health emergency in a century. The administration declined, noting that people who suddenly found themselves without coverage because they lost their jobs were able to sign up on the marketplace under ordinary rules. They also cited concerns that sick people who had resisted buying insurance before would buy coverage and drive up premiums.

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The Biden administration is promising to spend $50 million on outreach and education to get the word out about the new special enrollment period. That’s critical, experts said. Although the number of people signing up for Affordable Care Act plans has generally remained robust, the number of new consumers enrolling in the federal marketplace has dropped every year since 2016, according to KFF, corresponding to funding cuts in marketing and outreach. (KHN is an editorially independent program of KFF.)

“There are a lot of uninsured people who even before covid were eligible for either hefty marketplace subsidies or for Medicaid and not aware of it,” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. A marketing blitz can reach a broad swath of people and hopefully draw them in, regardless of whether they’re uninsured because of covid or not, she said.

Here are answers to questions about the new enrollment option.

Q: When can consumers sign up, and in which states?

The sign-up window will be open for three months, from Monday through May 15. Uninsured residents of any of the 36 states that use the federal healthcare.gov platform can look for plans during that time and enroll.

Most of the states and the District of Columbia that operate their own marketplaces are establishing special enrollment periods similar to the new federal one, though they may have somewhat different time frames or eligibility rules. In Massachusetts, for example, the sign-up window remains open until May 23, while in Connecticut, it closes March 15. Meanwhile, Colorado has reopened enrollment in its marketplace for residents who lack insurance, but anyone already enrolled in one of the state’s marketplace plans won’t be allowed to switch to a different plan until the regular open enrollment period in the fall.

At this point, only Idaho has not announced plans to open their marketplaces, said Corlette. It may still do so, however.

Q: Can people who lost their jobs and health insurance many months ago sign up during the new enrollment period?

Yes. The enrollment window is open to anyone who is uninsured and would normally be eligible to buy coverage on the exchange (people who are serving prison or jail terms and those who are in the country without legal permission aren’t allowed to enroll).

People with incomes up to 400% of the federal poverty level (about $51,500 for one person or $106,000 for a family of four) are eligible for premium tax credits that may substantially reduce their costs.

Typically, people can buy a marketplace plan only during the annual open enrollment period in the fall or if a major life event gives them another opportunity to sign up, called a special enrollment period. Losing job-based health coverage is one event that creates a special sign-up opportunity; so is getting married or having a baby. But usually people must sign up with the marketplace within 60 days of the event.

With the new special enrollment period, how long someone has been uninsured isn’t relevant, nor do people have to provide documentation that they’ve lost job-based coverage.

“The message is quite simple: Come and apply,” said Sarah Lueck, a senior policy analyst at the Center on Budget and Policy Priorities.

Q: What about people who are already enrolled in a marketplace plan? Can they switch their coverage during this new enrollment period?

Yes, as long as their coverage is through the federal marketplace. If, for example, someone is enrolled in a gold plan now but wants to switch to a cheaper bronze plan with a higher deductible, that’s allowed. As mentioned above, however, some state-operated marketplaces may not make that option available.

Q: Many people have lost significant income during the pandemic. How do they decide whether a marketplace plan with premium subsidies is a better buy for them than Medicaid?

They don’t have to decide. During the application process, the marketplace asks people for income information. If their annual income is below the Medicaid threshold (for many adults in most states, 138% of the federal poverty level, or about $18,000 for an individual), they will be directed to that program for coverage. If people are eligible for Medicaid, they can’t get subsidized coverage on the exchange.

People can sign up for Medicaid anytime; there’s no need to wait for an annual or special enrollment period.

Those already enrolled in a marketplace plan whose income changes should go back into the marketplace and update their income information as soon as possible. They may be eligible for larger premium subsidies for their marketplace plan or, if their income has dropped significantly, for Medicaid. (Likewise, if their income has increased and they don’t adjust their marketplace income estimates, they could be on the hook for overpayments of their subsidies when they file their taxes.)

Q: What about people who signed up under the federal COBRA law to continue their employer coverage after losing their job? Can they drop it and sign up for a marketplace plan?

Yes people in federal marketplace states can take that step, health experts say. Under COBRA, people can be required to pay the full amount of the premium plus a 2% administrative fee. Marketplace coverage is almost certainly cheaper.

Normally, if people have COBRA coverage and they drop it midyear, they can’t sign up for a marketplace plan until the annual fall open enrollment period. But this special enrollment period will give people that option.

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