Here is what to tell people who say the COVID-19 vaccine isn’t FDA approved

Dear Pandemic Problems,

There's a growing rift between me and my son-in-law, who says the COVID-19 vaccines are not safe because they have not been "FDA approved." What makes our rift even more difficult? His wife and grown kids with families themselves will also not get the vaccine because of this FDA approval issue. What do I do?


Ruffled by Rifts

Ruffled by Rifts, it does appear that rifts are all around you — or at the very least, you are in the minority of being willing to get vaccinated in your family. I know it's frustrating, and rest assured that you are not alone. I've answered many questions now from people who find themselves in similar predicaments. Plus, it doesn't help that families being divided on whether or not to get vaccinated is adding fuel to perhaps decades of family drama, and at the very least four years of the Trump era tearing families apart.

I have no idea if your family members are staunch anti-vaxxers, or to what extent political allegiances play a role here. But I do know that undermining their concerns won't help if there is any hope of them getting vaccinated. The best approach is to listen to their concerns, and have empathy, which it sounds like you've done a little bit of already.

So, you say that your son-in-law is saying the COVID-19 vaccines are not "safe" because they have not been approved by the United States Food and Drug Administration (FDA). While partly true, this is a classic example of how misinformation spreads. Technically, the COVID-19 vaccines haven't been "approved" by the FDA. However, all three vaccines available in the U.S. have been granted an emergency use authorization, also known as an EUA.

EUAs, by the way, aren't limited to vaccines — they sometimes are issued for medical devices, in vitro diagnostics, and some therapeutics. When it comes to passing an EUA, there are specific conditions that must be considered; they are likely to be granted in situations when "there are no adequate, approved, and available alternatives."

That is certainly that case with COVID-19. The FDA usually takes years to formally approve a vaccine, but in the coronavirus pandemic, the priority was to get a safe vaccine in as many peoples' arms as quickly as possible — hence the emergency use authorization.

But just because there's a bureaucratic difference between an EUA and approval doesn't mean that there isn't a rigor to attaining an EUA. Specific criteria must be met. For example, clinical trials must be done on tens of thousands of study participants to generate at least two months of sufficient scientific data needed for the FDA to determine a vaccine's safety and efficacy. You can read more about this process here.

In order to apply for full FDA approval, a company needs to show at least six months of data. Since Pfizer now has that, recently submitted an application for full approval. The FDA is expected to take at least a few weeks to review it, according to NBC News.

Now, what do you do? Well, I suggest expressing your concerns about their health and safety, and what the consequences are of not getting vaccinated. You could also note that attaining an emergency use authorization is a very rigorous process. And ask: Once the FDA formally approves the Pfizer vaccine, will you get it? While it's not ideal for your family members to wait, it's better than a straight-out refusal of getting vaccinated. Hopefully if they have more understanding into the EUA process, and perhaps speak with their doctors, they can be persuaded to be vaccinated.


Pandemic Problems

Dear Pandemic Problems,

My husband is refusing to get the Covid vaccine. I will be fully vaccinated by the end of the week. Am I wrong to not want to be intimate with him for fear he could infect me?


Hesitant about Intimacy

Dear Hesitant about Intimacy,

Congratulations on being fully vaccinated so soon. As someone who recently joined the fully-vaccinated club, I feel so grateful not having to worry (as much) about getting the coronavirus, potentially dying from it or spreading it to people. It seriously feels so good, and I'm excited for you to feel so good, too.

And yet, you are at a crossroads with your husband not getting vaccinated. I'm curious, why is he refusing the vaccine? The first step to understanding someone's hesitancy is to better understand why they don't want to be vaccinated. It could be due to misinformation they've consumed, a previous trauma or experience.

You ask: "Am I wrong to not want to be intimate with him for fear he could infect me?"

Unfortunately, I cannot answer this question for you. The CDC has not issued guidance on sex between vaccinated and unvaccinated people, and what the risk is. (Hopefully they will soon.) The CDC states that vaccinated people can still possibly get infected and spread the virus to others, but there is still much to be learned from this situation. I'm definitely not a marriage therapist, but here's what I would tell my best friend: do not anything you're uncomfortable with, as that won't be good for your marriage.

I hope you and your spouse can talk about the implications of him not getting vaccinated, and how that might impact the future of your marriage. My hope is that he will listen, and carefully consider your concerns. If not, there's always couple's therapy. If you can't afford to pay out of pocket, check with your insurance or look for free or low-cost counseling options.


Pandemic Problems

"Pandemic Problems" is an advice column that answers readers' pandemic questions — often with help from public health data, philosophy professors and therapists — who weigh in on how to "do the right thing." Do you have a pandemic problem? Email Nicole Karlis at nkarlis@salon.com. Peace of mind and collective commiseration awaits.

The Voyager 1 probe is now so far away that it can hear the background 'hum' of interstellar space

The Voyager 1 spacecraft holds the record for the most distant human-made object to ever exist. Though it was launched 44 years ago and is over 14 billion miles away from Earth, this space probe continues to send critical information and data back to Earth even as it floats through the void between our solar system and the next.

This article was originally published at Salon

What is this vast, empty void between stars like? It turns out that the galaxy has a hum, not unlike the static you might hear when you're moving the dial between two radio stations.

On Monday, scientists published research in the journal Nature Astronomy analyzing the data that Voyager 1's Plasma Wave System (PWS) sent back to Earth after it passed through our solar system's theoretical border — a region of space known as the heliopause, where the effect of our sun's solar wind on space and celestial objects is believed to end.

Notably, the PWS detected a low, unexpected emission pattering against its detector.

"It's very faint and monotone, because it is in a narrow frequency bandwidth," said Stella Koch Ocker, a doctoral student in the Department of Astronomy and Cornell Center for Astrophysics and Planetary Science, who is also the lead author of the study. "We're detecting the faint, persistent hum of interstellar gas."

In other words, the constant hum of "interstellar gas," also known as plasma waves, lingers at our solar systems' borders. Interstellar gas refers to the mix of radiative, gaseous matter that exists in between star systems and galaxies; it mostly consists of hydrogen and helium in various forms, including ionic, atomic, and molecular. The pitter-patter that Voyager 1 detected gives insight into how interstellar gas interacts with solar wind, along with the overall density of the heliopause region.

"The interstellar medium is like a quiet or gentle rain," said senior author James Cordes, an astronomy professor at Cornell University. "In the case of a solar outburst, it's like detecting a lightning burst in a thunderstorm and then it's back to a gentle rain."

Voyager 1 launched in September 1977, and famously flew by Jupiter in 1979, and then Saturn in 1980. The spacecraft travelled at 38,000 miles per hour when it passed through the heliopause in August 2012. Its nuclear battery grants the craft a very long life, hence its ability to continue sending data for decades. Indeed, researchers continue to be amazed at how Voyager 1 has gleaned new details about the solar system with multiple generations of scientists and astronomers.

"Scientifically, this research is quite a feat. It's a testament to the amazing Voyager spacecraft," Ocker said. "It's the engineering gift to science that keeps on giving."

Cornell research scientist Shami Chatterjee said in a press statement that evolving knowledge of the density in interstellar space is important information to track.

"We've never had a chance to evaluate it. Now we know we don't need a fortuitous event related to the sun to measure interstellar plasma," Chatterjee said. "Regardless of what the sun is doing, Voyager is sending back detail. The craft is saying, 'Here's the density I'm swimming through right now. And here it is now. And here it is now. And here it is now.' Voyager is quite distant and will be doing this continuously.

Vaccine-hesitant, vaccine refusers and anti-vaxxers: There's a spectrum, and the differences matter

Each day millions of people are getting their COVID-19 vaccines. More than 40 percent of Americans have received at least one dose of the COVID-19 vaccine, and more than 25 percent of the population is fully vaccinated. Despite this progress, public officials are concerned that the country is on the precipice of a new challenge — one in which supply of the vaccine will outweigh demand for it.

This article first appeared on Salon.

Mass vaccination sites, according to The New York Times, are already closing due to a decline in demand for the vaccine. An estimated 1 in 5 American adults remain unwilling to get vaccinated, according to the Monmouth University Poll, prompting fears that vaccine hesitancy could keep the country from reaching herd immunity and truly getting the pandemic under control.

But does that mean that all the people who say that they won't get the vaccine are "anti-vaxxers"? Not necessarily. And experts who study vaccine hesitancy and anti-vaccine organizations are sounding the alarm that there's an important distinction between someone who's "vaccine hesitant," a "vaccine refuser" or an "anti-vaxxer," especially during this critical phase of the pandemic. Lumping everyone together in the "anti-vaccine" category might deter those who are skeptics and hesitant, as opposed to those who might actually have an anti-vaccine agenda, hampering campaign efforts to get skeptics vaccinated altogether.

"Some figures have a tendency to call people that they disagree with anti-vaxxers, which is kind of unfortunate," David Broniatowski, an associate professor in the Department of Engineering Management and Systems Engineering at George Washington University, told Salon. "And it creates an environment in which you can't really have the conversations with vaccine hesitant people that you need to have in order to actually change their minds."

Broniatowski, whose research focuses on behavioral epidemiology and group-decision making, emphasized there's a "spectrum" of vaccine hesitancy that needs to be better understood.

"Hesitancy can mean anything from 'Yeah, I'm going to do it, but I'm a little nervous,' to hardcore refusers who say 'Well, I don't think I'm ever going to do it,' and those people, by the way, can change their minds," Broniatowski said. "I think we have to be very careful not to demonize people with whom we disagree, even if we're disagreeing on something as important as vaccination."

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Broniatowski said that's not to say that individuals with an explicit anti-vaccine agenda don't exist. But he often looks to see if a person is directly affiliated with an anti-vaxx organization before assuming they hold a deeply-entrenched belief.

"I think the most important thing is to distinguish between people and organizations," Broniatowski said. "A person can change their mind, and an organization has a charter or a mission statement and they don't change their minds. So you could have an anti-vaccine organization, and no matter what you do as long as the person you're talking to is representing that organization, you're wasting your time."

According to The Anti-Vaxx Playbook, published by the Center for Countering Digital Hate (CCDH), there are three key messages used by anti-vaccine groups and anti-vaccine "celebrities": 1. COVID-19 is not dangerous; 2. The vaccine is dangerous; and 3. Doctors and scientists cannot be trusted. When people on social media are explicitly pushing conspiracy theories, Broniatowski said these people likely fall into the "anti-vaxxer" category.

"A vaccine hesitant person might have heard something like that, either online or somewhere else, and they may believe it," Broniatowski said. "But when somebody is making that stuff up, and they're actively producing that material as opposed to consuming it, that's a pretty clear sign that they're probably an anti-vaxxer, right? And they're probably associated with an anti-vaccine organization."

As a separate report from the CCDH found, 65 percent of anti-vaccine content on social media is linked to just 12 individual accounts, including those of Joseph Mercola, Robert F. Kennedy, Jr., and Sherri Tenpenny, the author of four books opposing vaccination and supporter of the disproved belief, based on a debunked medical journal paper that has since been formally retracted, that vaccines are linked to autism.

In response to messages being spread by anti-vaxxers on social media, the CCDH recommends focusing on the following messaging: COVID is deadly; vaccines are among the safest and most effective human inventions of the past two centuries; and doctors, scientists and public health professionals are in their chosen professions because they want to help people.

Dr. Kasisomayajula Viswanath, a professor of health communication at the Harvard T. H. Chan School of Public Health and Dana-Farber Cancer Institute (DFCI), told Salon it's important to understand the "drivers" behind vaccine hesitancy, which will help public health officials address these concerns and hopefully get people vaccinated. For example, he said a Black American might be hesitant due to previous experiences with racism and discrimination in healthcare, and prefer to take a wait-and-see approach with the COVID-19 vaccine.

"That's very different from a group of people who are outright refusers who say 'No, this is my freedom,'" Viswanath said. "Personal liberty is one of the biggest drivers. Other drivers in other refusers are of a naturalistic healing."

Viswanath agreed that taking the spectrum of vaccine hesitancy seriously is "very critical" when it comes to the COVID-19 vaccines.

"What COVID-19 has done, unlike in the childhood vaccines issue, COVID-19 has pretty much upended everything we are doing in our lives," Viswanath said. "And so there is some consideration and really this urgency in looking at the spectrum much more carefully and developing the campaigns, more than ever, because it has brought everything to a halt, so to speak."

Are we finally done with lockdowns? Here's what public health experts say

Every day, million more Americans are inoculated with one of the three COVID-19 vaccines. According to the Centers for Disease Control and Prevention (CDC), as of April 7 more than 64 million people are fully vaccinated. More than 109 million people have received at least one dose.

This article was originally published at Salon

In other words, we're getting closer to going back to "normal" — whatever that might look like. Already some states like California are already announcing a date when they expect all pandemic-related social restrictions to be lifted, with some exceptions (including mask wearing). President Joe Biden believes some sense of normalcy will return by July 4, 2021.

Still, while the future looks better, the present does not. Some states have already lifted restrictions, which policymakers and public health experts believe was done preemptively; as a result, cases are surging in some states. The CDC announced earlier today that B.1.1.7, the coronavirus variant first detected in the United Kingdom and which has a higher mortality rate, is now the most common variant in the United States. The state of Michigan is currently undergoing a fourth wave in infections, one in which younger COVID-19 patients are being admitted to the hospital. Parts of Europe, like France, are undergoing 4-week lockdowns again.

So is the end merely a mirage? Does all this bad news combined mean that the United States could see more lockdowns and surges in its future?

While infectious disease experts can't say with absolute certainty, many believe the worst of the pandemic is over in the United States. Strict shelter-in-place orders like we saw last spring and winter, they say, are likely behind us.

"I don't think you're going to see anything like what's happening in Europe happening in the United States," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center. "Our vaccine rollout was sufficiently strong when it came to the high-risk individuals that were most likely to require hospitalization; meaning nursing home patients or high-risk community dwelling people, all of those individuals have been highly vaccinated."

Adalja said the country is facing a different kind of problem now.

"Where we see cases going up, but they're not necessarily going to translate into hospitals going into a crisis, and you have to remember that all of the public health mitigation measures in this country were largely driven by hospital capacity concerns — that's what flattening the curve was all about," Adalja said. "We've taken the ability of this virus away to put a hospital into crisis in the manner that it did just just a couple of months ago, in December and in January, because of where the vaccine went first."

Currently, pandemic-related restrictions vary by state, county and city. But when the pandemic first took hold in spring 2020, more than 310 million Americans were under restrictions such as "shelter in place" and "stay at home." Patchwork variations that continued beyond shelter-in-place orders included capacity limits, mask mandates, and closing some businesses — like gyms and bars — entirely.

But, as Adalja said, the goal of flattening the curve was to prevent hospitals from becoming overwhelmed and subsequently having to turn away patients or make life-and-death decisions about their cases based on a hospital's capacity to treat someone.

Fortunately, as more people get vaccinated, the likelihood of hospitals reaching that frantic state again decreases.

Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California–San Francisco, agreed.

"I think we have moved past that phase because of immunity; there is nothing, nothing that can get us through a pandemic, except for developing immunity in the population that has not previously been exposed to a new pathogen," Gandhi said. "Masks, social distancing, ventilation, those are all wonderful sorts of mitigation measures, but vaccinations are the fundamental solution."

Gandhi said even if there is a surge in the winter and fall, it is unlikely that it will have the same impact on our society as it did this previous year.

"What will change is that the population will have immunity," Gandhi said. "I do not think we will need lockdowns or restrictions in the fall and winter."

But what about the other variants emerging? Gandhi said she is confident that the vaccines will be effective in protecting people against the new variants, like B.1.1.7. Research agrees.

"The T-cell response, or cell-mediated immunity that we develop to vaccines is preserved across all these crazy variants," Gandhi said. "I fundamentally think we will get through this pandemic with this round of mass vaccination."

But this all depends on how fast people are vaccinated.

"As long as we continue to vaccinate at the pace we're doing, I think that we will likely see the end of COVID as a public health emergency," Adalja said. "Not an end of COVID as a disease, but one that's never able to put us in a position that it has, hopefully within the next couple of months."

Brian Spisak, a research associate of Health Policy and Management at Harvard University, told Salon via email it is critical to "intrinsically" motivate people to get vaccinated as soon as possible.

"Triggering the intrinsic motivation of society, as opposed to requiring certifications and 'passports,' using social psychological factors such as trust, reciprocity, compassion, and empathy is arguably the best path to ending the current lockdown and avoiding further lockdowns," Spisak said. "At the very least, these softer tactics will likely encourage prosocial behaviors (such as getting vaccinated) rather than hard and fast certification tactics which can polarize society and limit the overall percentage of people getting vaccinated."

Experts explain everyone is so exhausted right now

Besides being the year of the pandemic, 2020 was the year of keeping busy at home. Pandemic hobbies, as they're commonly called, substituted much of the human socializing that occupied pre-pandemic weeknights and weekends. Some people became prolific at growing the natural yeast for sourdough. Others turned to learning a musical instrument, reading more, or just binging television.

But as the era of the great indoors stretches into 2021, many people are reckoning with a more dominant emotion: exhaustion.

The experience of 62-year-old Lisa Johnson Mandell of Las Vegas epitomized this peculiar exhaustion that many have anecdotally reported on social media.

"I don't get just tired or sleepy, I find myself getting exhausted — bone tired, where I find it hard to place one foot in front of the other," Mandell said. "My limbs ache from exhaustion."

"Anyone else finding it hard to catch a break these days? So many folks are just exhausted (including me)," Dr. Desmond Upton Patton, a social work professor at Columbia University, opined on Twitter. His remark prompted a long thread of agreement from the Twitterverse. "Global fatigue," one person replied.

This collective exhaustion arrives at an unusual moment, as the slow-but-steady vaccine roll-out inches us closer to some sense of normalcy. One might think that would lead to a feeling of collective excitement, now that there's an end in sight. Yet it appears to be doing just the opposite.

So, what is going on?

Nathalie Theodore, JD, LCSW, a psychotherapist in Chicago, told Salon it could have to do with the fact that as a society, we've been living under the grip of chronic stress for one year now. From ongoing lockdowns to social distancing, many of the outlets that would usually alleviate a person's stress have been taken away from us for an extended period of time.

"Living with this chronic underlying stress means we have less bandwidth to deal with the ups and downs of daily life, or other emotional triggers," Theodore said, adding that "decision fatigue" could be causing excessive tiredness. "Due to the pandemic, any activity we choose to engage in requires a risk analysis, which is exhausting."

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Indeed, as more people get vaccinated, decisively analyzing the risk of leaving the house — and mingling with other vaccinated or unvaccinated people — continues to be tiring. Only until recently did the Centers for Disease Control and Prevention (CDC) provide the public with guidelines on how vaccinated people can interact with other vaccinated people and unvaccinated people. Still, with this guidance, what's safe and what isn't remains a bit confusing during this transitional period. Trying to hash out the details isn't the "normal" we're used to.

Mental health experts say there are other variables at play causing unmanageable fatigue. Ansley Campbell, a licensed marriage and family therapist (LMFT) and Clinical Director of The Summit Wellness Group, told Salon the exhaustion could actually be a result of having an end in sight. Since our nervous systems have been in survival mode for an entire year, we are finally at a point where it feels a little more safe to relax. That's led us to formally take in the challenges of the past year.

"Now that the infection rates have been decreasing, people are getting vaccinated, and some returning to more normal lives or feelings of safety, that space of feeling the need to constantly survive is also decreasing," Campbell said. "This is causing many clients to now have the time and space to pause and realize the impacts of the past year, which is leading to greater exhaustion."

Fatigue is common in delayed trauma responses, which could certainly be part of the extreme exhaustion many are experiencing. As researchers have noted, persistent fatigue, sleep disorders, nightmares, fear of recurrence, and anxiety are common delayed trauma responses among survivors.

Dr. Gail Saltz, Associate Professor of Psychiatry at the NY Presbyterian Hospital Weill-Cornell School of medicine and host of the "How Can I Help?" podcast on iHeartRadio, told Salon it might not even be a delayed trauma response, but something called Pandemic Trauma and Stress Experience (PTSE). The term, which was coined by the American Psychoanalytic Association, is described as a type of "ongoing trauma response."

"Part of that is the ongoing physiological and psychological effects of being in a pandemic — which is going to vary from person to person depending on the proximity of trauma for them — so trauma could be that you got COVID and were very sick or somebody close to you got COVID and was very sick or died," Saltz said. "You had to abruptly, and in fear, entirely change your life in an ongoing, super-stressful way.

Another part of the exhaustion may relate to our routines being thrown off indefinitely. Dr. Aude Henin, co-Founder and co-Director of the Child Cognitive Behavior Program told Salon that lockdown is like being "perpetually jet-lagged."

"Our daily routines — from the time we get up, to how we get ready for work or school, to when we eat lunch, when we exercise, or spend time with family and friends, to when and how we go to bed — are key to setting our body clocks and regulating our energy levels during the day," Henin said. "The amount and timing of daylight also plays a key role; the sudden and dramatic changes in daily routines, and the lack of time outdoors because of quarantining and social distancing have interfered with our biorhythms and have greatly decreased our energy levels."

For these reasons, mental health professionals emphasized it's important to take care of ourselves during this time.

"It's imperative we prioritize self-care and connect with others in pandemic-safe ways during this time in order to counteract the effects of isolation and get the support we need," Campbell said.

And if you are experiencing extreme exhaustion in addition to other symptoms of clinical depression, mental health experts emphasize it's best to get professional help from a therapist.

"Both poor sleep, and the experience of feeling incredibly exhausted and fatigued and low energy, are a significant part of clinical depression," Saltz said. "I think people should be aware that this could be clinical depression, and they should be knowledgeable of the other symptoms; and if it turns out that they're actually meeting criteria for a bunch of the other symptoms as well then that requires evaluation and treatment," she added.

Republican men are most likely to be COVID-19 anti-vaxxers, not women

Historically, Americans' stereotype of a vaccine-hesitant or anti-vaccine person was that of a woman — perhaps a New Agey yogi who posts about alternative medicine on Instagram, as memes about the stereotype depict. Indeed, researchers have found that a majority of online anti-vaxxers are women.

This article first appeared in Salon.

Yet it turns out that this stereotype does not mirror the public health demography of the real, offline world. As a recent PBS NewsHour/NPR/Marist poll found, the plurality of those who intend to refuse the COVID-19 vaccine, even when offered, are Republican men — once again debunking the sexist stereotype that anti-vaxxers are entirely women.

According to the poll, 30 percent of those surveyed in March 2021 stated that, if offered the COVID-19 vaccine, they would not take it. Forty-nine percent of that cohort consisted of Republican men; 6 percent were Democrat-identifying men. Moreover, 14 percent of Democrat women said they wouldn't receive the vaccine if offered, compared to 34 percent of Republican women.

More broadly, 40 percent of white non-college educated men and 38 percent of white evangelicals surveyed said they won't receive the coronavirus vaccine if offered. The poll surveyed 1,227 U.S. adults from March 3 to March 8.

The poll revealed an unfortunate truth: Republican men are central to COVID-19 vaccine resistance. Notably, the percentage of Republican men stating they will reject the vaccine actually increased from December, when Marist asked the same question.

So, what is going on?

According to a separate poll by CBS News, Republicans who cited they outright won't receive the vaccine are likely to cite their reason as distrust of the government. This is in part why Dr. Anthony Fauci, chief medical advisor to the president, has been making the rounds — urging Donald Trump supporters to get vaccinated, while simultaneously expressing his disbelief that anyone would refuse it. During an appearance on NBC's "Meet the Press," Fauci commented that it was "disturbing" that Trump voters are choosing to not get vaccinated.

"We've got to dissociate political persuasion from commonsense, no-brainer public health things," Fauci said. He added that vaccines have "rescued us from smallpox, from polio, from measles. . . what is the problem here?"

Fauci said on a separate appearance on Fox News over the weekend that if Trump told his supporters to get vaccinated, that could possibly help.

"If [Trump] came out and said, 'Go and get vaccinated. It's really important for your health, the health of your family and the health of the country,' it seems absolutely inevitable that the vast majority of people who are his close followers would listen to him," Fauci said.

Indeed, on Tuesday afternoon, former President Trump did something approximating that during an interview on Fox News. Yet in typical Trumpian fashion, Trump intimated that getting the vaccine was a "choice," and that one's choosing or not choosing to was an innate "freedom."

"I would recommend" the vaccine, Trump said in an interview with Maria Bartiromo. "And I would recommend it to a lot of people that don't want to get it — and a lot of those people voted for me, frankly. But again, we have our freedoms and we have to live by that and I agree with that also."

The overall resistance among conservative men to the vaccine hints at how incredibly polarized American culture has become, to the point that basic public health advice and data sparks partisan rancor. As a result, many right-wing outlets, including Fox News and One America News Network, often spout public health misinformation or disinformation. As Salon columnist Amanda Marcotte opined, this situation bodes ill for American politics and worse for American public health.

"There's also something deeper and more sinister going on with the anti-vaccination propaganda being pushed by [Tucker] Carlson and the right wing punditry in general," Marcotte wrote. "It really is about turning their audiences into something closer to a cult — even, apparently, a death cult."

A 2015 Pew Research poll surveyed 2,300 people across America about their views on vaccines. At the time, they found that 7 percent would describe their position as anti-vaccine; within that minority, 56 percent were men and 44 percent were female. Notably, the polling emphasized that people earning less than $25,000 a year were 50 percent more likely to distrust vaccines.

Public health experts have expressed concerns that anti-vax men could slow down America's road to recovery. In other words, the same bootstraps, hyper-macho mentality that made many Americans forgo masks could keep the country from returning to normalcy and achieving herd immunity through vaccination.

On CNBC, Dr. Vin Gupta said that anti-vax Republican men "will determine the trajectory of this pandemic."

"All forecasts right now say that we're going to be past the worst of this with normalcy by say end of June, early July. That, however, is contingent on people actually getting the vaccine to the tune of 75% to 80% of eligible adults by that time period," Gupta said. "If that's not the case —if there's skepticism or hesitancy that high — we're not going to get there."

Can Trump's QAnon followers be deprogrammed?

No one in 2017 could have imagined that QAnon — an inscrutable right-wing conspiracy theory that alleges that an underground global elite of pedophilic Satan-worshippers plotted to take down President Donald Trump — would have found so many adherents. What started as a strange series of posts on anonymous forums in 2017 culminated in a violent riot in the U.S. Capitol nearly three years later.

This article originally appeared at Salon.

Aside from its toxic effect on U.S. politics, the conspiracy theory's other side effects are profoundly personal: marriages and families have been torn apart because of QAnon, as thousands of Americans have watched their loved ones fall into its madcap delusions. Many of those whose family members have fallen victim to QAnon have banded together in support groups. As Salon previously reported, a Reddit group called QAnonCasualties has become a haven for 136,000 people to commiserate over loved ones consumed by QAnon.

Recently, a "sister" Reddit group to QAnonCasulaties, called ReQovery, was created not for family but for former believers themselves — ex-QAnon adherents looking to vent and provide emotional support. With a mere 8,100 followers, this new support group is not nearly as active as QAnonCasulaties. Still, the flurry of forum activity does show that people who have fallen for QAnon can recover — even if the path isn't quite yet clear.

Indeed, what makes "treating" QAnon tricky is that it technically doesn't neatly fit into the idea of a cult. That's a conundrum for therapists. Indeed, while there is a well-defined routine for cult recovery, there isn't quite the same for something like QAnon, which is in a gray area.

Cults are usually defined by devotion toward a particular figure or object; whereas those who go down the QAnon rabbit hole find themselves sucked into a baseless conspiracy theory that Satan-worshipping pedophiles in the "deep state" are seeking to undermine former President Donald Trump. Likewise, nobody knows exactly who is the leader of QAnon, and there isn't direct devotion to "Q."

Still, there are a lot of similarities between QAnon followers and cultists. So while there's a definitional debate around what QAnon is (and certainly some would argue it is a cult), there is a consensus that it's destructive to many people's lives. Once people get so far into it, they're living a life that's no longer grounded in reality and that can be destructive to themselves and the people around them.

In this context, approaching QAnon recovery like it is a cult is useful, experts say. Cult recovery experts — who are being inundated with calls from people desperate to help their loved ones — tell Salon recovery is possible, but not for everyone. That's because for many victims, QAnon beliefs are tied to an undiagnosed mental health disorder like schizophrenia or bipolar disorder.

Rachel Bernstein, a Licensed Marriage and Family Therapist (LMFT) and host of the Indoctrination Podcast, said there are a couple of different "predictors" that will help determine whether or not a QAnon follower will be able to "bounce back." The first is if they are willing to tolerate having a conversation about their loved ones' concerns.

"That's the first challenge," Bernstein said. "There's a pervasive defensiveness that actually gets transposed into offensiveness, and you can have a lot of aggression and a lack of tolerance for being what they think is being questioned or insulted."

Bernstein said the first barrier is trying to defuse what is often a charged environment, and turn it into a safe and open forum. But if that happens, the next step is to better understand what motivates that individual to be part of QAnon — which is crucial to bringing them back from it.

"The key is to understand what about QAnon interests people, and why they believe it, and what their motivation is," Bernstein said. "For some people, they really do believe it's the way to save the children; for other people they think that it's a way to feel like they're doing something, some way to be taken seriously — they feel like they hadn't been taken seriously before."

Bernstein said she has talked to a number of ex-QAnoners who said they didn't have a lot going on in their lives, and that they wanted to feel connected to something "greater than themselves."

For those who followed QAnon because they were motivated by a promise to "save the children," Bernstein said that the best approach is to commend their intentions, and then point them to the facts in a kind and understanding way. One of QAnon's biggest baseless conspiracy theories dates back to Pizzagate.

"You can say 'that's a wonderful idea and there should be more people like you who care,' but let's look at the documents and see the numbers and stats," Bernstein explained, adding that the idea is to show that QAnon isn't helping children while directing them to organizations that actually are.

Bernstein said an indicator that someone is likely not to recover is if that person is prone to conspiratorial and paranoid thinking. This type of person will likely be drawn to the conspiracy du jour, she noted.

Other experts approach QAnon recovery differently. Patrick Ryan, a cult intervention specialist, said he approaches his patients by seeking to understand what else is going in their life, starting with studying their family situation. Like Bernstein, Ryan has been working with families struggling to help loved ones who have become QAnon followers.

"We look at the entire family system, we look at the history of mental illness and families, and we look at, 'what is going on in the people's lives?'" Ryan explained. Incidentally, this is why he starts the process with extensive interviews with all family members involved.

Ryan recalled an incident with a family in which the QAnon adherent had previously been a Scientology follower; likewise, that patient's mom was schizophrenic. These clues help therapists piece together a broader picture.

Hence, recovery is a bespoke process, as Daniel Shaw, a psychoanalyst who specializes in cult recovery, attested.

"Coming out of delusional states is different for each person, how it happens, when it happens," Shaw said. "And it really depends on the ways in which family and friends and loved ones are interacting with that person, expressing concern, listening, wanting to be involved, and understanding and hearing what they have to say— and those efforts may or may not be successful."

'Vaccine guilt' is a real thing

When Emily Brimmer's family dentist sent out an email that they were administering vaccines, she jumped at the opportunity. Brimmer is certainly entitled to get one: though only 36 years old, she has type 1 diabetes, lives with family and helps to take care of her 101-year-old aunt. But once inoculated, Brimmer wasn't prepared for one of the unexpected side effects: guilt.

This article originally appeared at Salon.

"When you say, 'I got a shot,' there's automatically this kind of perceived feeling of judgment that is like 'Why did you get a shot, and how did you get a shot?'" Brimmer told Salon. "There's just this need to justify the entire thing."

Technically, as a type-1 diabetic, Brimmer is in the "high risk" category. Her primary care doctor wrote her a note affirming this, which she used to get her vaccine. The caveat was that she had to travel from New York, where she lives, to Pennsylvania.

"So that kind of made me feel guilty," Brimmer said in reference to having to cross state borders. "But it's not like I cut any lines, or dressed up like grandmothers and tried to sneak in. . . everything I did was by the book, and on paper I shouldn't feel guilty."

But Brimmer does. And far from being an isolated anxiety, vaccine guilt is actually quite common. Psychotherapist Alyza Berman, founder and clinical director of The Berman Center, told Salon via email that such feelings emerge from a variety of factors: situational comparison, survivor's guilt, and fear of criticism or retribution. And certainly the piecemeal vaccine rollout, and arcane tiered system of eligibility, factor into that guilt when patients appear to sidestep the rules — even if they aren't actually doing so.

"Given the severity of this pandemic and continued rising death toll, people feel guilty when they qualify to be vaccinated before others who've already suffered great losses during the pandemic, or could stand to lose even more as COVID goes on," Berman said. "As human beings, we have an intrinsic nature to want to quantify and compare ourselves to others, whether for good or bad reasons."

Berman said that this can create "an enormous mental toll on people and weigh heavily on someone's psyche when they're trying to evaluate if they're doing the right thing."

Hence, feelings of guilt.

Berman said the phenomenon is "more common than you'd think" and that it's "affecting many people in very similar ways." In other words, something is happening sociologically.

Rick Patterson told Salon via email that he and his wife were able to receive their vaccines "substantially early." She was volunteering at one of the vaccination sites, which often is a way for volunteers to get a vaccine early.

"It was complete luck we were able to obtain our vaccinations when we did, and I feel that there are so many people who need this more than we do right now," Patterson said. He added that it was an "overwhelming thought," that there were "still so many who have not and might not be able to get it anywhere in the near future." Indeed, the inequity troubled him.

Patterson said he feels that his wife, as a vaccination site volunteer, deserved the shot more than him.

"But as her husband, what really gave me the obligation to have one too?" he asked.

Many bioethicists and mental health professionals agree that feeling guilty isn't beneficial to anyone. If you're offered a vaccine, you shouldn't feel guilty. But if you are committing fraud to get a shot early — say, dressing up like an elderly person — then that is something to feel guilty about.

"There is a difference between accepting and even taking advantage of unfairness that exists, and creating unfairness," Dr. Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado, told Denver-based Magazine 5280. "We all have an obligation to try not to create unfairness."

So what are the guilty to do?

"The main advice I can give someone suffering from vaccine guilt is to give yourself a break," Berman said. "We've been put through an impossible situation over the past year, the likes of which no one has ever seen before." That's inarguably true.

Some New Age influencers believe Trump is a 'lightworker' -- here's why

Lorie Ladd gazes into the camera with glossy eyes, a look that mimics the long stare one gets after meditating. She's about to give one one of her sermons, one of "most challenging" ones she's ever had to make, she explains. Ladd says she's received a message that needs to be shared from "higher dimensional consciousnesses," what she refers to as the "Galactic Federation of Light." But before revealing the message, Ladd, a self-described "ascension teacher," advises her viewers to shed the stereotypes that have been "programmed" into them — "polarities," she calls them, like "Democrat" and "Republican" — and listen to her message: Donald Trump is a "massive and powerful lightworker."

"To say that I was shocked was an understatement," Ladd tells her nearly 139,000 YouTube followers of her revelation. "I have been digesting information from my guides about what this lightworker in human form looking like Donald Trump has been doing for the human collective; this man has more charge around him than any other human on the planet right now."

Ladd goes on to explain that her video isn't a "political one," but a "consciousness one," and that she's not talking about "voting," but "ascension." Trump, as she explains in the next half hour, is here to help assist humans in what many in the New Age and spiritual communities refer to as a great "awakening" of consciousness. The idea behind the awakening is that human consciousness is approaching a "fifth dimension," which will eventually bring humans closer to the "Source."

A lightworker, as defined by well-being magazine Happiness, is someone who feels "an enormous pull towards helping others." The term, they say, can be interchangeable with "crystal babies," "indigos," "Earth angels" and "star seeds"; "these spiritual beings volunteer to act as a beacon for the Earth, and commit to serving humanity," the story continues.

This rhetoric might sound cultish, but these phrases don't belong to any one specific religious sect. Indeed, such belief systems are part of a larger, more diffuse New Age culture embraced by the ever-increasing number of Americans leaving organized religion in droves — or who were never religious in the first place — and turning to conspirituality by way of many self-described spiritual and wellness influencers online.

Conspirituality, the term that defines this movement, was coined by researcher Charlotte Ward. She describes conspirituality as "a rapidly growing web movement expressing an ideology fueled by political disillusionment and the popularity of alternative worldviews." There is no official indoctrination video, no book to read; the hundreds of thousands of people who embrace these New Age-like beliefs find them on YouTube vlogs like Ladd's, as well as Instagram and Facebook. Recently, conspiritualists have begun to overlap with the far-right conspiracy theory QAnon.

[Related: Meet the spouses whose marriages were destroyed by QAnon.]

This notion that Trump is a lightworker shares obvious parallels with the belief, held by some evangelicals, that Trump is comparable to Jesus; similarly, some QAnon followers believe that Trump is the "world leader" whose mission is to "save the children."

Yet what makes the lightworker theory especially odd is that it has emerged from a demographic that would have previously been described as apolitical, or even far-left.

However, as the January 6 insurrection on the Capitol showed, QAnon and Trump adherents no longer middle-aged, conservative white men like the Republican Party of yore. Many of those who embrace right-wing fringe beliefs are yogis, woo-woo, love-and-light types, too. Take Jake Angeli for example, the so-called "QAnon Shaman" who donned a horned hat and spear-tipped American flag as he stormed the Capitol building on January 6. The 33-year-old, who identifies as having "shamanistic" beliefs, was recently granted the right to be fed an all-organic diet in jail in line with his religious practice.

Ladd's declaration that Trump was a lightworker sent shockwaves through conspiritual and self-help communities. (Salon reached out to Ladd for comment, but did not receive a response.) Some spirituality and consciousness bloggers vehemently disagreed. But many influential figures in the community thought Ladd was onto something, including Christiane Northrup, a physician and best-selling author who has been spreading anti-vaccination rhetoric and has embraced QAnon.

Matthew Remski, a co-host of the Conspirituality podcast and a cult dynamics researcher, described Northrup as a "conspirituality aggregator" who feeds what she finds most interesting to her followers, of which she has many.

"What I think is really brilliant about this particular iteration of QAnon — or 'soft' or 'pastel Q,' you could call it — is that it's really effective at evading content moderation," Remski said. "To only really say something positive about the person who's at the head of QAnon mythology and sort of soft-pedal all of the aggression and triumph that is going to be involved in his mission is a really good way of brand-washing QAnon for the wellness set."

Indeed, while social media companies like Twitter and Facebook have suspended many accounts sharing QAnon-related disinformation, the wellness influencers remain. Dr. Ronald Purser, a professor of management at San Francisco State University and the author of "McMindfulness," said that in uncertain times, societies see a rise of "occultures," meaning "groups of people who are attracted to strange occult and esoteric ideas, mixing them in unforeseen ways with political movements."

"A common theme in such movements is the need for purification, purifying and purging unwanted elements – toxins, impurities, or anything foreign or other," Purser said. "This is why we see so many New Age yoga practitioners seduced by QAnon."

Purser said there are parallels between the rise of "occultures" now and the role spirituality and mysticism played in Nazi Germany. Notably, the Third Reich appropriated the swastika, a symbol used by Hindus, Buddhists and Jains; the word means "well-being" in Sanskrit.

"Consider Hitler, who was obsessed with the occult, was a vegetarian, used astrologers [and] oracles," Purser said. "The Nazi Heinrich Himmler, head of SS, was enamored with Eastern mysticism, and he sent an expedition to Tibet in search of lost remnants of a secret and pure Aryan race; Hitler was seen as a 'light worker' [as in someone who's saving humanity] that would purge Germany of Jews."

Purser added that Trump and his enablers have "mastered the ability of weaponized mass delusion through social media."

"Many of the New Agers drawn to QAnon are probably suffering from unresolved trauma – like many in Trump's base as well," Purser said. "It's easier to look to a savior and to find scapegoats than to face one's own fears and pain."

When asked about the term lightworker, and where it derives from, Remski said he first heard it when he was in a "Course in Miracles" cult from 1999 to 2003. The name is a reference to a book, titled "A Course in Miracles," that was published by Helen Schucman in 1976; Schucman claimed the book had been spoken to her via "inner dictation" from Christ. Remski said the word "light" appears in the text frequently.

"Light is not only the sort of keynote of this Manichaean universe in which things are either light or shadow, they're either good or bad, it's also like schizotypal as a universe, it is given this materiality as well," Remski said of Schucman's book. "Light is said to be something that can fill a person up, it can blow a person apart, it can enter a person, and I think it probably overlaps with some pre-modern ideas like prana or ch'ithose kind of folk medicine ideas of vital force — but it's also associated with an absolute truth, an ontological transformation . . . like once once light enters into you, you are forever changed."

While the book "A Course in Miracles" doesn't include the term "light worker," the theme of light itself runs throughout. "The key is only the light that shines away the shapes and forms and fears of nothing," a typical passage reads.

One prominent figure who was deeply influenced by "A Course in Miracles" is former presidential candidate Marianne Williamson. In 1996, Williamson wrote a book, "A Return to Love: Reflections on the Principles of 'A Course in Miracles,'" that was structured as a reflection on the original text. Williamson, too, has used the term "light worker" before; in a 2013 Facebook post, Williamson wrote, "A light-worker is not someone who ignores the darkness; it's someone who transforms the darkness."

Obviously, Williamson and Trump are political opposites; Williamson, a Democrat, came down hard and repeatedly on Trump's policies during her 2020 campaign. Salon asked Williamson what she thought about the term "lightworker" being used to describe Trump. She replied via email: "I think it's insane. . . . Like many others, I don't understand it but I find it deeply disturbing."

When asked why he believes people have been so eager to embrace this belief that Trump is a "lightworker," Remski said that it is because it can "offer all of the benefits of the conspiratorial mindset, without a lot of the drawbacks."

"Because you're saying something kind about him," Remski said, "as the social psychologists basically repeat over and over again."

Remski believes conspiracy theories are attractive because they "satisfy epistemic needs." "Like, 'I'm now I'm going to know something that nobody else knows,' or 'I'm going to meet my survival needs, meaning this information is going to help me tolerate what's happening, but also maybe even preserve me from danger,'" he said.

But as the social media spread of the "lightworker" theory illustrates, conspiracy theories also open up their adherents to communities of people that they can hang out with, Remski mused.

Meet the spouses whose marriages were destroyed by QAnon

Adam and his wife were always pretty conservative. While she was an "ardent" supporter of Donald Trump, as he described, it wasn't until the November 2020 election — and nearly eight months into the coronavirus pandemic — that he started to get increasingly concerned about how deep her support for Trump ran. She was spending hours on her phone watching videos by pro-Trump conservatives like Dan Bongino and Ben Shapiro.

"I didn't have a problem with that," Adam, whose name has been changed, said in a phone interview. "But then she started to watch a lot of the QAnon conspiracy videos, and started to share those with me."

She would watch these videos until 2 or 3 in the morning, Adam said. He feared she was having a "psychotic break." Previously, she had been on antidepressants. He wondered if a mix of the pandemic and political chaos was driving her to the edge.

Then, one day, she came home and announced: "I'm going to join the militia."

Adam said he's still "emotional" about it, his voice cracking. He said he couldn't believe what he was hearing as his wife repeated QAnon talking points.

"She started to tell me that we needed to start amassing guns, that we needed to start converting our currency into gold and silver because when the Civil War happens, we need to have something to trade other people," he explained. "The adrenochrome, the pedophile rings — she was a believer that Tom Hanks was a pedophile, and it got to a point where I couldn't watch the national nightly news without her believing I was giving in to the liberals and helping mainstream media ratings by continuing to watch."

When he did watch the news, she would get so angry that she would leave the room, go to the basement, and watch more QAnon conspiracy theory videos, he said.

Adam tried to rationalize with her, and so did her two children. He begged her to see a therapist, but she refused. One morning, she woke him up early and asked him to watch a 40-minute video purporting to explain how Trump is the "world leader." He watched it, and in return asked her to watch a Vice documentary on QAnon. Again, she refused.

Finally, he gave her an ultimatum: see a professional, or their marriage was over. He filed for divorce earlier this month.

"I just have to move forward, I really wish that she could have gotten some help," he said. "I love her, I love her still."

Adam is one of tens of thousands of people who have shared their stories on r/QAnonCasualties, a Reddit group for people whose spouses, family members and loved ones have been consumed by the baseless conspiracy theory known as QAnon. The Reddit forum has become a digital support group for nearly 137,000 people who swap stories, advice and guidance. Posters on the forum reach out for support, guidance, and advice. Some posters describe the experience of completely "losing" their loved one. Others are more alarming, like the woman whose "Qhusband" got a gun license because of the conspiracy, which made her feel "sick to my stomach."

One Reddit user described their girlfriend of 10 years becoming a QAnon follower. "She refuses to believe Trump lost which is bad enough, but she won't even consider getting the COVID vaccine as she believes it will cause deadly side effects and tells me I am a sheep for getting one," the poster said. "She just [in my opinion] has become brainwashed and refuses to ever admit she is wrong with anything concerning Trump, QAnon or the vaccine. I am at the point where it is going to become a deal breaker soon. Is there any hope of saving her?"

But QAnon's effect on families extends far beyond the capabilities of one Reddit support group. QAnon-related strife is overwhelming professional therapists. Daniel Shaw, a psychoanalyst who specializes in cult recovery, said he gets between two and three calls a day from people looking for help for their loved ones. Sometimes, the person is seeking help for a spouse who has become a QAnon follower. Other times, it's for a parent.

"I've never seen anything like this before, and I've never had as many calls like this," Shaw said.

One woman, who asked to remain anonymous, is struggling with her husband since he became a QAnon adherent. In a phone interview, she said he was always into pseudoscience, but his obsession with QAnon is beyond anything she's ever observed.

"He has fallen real hard for it, more so than anything he has been into before," she said. "That's what he does every single evening — he reads stuff about it, and if he wants to talk to me that's all he wants to talk about," she said. "So we're just not spending a lot of time together — we meet together to take care of our children, then he goes to work and I'm home with the baby."

One night, she found him crying in the kitchen because of the "children," as he explained. One of QAnon's biggest baseless conspiracy theories, known as #SaveTheChildren, dates back to Pizzagate— a completely false theory that emerged in 2016, claiming that Hillary Clinton and John Podesta, her former campaign manager, operated a child sexual abuse ring. Conspiracy theorists peddled the false claim that Podesta's use of the word "pizza" in the emails meant pedophilia; the email exchange surfaced when WikiLeaks published Podesta's hacked emails. Four years later, there is still no evidence that there is any child sex–trafficking ring, or evidence of the other misinformation the conspiracy theory has generated.

Since her husband has also embraced anti-vaccine rhetoric, the anonymous woman now has to vaccinate their child without his knowledge. (Pandemic conspiracy theories and QAnon conspiracy theories often run together.)

"I'm actually going behind his back now — I wish I didn't have to, but it's a matter of my children's health," she said. "You have to keep things from your spouse, like that you're going to a doctor's appointment, and that doesn't seem right."

Shaw said having a marriage, or any type of relationship, with a QAnon follower can be very challenging because most of them are no longer grounded in reality.

"Partners are used to having a rational, logical, partner, and suddenly they do not," Shaw said. "This speaks to the extent to which some QAnon believers lose touch with reality altogether, and refuse to be willing to make contact with any other reality . . . the creation of this completely alternate reality has completely taken over their imagination and it becomes an obsessions, and fuels an enormous amount of paranoia, and this loss of touch with reality is not what most spouses are used to seeing in their partner."

Shaw said it takes an "enormous amount of empathy, love, patience and persistence" to get through to a loved one who has fallen for QAnon.

"You cannot directly confront them, try to attack them, prove in a legalistic way that their ideas are false," he said. "None of those things work, they just backfire — and it's not normal for a partner to have that kind of gentle and caring approach when something so crazy is going on."

Melissa Rein Lively is a former QAnon adherent who has been outspoken about how she was drawn in. Lively said she fell into the conspiracy theory by way of "spiritual influencers" that she followed online. It all culminated with her having a breakdown at Target that went viral, and nearly ruined her marriage.

"It absolutely ripped our marriage apart and drove us to the brink of divorce," she said. "I've been in a lot of therapy with my husband and we've worked through our relationship, and we've come through stronger because of it, but I will regret for the rest of my life the day I sat there and looked at my husband and face and said 'I choose QAnon over you.'"

Vaccine 'scavengers' are waiting outside clinics for leftover doses — and their strategy often works

Last week, Amanda Kloots, a co-host on CBS' "The Talk," posted an Instagram photo of herself getting the COVID-19 vaccine. The post sparked a minor social media furor, as many wondered how a 38-year-old woman in California, who by state standards isn't yet eligible for the vaccine, qualified for inoculation. Kloots revealed that she waited at a vaccine site until the end of the day when all other appointments were over — her hope being that she could get a vaccine from an open batch that would otherwise have to be thrown out.

This article originally appeared at Salon.

"I went to a site and waited in my car until all appointments were over in hopes that they had any extra vaccine," Kloots explained in an Instagram post. "I was fully prepared to be turned away, but they said they had enough tonight for everyone waiting."

If Kloots' tale of waiting outside a clinic for an extra vaccine to fall off the truck gives you ideas, you're not alone. Many have wondered if waiting outside clinics at the end of the day can yield a free vaccine, one that might otherwise be chucked, or if Kloots' experience was exceptional.

As NPR reported previously, many COVID-19 vaccines at vaccination sites are getting thrown away. That's partly due to the logistics of properly storing the vaccines. The Pfizer vaccine needs to be kept in a freezer at -70° Celsius. Once it is transferred to a refrigerator, it has a short shelf life of just five days because of the fragile mRNA (synthetic messenger RNA) within. The Moderna vaccine is more hardy; it can be kept at a still-frosty -20°C, and can remain stable for up to one month at consumer refrigerator temperatures. But in the case of both vaccines, once the vials have been opened and the content has been thawed, they must be used or thrown out within five to six hours.

Many local news channels in various states are reporting that thousands of vaccines are being discarded for refrigeration reasons, besides people not showing up for their appointments. In North Carolina, an estimated 2,300 were thrown out due to shipping issues, lack of patients, and refrigeration problems. A similar investigation in Massachusetts found that no-shows were primarily responsible for nearly 1,204 doses of the vaccine that had gone to waste. In states where millions are now being vaccinated a day, just a small percentage of vaccines are going to waste — but that's still thousands of people who could have been vaccinated.

Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, told Salon "vaccine scavengers," which is the term he uses to describe the people who wait to get extra doses after hours at vaccination sites, are "serving an important role."

"Their role is to put their arm in the way of the trash can, so if someone's jumping in front of a needle so it doesn't end up in the trash can, I think that's a good thing," Adalja said. "It's unfortunate that it has come to this, but we've got so many problems with the roll-out that these vaccine scavengers are playing a vital role in the ecosystem to prevent us from wasting vaccines."

Other people refer to them as "vaccine hunters," and there's even a website, VaccineHunter.org, designed to help everyday people find leftover doses. According to the website, vaccine hunters should look for standby lists, call their local providers, or visit their local vaccination sites around closing time. The website links to several Facebook groups where people can swap information about extra doses in their communities. Another similar website, HiDrB, was created to match vaccine hunters with vaccine providers in the case that they have to throw out a dose or find an arm.

But not everyone agrees that these strategies are the best approach. As reported by Boise State Public Radio, public health officials in Idaho don't want people lining up after the vaccination site closes to get an extra vaccine before it goes to waste. It's the same in Los Angeles: according to the LA Times, the Los Angeles County Department of Public Health officials say that the county "does not advise residents to show up at vaccination sites in the hopes of receiving a leftover vaccine at the end of day." As an alternative, some healthcare providers are trying to utilize internal lists of employees and family members; or, in other cases, asking those with appointments to come in earlier.

Meanwhile, some doctors have actually been punished for trying to efficiently use their limited supply of vaccine. As reported by The New York Times, a doctor in Texas was fired and then charged with stealing 10 vaccine doses; he had six hours to give out the extra doses before they ended up in the trash. A judge ended up dismissing the charge.

Still, many doctors are supportive of the vaccine-hunter movement.

"These are people who are being aggressive about getting vaccinated, and I'd rather have people being aggressive about getting vaccinated than not wanting to get vaccinated at all," said Dr. George Rutherford, a professor of epidemiology at the University of California–San Francisco. "It doesn't exactly stick with the tier system, but I think it's better than actually throwing it away at the end of the day."

As Rutherford alluded to, there are concerns around ethics and equity when it comes to the vaccine hunter approach. Countless Americans that are qualified to get a vaccine still cannot get a timely appointment. But bioethicists agree that if a dose is truly in danger of going to waste, it's fair to put that shot in someone's arm even if they are technically unqualified.

"I think that this kind of dogmatism over the priority groups — when the choice is to put the vaccine in someone's arm or put it in the trash can, when you've got politicians that would rather have trash cans — it's really, really mind boggling to me," Adalja said.

As for the individual hunt to get vaccinated, the efficacy of vaccine-hunting often depends on where you are located. After spending hours sifting through Reddit threads and Facebook groups, some hunters manage to find a vaccine, while others haven't been as lucky.

The coronavirus pandemic is making many Americans rethink having kids

When lockdowns rippled across the country last March, many experts speculated that couples cohabitating together would be more apt to have sex and therefore procreate. There is precedent for this speculation: a month-long blackout in Zanzibar in 2008 — in which many were forced to stay home more frequently, just as one might during a pandemic — caused a mini-baby boom nine months later.

This article first appeared in Salon.

Yet predictions of a pandemic baby boom did not take into account how the loss of jobs, income, childcare services — and an overburdened healthcare system fighting a highly contagious coronavirus — would take a massive mental and emotional toll on women and families across the country. Monthly birth data shows that being confined to one house with your significant other doesn't make for primed conditions to bring another human being into this world, even if popular Etsy baby-wear emblazoned with "Mommy and daddy didn't practice social distancing" suggests otherwise.

According to a Bloomberg analysis, births decreased by 19 percent in California between December 2019 and December 2020. Data from Florida, Hawaii, Arizona, and Ohio show large declines in birth rates since the pandemic started compared to the previous year's data, too. A survey conducted by Modern Fertility, a company that sells fertility tests directly to consumers, found that 30 percent of nearly 4,000 people surveyed stated they changed their fertility plans due to COVID-19. One in four of those respondents said they've become unsure about having children at all; the most commonly cited reason was uncertainty about the world. Notably, a similar number of respondents stated that COVID-19 accelerated their timelines for having children.

Indeed, this tumultuous moment has caused many to rethink having kids.

Sarah Logan, editor of The Bunny Hub, told Salon via email that she and her husband decided not to have another baby right now because of the pandemic.

"These difficult times are not the best time to have another family member," Logan said.

Sandra Henderson, a love dating coach in Los Angeles, told Salon via email she can't help but feel "worried" about raising a child in this "chaos."

"For us, it is better to have a child when everything's back to normal and where everything and every place is a safe place to be," Henderson said. "Plus, we are both working from home now, and with lots of responsibilities we are currently juggling in our hands right now, we think we really can't do it for now."

Mike Miller, editor-in-chief of Wilderness Times, said via email in the beginning of 2020 he and his spouse were talking about having a third child, but decided to put that idea on hold.

"During the early days of the pandemic, it was the sheer amount of fear and uncertainty that deterred us from falling pregnant," Miller said. "The thought of going through a pregnancy while the healthcare system is collapsing is absolutely terrifying; we just couldn't deal with any added stress, let alone another human life to take care of and keep safe in amongst all the madness."

Nearly a year later, they are still on pause.

"With both of us working from home while there are two little rugrats running circles around us all day long, it's a miracle we manage to get anything done," Miller said. "We know we're not getting any younger, but unfortunately our biological clocks don't always align perfectly with our plans in life; if there's one thing I'm sure of, it's that no good comes of forcing something that doesn't feel right. So, our plan is to sit tight and see how things unravel."

But deciding not to have children during the pandemic is a choice that not everyone has the privilege to make. For some who were pregnant and seeking abortions just as the pandemic hit, lockdown limited their access to providers and clinics as a handful of states made it it nearly impossible to terminate pregnancies. For people who were planning on undergoing fertility procedures like in vitro fertilization, the pandemic completely threw a wrench in those plans too — as, at the beginning of the pandemic, many of these appointments were put on hold, delayed, or deemed "non-essential" or "elective" procedures.

Sarah Urbanski had originally planned to utilize a known donor's sperm who lived abroad. The known donor would also be the same donor for her partner's pregnancy later on. But the couple quickly realized that once the pandemic hit, due to travel restrictions, that they were going to have to change plans.

"We pivoted to egg retrievals to allow ourselves to push our timeline out with our known donor hoping that travel restrictions might lessen," Urbanski said, adding that they're now doing reciprocal IVF which is when one partner supplies the eggs to be used for IVF, while the other partner carries the pregnancy. "We're trying to see it as a wonderful option for us, but no part in our fertility journey has gone according to what we originally had planned."

Urbanski said they will be working with an anonymous donor from a cryobank now, but it's been tough to rework their original plan in the middle of the pandemic.

"Any given day there's definitely some highs and lows and you know there's nothing really easy about that, and we're not in a vacuum," Urbanski said. "We have folks who are becoming pregnant and announcing that, and we're so happy for people in our chosen family and community. But it's definitely tough when we're coming around — you know, a year and a half, two years that we've been talking about this — and we still feel like we're at the starting line of our journey."

Joe Biden shocked by Trump's COVID failures

President Joe Biden appeared in his first network television interview with CBS News since taking office, and provided insight into the COVID-19 pandemic plan his administration inherited from the Trump administration.

This article originally appeared at Salon.

In the interview with Norah O'Donnell, she asked if the Super Bowl would have a full stadium next year.

"It's my hope and expectation if we're able to put together and make up for all the lost time in fighting COVID that's occurred," Biden said, indicating that the Trump administration's handling of the pandemic was "more dire than we thought."

"One of the disappointments was when we came into office is the circumstance relating to how the [former] administration was handling COVID was even more dire than we thought," Biden said. "We thought that it had indicated there was a lot more vaccine available and it didn't turn out to be the case."

Biden added that's why his administration has "ramped up every way we can."

Biden took office promising to aid the nationwide rollout of vaccines, with a focus on getting them to marginalized populations who have been hit the hardest by COVID-19. To do this, the Biden administration set a goal to reach 100 million vaccinations in its first 100 days of office. The administration has increased its weekly vaccine supply to states and is purchasing an additional 100 million doses of both the Pfizer and Moderna vaccines to quicken the pace of the roll-out throughout the summer. The purchases will provide enough supply to vaccinate nearly 300 million Americans by the end of the summer.

Last week, the Biden administration also announced that it will start shipping vaccine doses to retail pharmacies across the nation; this move is separate from an ongoing federal program to have Walgreens and CVS vaccinate residents of long-term care facilities.

"The Centers for Disease Control, which has quite a bit of experience working with pharmacies, is making sure that we are picking pharmacies in that first phase that are located in areas that are harder to reach to ensure that we have equitable distribution of the pharmacy doses," said Jeff Zients , White House coronavirus response coordinator, adding that the first couple of weeks will be a dry run. "Eventually, as we're able to increase supply, up to 40,000 pharmacies nationwide could provide COVID-19 vaccinations."

Biden calling the vaccine situation "dire" during the CBS interview didn't come exactly as a surprise. Politico previously reported that the Biden administration arrived at the White House ready to hit the ground running, but had to spend much of their first week trying to locate 20 million missing vaccines — a consequence of the Trump administration's infrastructure that failed to track the route vaccines took once they left the federal government's storage spaces.

"Nobody had a complete picture," said Julie Morita, a member of the Biden transition team and executive vice president at the Robert Wood Johnson Foundation, to Politico. "The plans that were being made were being made with the assumption that more information would be available and be revealed once they got into the White House."

The Biden administration is also gearing up to use sports stadiums as mass vaccine sites across the country, which Biden spoke about in the CBS interview. NFL Commissioner Roger Goodell offered the league's 30 stadiums as potential vaccination sites.

When asked if the Biden administration would accept the offer, Biden said, "Absolutely, we will."

"Let me put it this way, I'm gonna tell my team they're available and I believe we'll use them," Biden said.

Some scientists believe life may have started on Mars -- here's why

On February 18, NASA's Perseverance rover will parachute through thin Martian air, marking a new era in red planet exploration. Landing on the Jezero Crater, which is located north of the Martian equator, will be no easy feat. Only about 40 percent of the missions ever sent to Mars succeed, according to NASA. If it does, Perseverance could drastically change the way we think about extraterrestrial life. That's because scientists believe Jezero, a 28 mile-wide impact crater that used to be a lake, is an ideal place to look for evidence of ancient microbial life on Mars.

Once it lands, Perseverance will collect and store Martian rock and soil samples, which will eventually be returned to Earth. This is known as a "sample-return mission," an extremely rare type of space exploration mission due to its expense. (Indeed, there has never been a sample return mission from another planet.) And once Martian soil is returned to Earth in a decade, scientists will set about studying the material to figure out if there was ever ancient life on Mars.

Yet some scientists believe that these samples could answer an even bigger question: Did life on Earth originate on Mars?

Though the idea that life started on Mars before migrating on Earth sounds like some far-fetched sci-fi premise, many renowned scientists take the theory seriously. The general idea of life starting elsewhere in space before migrating here has a name, too: Panspermia. It's the hypothesis that life exists elsewhere in the universe, and is distributed by asteroids and other space debris.

To be clear, the notion of life on Earth originating on Mars isn't a dominant theory in the scientific community, but it does appear to be catching on. And scientists like Gary Ruvkun, a professor of genetics at Harvard Medical School, say that it does sound "obvious, in a way."

The evidence starts with how space debris moved around in the young solar system. Indeed, we have evidence of an exchange of rocks from Mars to Earth. Martian meteorites have been found in Antarctica and across the world — an estimated 159, according to the International Meteorite Collectors Association.

"You can assign them to Mars based on the gaseous inclusions that they have, that are sort of the equivalent of the gases that were shown by the Viking spacecraft" to exist in Mars' atmosphere, Ruvkun said. In other words, small bubbles of air in these rocks reveal that they were forged in the Martian air. "So, there is exchange between Mars and Earth — probably more often going from Mars to Earth because it goes 'downhill,' going to Mars is 'uphill,' gravitationally-speaking."

But for Ruvkun, whose area of expertise is genomics, it's the timing of cellular life that he believes makes a strong case that life on Earth came from somewhere else — perhaps Mars, or perhaps Mars vis-a-vis another planet.

Ruvkun noted that our genomes reveal the history of life, and provide clues about the ancestors that preceded us by millions or even billions of years. "In our genomes, you can kind of see the history, right?" he said. "There's the RNA world that predated the DNA world and it's very well supported by all kinds of current biology; so, we know the steps that evolution took in order to get to where we are now."

Thanks to the advancement of genomics, the understanding of LUCA (the Last Universal Common Ancestor) — meaning the organism from which all life on Earth evolved from — has greatly advanced. By studying the genetics of all organisms on Earth, scientists have a very good sense of what the single-celled ancestor of every living thing (on Earth) looked like. They also know the timeline: all modern life forms descend from a single-celled organism that lived about 3.9 billion years ago, only 200 million years after the first appearance of liquid water. In the grand scheme of the universe, that's not that long.

And the last universal common ancestor was fairly complicated as far as organisms go. That leaves two possibilities, Ruvkun says. "Either evolution to full-on modern genomes is really easy, or the reason you see it so fast was that we just 'caught' life, it didn't actually start here." He adds, "I like the idea that we just caught it and that's why it's so fast, but I'm an outlier."

If that's the case, then Erik Asphaug, is a professor of planetary science at the University of Arizona, is also an outlier. Asphaug said that what we know about the oldest rocks on Earth — which have chemical evidence of carbon isotopes, tracing back to nearly 4 billion years ago — tell us that life started "started forming on Earth almost as soon as it was possible for it to happen."

If that's the case, it makes for an interesting precedent. "Let's say you expect life to be flourishing whenever a planet cools down to the point where it can start to have liquid water," Asphaug said. "But just looking at our own solar system, what planet was likely to be habitable first? Almost certainly Mars."

This is because, Asphaug said, Mars formed before Earth did. Early in Martian history when Mars was cooling down, Mars would have had a "hospitable" environment before Earth.

"If life was going to start anywhere it might start first on Mars," Asphaug said. "We don't know what the requirement is — you know, if it required something super special like the existence of a moon or some factors that are unique to the Earth — but just in terms of what place had liquid water first, that would have been Mars."

An intriguing and convincing piece of evidence relates to how material moved between the two neighboring planets. Indeed, the further you go back in time, the bigger the collisions of rocks between Mars and Earth, Asphaug said. These impact events could have been huge "mountain-sized blocks of Mars" that were launched into space. Such massive asteroids could serve as a home for a hardy microorganism.

"When you collide back into a planet, some fraction of that mountain-sized mass is going to survive as debris on the surface," he said. "It's taken a while for modeling to show that you can have a relatively intact survival of what we call 'ballistic panspermia' — firing a bullet into one planet, knocking bits off, and having it end up on another planet. But it's feasible, we think it happens, and the trajectory would tend to go from Mars to the Earth, much more likely than from Earth to Mars."

Asphaug added that surviving the trip, given the mass of the vehicle for the microorganisms, wouldn't be a problem — and neither would surviving on a new, hospitable planet.

"Any early life form would be resistant to what's going on at the tail end of planet formation," he said. "Any organism that's going to be existing has to be used to the horrific bombardment of impacts, even apart from this, swapping from planet to planet."

In other words, early microbial life would have been fine with harsh environments and long periods of dormancy.

Harvard professor Avi Loeb told Salon via email that one of the Martian rocks found on Earth, ALH 84001, "was not heated along its journey to more than 40 degrees Celsius and could have carried life."

All three scientists believe that Perseverance might be able to add credibility to the theory of panspermia.

"If you were to go and find remnants of life on Mars, which we hope to do with Perseverance rover and these other Martian adventures, I would be personally surprised if they were not connected at the hip to terrestrial life," Asphaug said.

Ruvkun said he hopes to be one of the scientists to look for DNA when the sample from Mars hopefully, eventually, returns.

"Launching something from Mars is a seriously difficult thing," he said.

But what would this mean for human beings, and our existential understanding of who we are and where we came from?

"In that case, we might all be Martians," Loeb said. He joked that the self-help book "Men are from Mars, Women are from Venus" may have been more right than we know.

Or perhaps, as Ruvkun believes, we're from a different solar system, and life is just scattering across the universe.

"To me the idea that it all started on Earth, and every single solar system has their own little evolution of life happening, and they're all independent — it just seems kind of dumb," Ruvkun said. "It's so much more explanatory to say 'no, it's spreading, it's spreading all across the universe, and we caught it too, it didn't start here," he added. "And in this moment during the pandemic — what a great moment to pitch the idea. Maybe people will finally believe it."

A new COVID vaccine is 66 percent effective — but how much does vaccine efficacy matter?

Last week, Novavax released results from its COVID-19 vaccine trials that are raising concerns in the United States as new, more transmissible — and perhaps more deadly — variants emerge. In Britain, where a more transmissible strain known as s B.1.1.7 is the dominant strain, the two-dose vaccine had an efficacy rate of nearly 89.4 percent. But in South Africa, where the strain B.1.351 is predominantly circulating, the efficacy rate decreased to 50 percent.

This article first appeared in Salon.

Clinical trial data from Johnson and Johson yielded similar results. The company's single-shot vaccine had 66 percent efficacy in a large-scale trial which spanned three continents. In the US, the vaccine's efficacy reached 72 percent. In South Africa, it was 57 percent.

While the headlines communicating the news of reduced efficacy might seem alarming, epidemiologists say it's not time to panic yet. In the world of vaccines, 50 percent efficacy is still impressive.

"The flu vaccine has an efficacy of 36 percent," said Dr. George Rutherford, a professor of epidemiology at the University of California, San Francisco. "The fact that we set the bar at 95 is just phenomenal; and that's the best vaccine we have, which is the measles vaccine."

Both the Moderna and Pfizer vaccines are over 90 percent, too.

Rutherford said that news about the Johnson & Johnson and Novavax vaccines' protecting against the new variant is "very encouraging."

"That's solid protection," Rutherford said.

Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, agreed.

"You have to remember that that 50 percent number reflects how effective it is at preventing symptomatic disease, so that's not the same thing as severe disease, death and hospitalization, where it is highly effective," Adalja said. "So the proper story of the Novavax vaccine is that even in the face of the South African variant, the Novavax vaccine prevents severe disease from COVID-19, prevents deaths from COVID-19, prevents hospitalization from COVID-19."

As explained by the World Health Organization, vaccine efficacy is the percentage of "reduction in disease incidence in a vaccinated group compared to an unvaccinated group under optimal conditions." This shouldn't be confused with vaccine effectiveness, which is the "ability of vaccine[s] to prevent outcomes of interest in the 'real world.'"

Experts warned in the The BMJ that comparing the lower efficacy rate to higher ones is a "mistake," especially considering how Johnson & Johnson is expected to be a game-changer in the international vaccine roll-out. Unlike the Moderna, Pfizer and Novavax vaccines, which all require two shots, Johnson & Johnson only requires one. It also has lower storage requirements that make it more flexible to store and administer.

"The real headline result is that a single shot vaccine, capable of easy long term storage and administration, provided complete protection against hospitalisation and death," said Kevin Marsh, professor of tropical medicine at the University of Oxford, in The BMJ. "This is important, because the immediate requirement of vaccination globally is to limit deaths as quickly as possible."

The variant B.1.351 first emerged in Durban, South Africa. Scientists were alarmed that the mutation of the virus is at the SARS-CoV-2 Spike, disguising its appearance to the immune system, which can make it easier to bypass immune protection. This is why scientists are seeing a decrease in efficacy in the vaccine, which is what they predicted would be the case from the start.

There is cause for concern that the coronavirus is mutating where it is. Yet any marginally efficacious vaccine will help stop the spread of the coronavirus. That will have a domino effect, as lower transmission means fewer viruses replicating, and therefore mutating.

"Viruses cannot mutate if they can't replicate," Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said on Monday. "If you stop their replication by vaccinating widely ... not only are you going to protect individuals from getting disease, but you are going to prevent the emergence of variants."

Adalja told Salon the goal right now isn't to eradicate the coronavirus, but instead to decrease severe outcomes.

"We're not getting rid of this, this is not going to be eradicated like Smallpox," he said. "What we're trying to do is defang this virus, make it something that's more like the other coronaviruses that cause 25 percent of our common colds by giving people immunity through a vaccine . . . so that's what these vaccines are doing, people are forgetting that the end game here is to prevent death."

But what if new variants emerge, and become smart enough to completely outwit our vaccines? Well, then, scientists will have to modify the vaccines. Adalja said it's "unclear" at this point if that is something we will have to do in the future, but if we do, it's relatively "easy to do."

"Novavax uses a recombinant platform, which is very easy to modify," Adalja said.

Rutherford said that the vaccines might need to be modified "as this virus evolves." Still, he's encouraged by news, specifically what has been making its way into the Israeli press. A man who previously recovered from COVID-19 got reinfected with the B.1.351 strain, but the second time around he had very little in the way of symptoms.

"Naturally acquired immunity seems to have some level of protection against serious disease, which is what we're trying to do," Rutherford said.

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