Covid News Watch
Congress Must Modernize Our Approach to Rare Vaccine Injuries + More
Congress Must Modernize Our Approach to Rare Vaccine Injuries
One important ongoing way to combat vaccine hesitancy is to ensure consumers are swiftly and fairly compensated should they suffer a rare vaccine-related injury, an injury usually caused by an error in the administration of the vaccine, rather than the vaccine itself.
To provide such compensation, in 1986, Congress established the National Vaccine Injury Compensation Program (VICP), a no-fault alternative to the traditional legal system that reimburses consumers for vaccine-related injuries. While I strongly disagree with dangerous anti-vax misinformation campaigns, I believe those who suffer rare injuries associated with vaccines, including COVID-19 vaccines, deserve compensation for medical bills and other losses.
Unfortunately, for the few who have suffered adverse effects from the COVID-19 vaccine, fair compensation is being delayed and denied. Due to the unique circumstances in which that vaccine was approved, COVID-19 claims are being considered under a separate, inadequate process known as the Countermeasures Injury Compensation Program (CICP). The CICP has far fewer consumer protections and no judicial review. It is still very slow and provides very inadequate compensation. Of the few COVID-19 claims processed by the CICP, payments have been made for only four — each less than $4,000.
Compensation under the VICP accounts for medical costs, any work-loss compensation, and damages. Outrageously, after decades, the damages cap has never been increased — leaving too many consumers without sufficient protection. Our legislation would raise the cap in line with inflation and index it moving forward.
Biden’s Fall COVID Vaccine Rollout for the Uninsured Won’t Include Pharmacies at First
The Biden administration’s effort to provide free COVID-19 vaccines to the uninsured will not start at retail pharmacies until mid-October, weeks after the government plans to make an updated version of the shot available to the broader public.
The gap in timing, which comes as COVID hospitalizations have ticked up in recent weeks, means that millions of Americans without health coverage will not be able to immediately get a no-cost vaccine at popular places like CVS and Walgreens, even as it will be widely available for those who have insurance.
The CDC expects the updated vaccine rollout to begin the third or fourth week of September, she said. But the contracts with pharmacies will likely not be finished until mid-October.
The uninsured will instead need to go to federal health centers or individual providers for free vaccines during the first stage of the fall vaccination campaign. That adds a layer of complexity, public health officials warn, that could discourage people from getting the shot.
The CDC Works to Overhaul Lab Operations After COVID Test Flop
In early February 2020, Kirsten St. George and her team at New York State’s public health lab received a test developed by the Centers for Disease Control and Prevention to diagnose people infected with the new, rapidly spreading coronavirus.
But, like many labs around the country, it quickly found the test gave inaccurate results. So test samples had to be sent back to the CDC for processing, wasting time and leaving state officials “sort of blind to what the situation was with the disease,” said St. George, chief of the laboratory of viral diseases at the Wadsworth Center, one of the nation’s largest state public health labs.
An independent panel of laboratory researchers, public health and policy experts, and doctors say the CDC’s flawed diagnostic test was one of the “most consequential” of the agency’s pandemic missteps because it stymied national efforts to contain COVID-19 as the disease spread.
The CDC’s original COVID test had two key problems, according to an internal analysis in 2021 by a group of agency staff. A design flaw and contamination during production at the CDC led the tests to give false positive results.
Which Arm Gets the COVID Booster May Make a Difference, Study Shows
When you go to get your newly updated COVID-19 booster this fall, you might want to choose the arm the vaccine goes in carefully. The immune response may be stronger if your booster goes in the same arm as your last COVID-19 shot, according to a study published on August 11 in the journal eBioMedicine.
“The question seems so banal, so trivial that nobody before has thought to ask it,” study coauthor Martina Sester, a biologist and head of the department of the Institute of Infection Medicine at Saarland University Hospital in Germany, said in a news release.
The researchers used the data of 303 people who received the mRNA vaccine as well as a booster shot as part of Germany’s vaccine campaign. Two weeks after the booster, the number of “killer T cells” was significantly higher in those who had both shots in the same arm, according to the study.
The immune cells are important for quickly destroying the virus, but antibodies are also important to prevent further harm, the study said. And researchers did not find a larger number of antibodies.
CDC Tracking New COVID Variant BA.2.86 After Highly-Mutated Strain Reported in Michigan
The U.S. Centers for Disease Control and Prevention announced Thursday it is tracking a recently discovered COVID-19 strain, BA.2.86 after a case of the highly-mutated variant was discovered in Michigan.
Experts say reports of BA.2.86 being spotted in countries on multiple continents — Denmark, Israel, U.K. and the U.S. — suggest it is at least capable of transmitting widely and could have been spreading undetected for some time.
It comes after the World Health Organization announced it had classified BA.2.86 as a “variant under monitoring” due to its large number of mutations.
This strain’s rapid escalation to the WHO’s “variant under monitoring” category is uncommon. Just three cases had been spotted of the variant worldwide. Virus trackers officially designated the strain as BA.2.86 just a day ago.
The strain’s dozens of genetic changes — an evolutionary jump on par with the emergence of the original Omicron variant in 2021 — have raised eyebrows among virologists as cases have started to crop up around the world. Its mutations include some changes at key parts of the virus that could help it better dodge the body’s immunity from prior infections or vaccination.
Moderna Says New COVID Vaccine Was Effective Against Eris Variant in Early Trial
Moderna’s new COVID vaccine generated a robust immune response against the now-dominant Eris variant and another rapidly spreading strain of the virus in an early clinical trial, the biotech company said Thursday.
The updated shot is designed to target Omicron subvariant XBB.1.5, but the results suggest that the jab may still be effective against newer variants of the virus that are gaining ground nationwide. That includes Eris and another variant nicknamed Fornax, both of which are also descendants of the Omicron virus variant.
Moderna’s vaccine and new shots from Pfizer and Novavax are slated to roll out within weeks, pending potential approvals from the U.S. Food and Drug Administration.
The World Health Organization designated Eris a “variant of interest,” meaning it will be monitored for mutations that could make it more severe. Fornax, or FL 1.5.1, is also beginning to surge in parts of the U.S. It accounted for 8.6% of all cases nationwide as of earlier this month, the CDC said.
U.K. Reports First Case of New COVID Virus Variant
The U.K. Health Security Agency (UKHSA) said on Friday the first case of COVID-19 variant BA.2.86 had been detected in the country in an individual with no recent travel history.
On Thursday, the U.S. Centers for Disease Control and Prevention said it was tracking the new, highly mutated variant of the virus that causes COVID.
The variant has also been identified in Israel, Denmark and the United States.
COVID Booster Jabs Could Go on Sale Privately in U.K. in 2024
COVID booster vaccines may become available for the U.K. public to buy for the first time after health officials reiterated their backing for the proposal.
Pharmacists and private clinics will be allowed to offer jabs for sale on the high street, as they do with the flu vaccine. They are unlikely to be available in time for an autumn booster campaign but could become available next year.
A U.K. Health Security Agency (UKHSA) official said there were “no blanket restrictions” on the private sales of vaccines after scientists backed the move amid concerns over a new wave of the virus that could worsen in autumn and winter.
In addition, sources said health authorities would not prevent manufacturers from initiating a private market for the vaccines. In the U.K., COVID jabs have only been available on the NHS, where they are free at the point of delivery since the first jab was administered in December 2020.
6.5 Million Students Chronically Absent After the Pandemic, New Study Shows + More
6.5 Million Students Chronically Absent After the Pandemic, New Study Shows
Students across the U.S. have been chronically absent in record-high numbers after the COVID-19 pandemic, a new study from Stanford Research shows.
More than 25% of students were classified as chronically absent in the 2021-22 school year because they had missed at least 10% of the school year. Comparatively, before the pandemic, only 15% of students had such high levels of absenteeism, the study noted.
Between the 2018-19 and 2021-22 academic years, the percentage of students classified as chronically absent increased by 13½ points. This increase, which equates to a 91% spike, suggests an estimated 6.5 million more students are now falling into the category of being chronically absent compared to before the pandemic.
“The substantial, negative effects of the COVID-19 pandemic on multiple indicators of well-being and development among children in the United States are increasingly well-documented,” the author of the study, Thomas S. Dee, wrote.
The study, presented in an eight-page report, found that in the hardest-hit states, such as Alaska and New Mexico, nearly 50% of students are absent for a tenth of their classes. Nearly half of the students in Washington, DC, were also virtually AWOL.
Counterpoint: In Defense of Physicians Who Treated COVID With Alternative Approaches
The article “Doctors who threatened the public health still practicing” (a reprint from the Washington Post in the Star Tribune’s Science+Health section, Aug. 13) propagates the most egregious error in the handling of the COVID pandemic.
As a primary care physician, I continue to work daily to restore patients’ trust in medicine. When the government repeatedly stated as fact their latest recommendations, only to later change those “facts,” it undermined patient confidence in the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration.
When dealing with a new disease we should approach it with humility. Recommendations for isolation, mask-wearing, immunizations and treatment were often changed as the understanding of COVID evolved. Unfortunately, the certainty with which the original statements were made created animosity toward those who continued to question and investigate options.
Instead of perpetuating the idea of punishing providers who were trying alternative treatments, we must acknowledge that many patients today try alternative therapies rather than what is considered standard of care. A common example is those who choose holistic therapy for cancer rather than well-established medical protocols. As a physician, while I may disagree with their decision, I still feel obligated to provide other healthcare to these patients. But part of this patient autonomy also includes the freedom to choose your healthcare provider.
Who’s Got COVID? Dogs Can Quickly Tell
U.S. News & World Report reported:
Do you have COVID-19? With a little training, your dog might be more effective at figuring that out than even at-home antigen or sophisticated hospital tests. Dogs are so good at it, according to a new research review, that they may be ready for mainstream medical use if people didn’t consider this a curiosity rather than a real possibility.
Man’s best friend can be faster, more precise and less expensive at detecting COVID than standard tests, according to the review of a growing number of studies.
Over the past couple of years, “it went from four papers to 29 peer-reviewed studies — that includes more than 400 scientists from over 30 countries and 31,000 samples,” said co-author Tommy Dickey, an emeritus professor of geography at the University of California, Santa Barbara.
In detecting COVID, the studies found that trained dogs are as effective as the gold-standard RT-PCR (reverse transcription polymerase chain reaction) tests deployed in hospitals and clinics — if not more so.
Dogs can even identify COVID when it’s obscured by cold and flu viruses. They are able to do this because they have highly evolved noses, with both physical and nerve optimizations for smell.
Dartmouth Hitchcock Medical Center Researchers to Develop Nasal Spray COVID Vaccine
Researchers at Dartmouth Hitchcock Medical Center are part of a team working to develop the first nasal spray COVID-19 vaccine on the market.
Dartmouth Health officials said the vaccine will not require refrigeration and won’t need to be administered by a medical professional, so it could be easily distributed in developing parts of the world.
Intranasal vaccines have been used to protect against other viruses, such as measles and rubella.
The work is being undertaken in collaboration with the National Institutes of Health and Exothera, a viral vector manufacturer based in Belgium. DHMC is the sole research and development site for the vaccine, and clinical trials are planned in the U.S. and Africa.
COVID Victims’ Families Sue EcoHealth Alliance for ‘Funding, Releasing’ Virus
The families of four people who died from COVID-19 are suing EcoHealth Alliance, the New York-based nonprofit that was conducting gain-of-function research on bat coronaviruses in Wuhan, China, before COVID-19 broke out across town.
According to the Aug. 2 lawsuit filed before the New York Supreme Court in Manhattan, EcoHealth and its president, Peter Daszak, knew the virus was “capable of causing a worldwide pandemic.”
Not only did EcoHealth help to create a ‘genetically manipulated virus,’ the lawsuit claims, it worked to cover up the origins of the outbreak.
“If we had known the source or origin of this virus and had not been misled that it was from a pangolin in a wet market, and rather we knew that it was a genetically manipulated virus and that the scientists involved were concealing that from our clients, the outcome could have been very different,” victims’ attorney Patricia Finn told the NY Post.
Finn is also suing EcoHealth and Daszak in Nassau and Rockland Counties on behalf of the families of other victims killed by the virus, as well as two who survived.
As the New Eris COVID Variant Spreads Across the World, Here’s What We Know so Far
The World Health Organization is monitoring a new strain of COVID-19 called EG.5, or “Eris,” that accounts for a growing share of cases in countries including China and the United States.
The WHO has designated it a “variant of interest,” meaning it will be monitored for mutations that could make it more severe.
Based on current evidence, the organization says it presents a low public health risk at a global level, in line with other variants currently in circulation. In May, the WHO more broadly said COVID-19 was now “an established and ongoing health issue which no longer constitutes a public health emergency of international concern.”
According to the Centers for Disease Control and Prevention, EG.5 is now the dominant strain in the U.S., accounting for 17.3% of cases as of the week ended Aug. 5.
As COVID Vaccine Makers Gear Up to Launch Updated Shots in the Private Market, Can the New Vaccines Keep Up With the Virus?
After the recent cratering of COVID-19 vaccine demand, biopharma’s pandemic superstars are looking to bounce back with private-market launches this fall.
Meanwhile, the evolving nature of the virus presents a need for vaccines that can offer protection against new variants. And even as Pfizer, Moderna and Novavax wait for the FDA to sign off on their tweaked vaccines, a new virus variant has taken hold.
EG.5, nicknamed “Eris,” has taken over as the dominant variant in the U.S., causing 17.3% of COVID cases so far this month, according to the Centers for Disease Control and Protection (CDC).
Vaccine Hesitancy Behind Most Decisions to Not Get COVID Vaccines + More
Vaccine Hesitancy Behind Most Decisions to Not Get COVID Vaccines
A new study in the American Journal of Epidemiology shows that for three out of every four Americans who were not vaccinated with COVID-19 vaccines by mid-2021, vaccine hesitancy was the main reason for their refusal to get vaccinated.
The study used data from the Centers for Disease Control and Prevention’s Research and Development Survey, given to 5,458 US adults in May and June of 2021. The authors of the study wanted to calculate the adjusted population attribution fraction (PAF) of vaccine hesitancy.
In total, 40.7% of survey participants were hesitant and 67.2% were vaccinated. Through a series of questions, the authors found the adjusted PAF of non-vaccination attributed to vaccine hesitancy was 76.1%.
Fauci Referred to Justice Department for Criminal Investigation for Allegedly Lying Under Oath to Congress
Sen. Rand Paul, R-Ky., has referred Dr. Anthony Fauci to the Justice Department for an investigation into possible criminal prosecution for allegedly lying under oath to Congress about his knowledge of gain-of-function research conducted at China’s Wuhan virus lab.
In a letter to District of Columbia U.S. Attorney Matthew Graves, the Kentucky Republican requested that the DOJ investigate whether the former director of the National Institute of Allergy and Infectious Diseases (NIAID), which is a part of the National Institutes of Health (NIH), broke the law with false statements made in congressional testimony under a statute punishable by time in federal prison.
“Before Congress, Dr. Fauci denied funding gain-of-function research, to the press he claims to have a dispassionate view on the lab leak hypothesis, and in private he acknowledges gain-of-function research at WIV (Wuhan Institute of Virology) to his colleagues,” Paul wrote.
Fauci testified before the Senate Committee on Health, Education, Labor and Pensions on May 11, 2021, saying that “the NIH has not ever and does not now fund gain-of-function research in the Wuhan Institute of Virology.”
New COVID Vaccine and Booster Shots for This Fall to Be Available by End of September
The first new COVID-19 vaccines updated for this fall season are now expected to be available by the end of September, once both the Food and Drug Administration and the Centers for Disease Control and Prevention sign off on the new shots. The new shots are designed to target the XBB variants — strains of the virus descended from the original Omicron variant — which are now the most common form in circulation.
Three vaccine manufacturers, Moderna, Pfizer and Novavax, are expected to offer the revised shots for this fall, which virtually all children and adults will be eligible for. The rollout of the shots will also mark three major shifts in the U.S. response to the virus: the end of government-bought vaccine supplies, a simplification of who is eligible to get shots and a significant change to the recipe used in the vaccines.
After a meeting of its outside vaccine advisers in June, the FDA said it would ask vaccine makers to switch to using only a single component in their recipes targeted at the XBB.1.5 variant, in hopes of broadening immunity.
This is a change from the “bivalent” composition used in the last round of boosters, which blended two components: one aimed at boosting immunity against the original strain of the virus and another aimed at the Omicron BA.4/5 strain.
CDC Director Overhauls Leadership of Center That Oversaw Response to COVID
The new director of the Centers for Disease Control and Prevention, Mandy Cohen, is overhauling the leadership of the CDC center that led the agency’s COVID-19 response. In an announcement to staff issued Tuesday, Cohen said José Romero, who headed the National Center for Immunization and Respiratory Diseases for the past 14 months, would be leaving the CDC at the end of August.
Replacing Romero, at least on an acting basis, is Demetre Daskalakis, who has spent the past year in Washington as deputy director of the White House’s national mpox response team. The White House operation is being wound down and will be completed by the end of August.
Daskalakis, who has spent much of his career working on HIV prevention and control, was director of the CDC’s Division of HIV/AIDS Prevention in the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. For much of 2021, he led the CDC’s COVID-19 vaccine task force.
Two other high-ranking officials in NCIRD are being moved to other centers within the agency. Sam Posner, who served as acting director of the center in the second year of the pandemic, and has been principal deputy director since Romero’s hiring, is going to be acting director of the National Center for Injury Prevention and Control.
WHO Declares ‘Eris’ COVID Strain a Variant of Interest as Cases Rise Globally
A new strain of COVID-19 has been designated as a variant of interest by the World Health Organization, although the public health risk has been judged as low.
The variant, known as EG.5 or “Eris”, is related to an Omicron subvariant called XBB.1.9.2, and is growing in prevalence globally, with countries including the U.K., China and the U.S. among those affected.
However, the WHO suggested the variant does not pose a particular threat. “Based on the available evidence, the public health risk posed by EG.5 is evaluated as low at the global level,” the agency said, adding that the risk appeared to be on a par with other circulating variants of interest.
SARS-CoV-2 Can Damage Mitochondrion in Heart, Other Organs, Study Finds
The COVID-19 International Research Team (COV-IRT) and the Children’s Hospital of Philadelphia (CHOP) report that they have identified abnormal mitochondrial function in the heart, kidneys, and liver after SARS-CoV-2 infection, which leads to long-term damage and may help explain long COVID.
Mitochondria are the so-called “powerhouses” of cells, and the researchers noted that previous studies have shown that SARS-CoV-2 proteins can bind to mitochondrial proteins in host cells, possibly leading to dysregulation.
Co-senior author Douglas Wallace, Ph.D., of CHOP, said that the study offers strong evidence that COVID-19 is a systemic disease that affects multiple organs rather than strictly an upper respiratory illness. “The continued dysfunction we observed in organs other than the lungs suggests that mitochondrial dysfunction could be causing long-term damage to the internal organs of these patients,” he said in the release.
England to Deny COVID and Flu Jabs to Under-65s This Winter + More
England to Deny COVID and Flu Jabs to Under-65s Despite Fears for NHS This Winter
Millions of people under the age of 65 in England will be denied flu and COVID jabs this winter despite one of the government’s top public health officials warning that coronavirus has not “gone away.”
The Joint Committee on Vaccination and Immunization (JCVI), which advises the U.K. government, said on Tuesday its plan for COVID was to offer jabs only to those at “high risk of serious disease” who are “most likely to benefit” from vaccination.
COVID boosters will be offered to residents in care homes for older adults, those aged six months to 64 in clinical risk groups, frontline health and social care workers, people aged 12 to 64 who are carers or household contacts of people with immunosuppression, and all adults aged 65 and over. The Department of Health and Social Care said it had accepted the advice for England.
The government said in May that people in England under 65 would not be offered flu jabs this winter. It means about 12 million people aged 50 to 64 are no longer eligible for either free flu or COVID-19 vaccines.
Last year everyone over 50 was offered both. The COVID jab is not available privately in the U.K., so those ineligible this year will be unable to buy the jab themselves.
Heart Scarring Observed in Children Months After COVID Vaccination: Study
Some children who experienced heart inflammation after COVID-19 vaccination had scarring on their hearts months later, a new long-term study found.
Researchers followed a group of 40 patients aged 12 to 18 for up to one year after the children were diagnosed with myocarditis, or heart inflammation, following vaccination with one of the messenger RNA shots from Pfizer or Moderna. They performed a series of tests, including echocardiograms.
Cardiac magnetic resonance imaging, or cardiac MRIs, was performed on 39 of the 40 patients. Abnormal results came in for 26 of those who were imaged, including 19 who had late gadolinium enhancement, or signs of scarring.
The patients with abnormal results returned for follow-up cardiac MRIs at least five months after the initial tests and 15, or 58 percent, had residual late gadolinium enhancement (LGE). The one patient without an initial scan also had mild late gadolinium enhancement when scanned during a follow-up visit.
Is COVID Vaccination Linked to Psoriasis Emergence or Flare-Ups?
News Medical Life Sciences reported:
In a recent review published in Biomedicines, a group of authors explored the relationship between coronavirus disease 2019 (COVID-19) vaccination and psoriasis onset or exacerbation, utilizing data from 49 studies, while emphasizing the importance of vaccination and the need for further research.
Psoriasis, a chronic skin disorder, affects millions globally and is marked by red, scaly patches. Its comorbidities include hypertension, diabetes, and anxiety, impacting mental well-being and quality of life.
The COVID-19 pandemic brought teledermatology to the forefront for remote care and COVID-19 vaccines to control the virus. Mild to moderate adverse events occurred post-vaccination, and some reports linked vaccination with psoriasis exacerbation or onset, though conclusive research on this connection remains sparse.
New COVID Variant EG.5 Now Dominant in U.S., CDC Says
U.S. News & World Report reported:
A variant nicknamed Eris now accounts for the largest proportion of new COVID infections across America.
About 17.3% of U.S. COVID cases are believed to have been caused by the variant, formally known as EG.5, in early August, according to the U.S. Centers for Disease Control and Prevention. That number is 7.5% higher than it was in early July.
Other dominant variants include XBB.1.16, with 15.6% of cases, and XBB.2.23, with 11.2% of cases, CDC data show. Another 10.3% of COVID cases are from XBB.1.5, while 8.6% of cases were caused by an XBB-related variant known as FL.1.5.1.
Blue Cross of Minnesota Settles Lawsuit Over Lab’s Alleged ‘Profiteering’ With COVID Tests
Blue Cross and Blue Shield of Minnesota has reached a settlement with an Omaha-based lab company that the health insurer alleged was charging unreasonably high prices for COVID-19 tests.
The settlement with GS Labs, which operated several testing facilities in the Twin Cities, was announced Friday in the U.S. District Court of Minnesota.
In its March 2022 lawsuit, Blue Cross alleged that GS Labs was “profiteering off the pandemic and at Blue Cross’s expense” by pocketing “millions of dollars in wasteful and duplicative testing fees.”
A spokesman for the lab shot back that Blue Cross’ actions provided yet another example of “strong-arm gamesmanship by ‘big insurance,’ designed to hide their egregious failure to obey [federal law]” on paying for COVID-19 tests.
COVID Rancor Tests Friendships in Congress
The battle over blame for the COVID-19 pandemic and how to tackle the next one is testing the limits of a decades-long friendship between Reps. Brad Wenstrup (R-Ohio) and Raul Ruiz (D-Calif.), POLITICO’s Alice Miranda Ollstein reports.
Ruiz, Wenstrup and their staffs began the year with high hopes that the lawmakers — fellow doctors who both entered Congress in 2013, had neighboring offices, regularly went out to dinner together and co-wrote several wonky health care bills — could meaningfully collaborate. But the past six months have dashed those hopes.
Wenstrup is frustrated with the partisan divide, as demonstrated by the separate majority and minority reports on COVID’s origins, even as he says he’s happy with the committee’s work so far.
Public health experts warn that if the two friends can’t even agree on what to investigate, much less how to go about it, COVID will be further politicized and the nation will be more vulnerable to future pandemics.
China’s CanSino in mRNA Vaccine Deal With AstraZeneca
CanSino Biologics (6185.HK) has agreed with AstraZeneca (AZN.L) to provide “contract development and manufacturing services” to support the Anglo-Swedish drugmaker’s messenger RNA (mRNA) vaccine program, the Chinese company said on Tuesday.
In a filing to Shanghai’s stock exchange, CanSino said it would manufacture and supply unspecified mRNA products to AstraZeneca. It did not disclose the value of the deal.
CanSino has been working on its own mRNA COVID-19 vaccine and said in February it was in discussion with Chinese regulators around the protocol for a late-stage study for its COVID-19 mRNA booster vaccine, CS-2034.
AstraZeneca is China’s largest drugmaker and is doubling down on the world’s No.2 pharmaceutical market amid slumping sales of its COVID vaccine.
