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"content": "\u003cp>When Henry Genung was 4 months old, doctors cut a hole in his windpipe and inserted a tube to help him breathe. Born with a rare genetic mutation that blocked his upper airway, Henry, who is now 18 months old, will need the tube for several more years.\u003c/p>\n\u003cp>For three months, Henry hasn’t had a new rubber tracheostomy tube even though doctors recommend that they be replaced weekly to reduce the risk of infection. Instead, Henry’s parents have resorted to soaking his used tubes in hydrogen peroxide and boiling them for five minutes. Their medical supplier and doctor’s office told them they don’t know how soon new supplies will be available.\u003c/p>\n\u003cp>“It’s an ongoing saga of delayed shipments,” said Myah Genung, Henry’s mother, who lives in Los Angeles with her husband Dillon and son.\u003c/p>\n\u003cfigure id=\"attachment_11897227\" class=\"wp-caption alignnone\" style=\"max-width: 1000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11897227\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02.jpg\" alt=\"A baby sitting on a couch smiling, wearing a T-shirt. \" width=\"1000\" height=\"1250\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02.jpg 1000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02-800x1000.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02-160x200.jpg 160w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\">\u003cfigcaption class=\"wp-caption-text\">Henry Genung was born with CLAPO syndrome, which causes malformations of the lymph nodes and obstructs his breathing. He had a tracheostomy put in at 4 months and the tube is supposed to be replaced weekly, but the Genung family has been unable to get new tracheostomy tubes since September because of the port logjam and supply chain backlogs. \u003ccite>(Photo courtesy of Maya Genung)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>With upwards of 80 container ships languishing off the coast of Southern California, patients and medical suppliers are worried that stories like Genung’s will become increasingly common.\u003c/p>\n\u003cp>The \u003ca href=\"https://calmatters.org/economy/2021/11/california-ports/\">logjam at the ports of Los Angeles and Long Beach\u003c/a> — which handle \u003ca href=\"https://www.portoflosangeles.org/business/statistics/facts-and-figures\">40% of all waterbound imports\u003c/a> to the U.S. — has triggered shortages of everything from computer chips to paper products to kitchen appliances, and drawn the \u003ca href=\"https://www.washingtonpost.com/business/2021/10/13/biden-port-los-angeles-supply-chain/\">attention of President Joe Biden\u003c/a>. But, while many people are worrying about delayed Christmas gifts, many Californians are grappling with shortages of lifesaving medical supplies.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California hospitals say medical supplies are more difficult to acquire now or are taking much longer to be delivered. Although the Hospital Association of Southern California says no one has reported any acute shortages yet, administrators are concerned about the delayed shipments that are anchored off the coast.\u003c/p>\n\u003cp>Experts say the shortages and inflation will drive health care costs up, increasing insurance premiums. In addition, some medical device suppliers are considering cutting off sales to patients on Medi-Cal, the state’s insurance for low-income people, as they look for ways to reduce costs.\u003c/p>\n\u003ch3 id=\"h-where-are-the-medical-supplies\">Where are the medical supplies?\u003c/h3>\n\u003cp>Port gridlock is the latest chapter in a long saga of medical supply chain disruptions during the pandemic. Demand for personal protective equipment and respirators skyrocketed globally at the same time that overseas manufacturers temporarily closed to reduce the spread of COVID-19 among workers.\u003c/p>\n\u003cp>Last winter, hospitals desperate for bed space were sending less-severe COVID-19 patients home on supplemental oxygen. “We couldn’t keep oxygen concentrators on the wall, couldn’t keep them in inventory,” said Terry Racciato, who owns a durable medical equipment supply company in San Diego. “The shipping backlog prevented them from getting into the country, much less getting to patients that need them.”\u003c/p>\n\u003cp>Now, specialized equipment like walkers, canes, wheelchairs, crutches, syringes, needles, catheters, surgical gloves, feeding tubes and suction canisters are increasingly hard to come by.\u003c/p>\n\u003cfigure id=\"attachment_11852807\" class=\"wp-caption alignnone\" style=\"max-width: 1000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11852807\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/1000.jpeg\" alt=\"Phlebotomist lab assistant Jennifer Cukati, right, and Registered Nurse Carina Klescewski, left, care for a COVID-19 patient inside the Sutter Roseville Medical Center ICU in Roseville, Calif.\" width=\"1000\" height=\"665\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/1000.jpeg 1000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/1000-800x532.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/1000-160x106.jpeg 160w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\">\u003cfigcaption class=\"wp-caption-text\">Phlebotomist lab assistant Jennifer Cukati, right, and Registered Nurse Carina Klescewski, left, care for a COVID-19 patient inside the Sutter Roseville Medical Center ICU in Roseville, Calif. \u003ccite>(Renee C. Byer/The Sacramento Bee via AP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In September, the \u003ca href=\"https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/medical-device-shortages-during-covid-19-public-health-emergency#shortage\">FDA announced\u003c/a> nationwide shortages of ventilators. Specimen collection tubes also have been in short supply since the summer.\u003c/p>\n\u003cp>Compounding the issue, hospitals, which are admitting above-average numbers of patients who delayed care during the pandemic, are trying to stay ahead of any potential winter COVID-19 surge.\u003c/p>\n\u003cp>“A key concern for hospital directors right now is that they’re trying to schedule an enormous backlog of patients that weren’t able to get into facilities in the last year due to COVID patients that might have needed a scheduled surgery in 2019 or 2020 or 2021,” said Dr. William Padula, an assistant professor of pharmaceutical & health economics at the USC Leonard D. Schaeffer Center for Health Policy and Economics. “With the backlog of supplies in the medical sector, they might not be able to get the procedure that they were anticipating, or they might not be able to get the materials that they need to follow up from a procedure for rehabilitative care. So it really creates a concern that those who have already delayed or foregone certain procedures now have to wait more so until the supplies catch up.”\u003c/p>\n\u003cp>Prime Healthcare, which operates hospitals throughout the state, has been able to shift supplies as needed between its hospitals, but has joined other health systems and the California Chamber of Commerce in \u003ca href=\"https://calchamberalert.com/2021/11/05/calchamber-practical-steps-to-ease-supply-chain-crisis/\">requesting help\u003c/a> from Gov. Gavin Newsom and the Legislature to speed up the movement of medical goods.\u003c/p>\n\u003cp>“We have a number of hospitals and health care suppliers saying ‘Hey we’ve got products sitting out there.’ So they’re pretty concerned about that issue in particular,” said Leah Silverthorn, policy advocate for CalChamber, which sent the letter to Newsom and the Legislature.\u003c/p>\n\u003cp>Increased purchasing of all consumer goods coupled with labor shortages, outdated port infrastructure\u003cem>, \u003c/em>and prior disruptions to shipping and manufacturing early in the pandemic have culminated in the \u003ca href=\"https://calmatters.org/economy/2021/11/california-ports/\">offshore traffic jam\u003c/a>.\u003c/p>\n\u003cp>While the two ports have \u003ca href=\"https://www.portoflosangeles.org/references/2021-news-releases/news_111521_dwelpostpone\">reduced the backlog of idling containers by 26%\u003c/a> in the past three weeks by threatening steep fines, more than 40,000 containers have sat at the terminals for at least nine days. Before the pandemic, the average wait was less than four days, according to port operations reports in Los Angeles and Long Beach. Some ships have been anchored off the coast for more than 30 days while they await a spot to dock.\u003c/p>\n\u003cp>“There’s some concern about a winter surge of COVID and having access to those containers,” Silverthorn said.\u003c/p>\n\u003cp>CalChamber is working with its nearly 1,000 health care members to track down the container numbers for delayed shipments and identify the ships.\u003c/p>\n\u003cp>“It’s kind of a bottleneck of data right now,” Silverthorn said. “The data lies with each link of the shipping supply chain, and so trying to aggregate it in a convenient way is challenging.”\u003c/p>\n\u003cp>Currently, no one knows how many containers may be carrying medical supplies or the quantity of goods waiting offshore. Experts say the lack of data is a systemic problem in the supply chain that makes it nearly impossible to prioritize critical health care devices. No information system connects the manufacturers, shipping companies, port terminal operators, suppliers and buyers.\u003c/p>\n\u003cp>“This is already 2021, but shipping companies cannot give an accurate hour-by-hour estimation about when goods will arrive or where they are,” said Tinglong Dai, a professor of operations management and business analytics at Johns Hopkins University who specializes in health care operations.\u003c/p>\n\u003cp>Dai has spent the 20 months of the pandemic advocating for supply chain transparency, particularly when it comes to medical supplies.\u003c/p>\n\u003cp>“What they are producing is very important to public health,” he said, “and public health authorities have no idea exactly how much inventory we’re going to have if and when similar crises will arise in the future.”\u003c/p>\n\u003cp>In response to the letter to Newsom and an earlier \u003ca href=\"https://www.gov.ca.gov/2021/10/20/governor-newsom-signs-executive-order-to-help-tackle-supply-chain-issues/\">executive order\u003c/a>, GO-Biz, the governor’s Office of Business and Economic Development, and other state agencies have been working to identify sites that can be used to store empty, abandoned and slow-moving containers that are exacerbating the backlog, said GO-Biz spokesperson Heather Purcell.\u003c/p>\n\u003cfigure id=\"attachment_11892157\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11892157\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/GettyImages-1344305961-scaled.jpg\" alt=\"Gavin Newsom, wearing a black mask and standing beyond a podium with the Seal of California, scribbles in a tiny notepad.\" width=\"2560\" height=\"1706\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Gov. Gavin Newsom takes notes before speaking at a news conference on Oct. 1, 2021, in San Francisco. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This will free up crowded dock space to move integral medical supplies. Additionally, GO-Biz is directly in coordination with a terminal operator to speed up the movement of medical supplies,” Purcell said.\u003c/p>\n\u003cp>However, Purcell said the state has no way to identify medical supplies other than consulting with individual buyers. Even then, the contents of specific containers are frequently unknown.\u003c/p>\n\u003ch3 id=\"h-shortages-and-delays\">Shortages and delays\u003c/h3>\n\u003cp>Cedars Sinai in Los Angeles has experienced supply chain problems acquiring catheters, syringes and blood collection tubes, communications director Duke Helfand said. However, the hospital has been able to rely on pre-existing reserves and alternate suppliers to avoid any impact on patients.\u003c/p>\n\u003cp>Similarly, Community Medical Centers in the Central Valley have experienced periodic shortages of computers, suction canisters and masks during the pandemic, according to Lucky Malhi, vice president of supply chain management. His team has worked round-the-clock to secure supplies through alternate distributors.\u003c/p>\n\u003cp>But patients requiring supplies for home use, like the Genungs’ son Henry, typically don’t have the option to find alternate suppliers, so they have felt the scarcity much more sharply.\u003c/p>\n\u003cp>Myah Genung said she has turned to Facebook groups where parents of “trach babies” share extra supplies. She has snagged humidifying filters for Henry’s breathing tube through social media, but more often than not, there are more people seeking supplies than there are extras.\u003c/p>\n\u003cp>“We’re just having to make do the best we can,” she said.\u003c/p>\n\u003cp>More than \u003ca href=\"http://rc.rcjournal.com/content/59/6/895#ref-20\">100,000 tracheostomy\u003c/a> procedures are performed annually across the country. Racchiato, whose supply company, SpecialCare, primarily distributes directly to patients, said replacement tubes are one of the most difficult things to acquire right now.\u003c/p>\n\u003cp>“There are people who are trying to sterilize (the tubes) themselves and reuse them. They’re risking serious infection because new supplies aren’t available,” Racciato said.\u003c/p>\n\u003cp>Most tracheostomy tubes are only supposed to be used once, said Dr. Maggie Kuhn, associate professor of otolaryngology at UC Davis Health. Reusing the tubes can cause serious problems, including increased risk of infection and device malfunctioning.\u003c/p>\n\u003cp>“We have observed complications from this practice which can be life-threatening, including mucous plugging and airway trauma,” Kuhn said.\u003c/p>\n\u003cp>Other devices like oxygen concentrators face months-long delays compared to typical delivery times of one to two weeks.\u003c/p>\n\u003cp>Complicating matters, one of the largest manufacturers of continuous positive airway pressure, or CPAP, machines \u003ca href=\"https://www.nytimes.com/2021/08/17/health/cpap-breathing-devices-recall.html\">recalled millions of devices\u003c/a> in June and is reserving its inventory for patients that need replacement machines. As a result, Racciato said she has at least 1,000 patients diagnosed with sleep apnea who have been on a waiting list without treatment for five months.\u003c/p>\n\u003ch3 id=\"h-prices-increase-while-access-decreases\">Prices increase while access decreases\u003c/h3>\n\u003cp>\u003ca href=\"https://www.newyorker.com/news/our-columnists/inflation-and-the-great-global-logjam\">Inflationary pressure\u003c/a> on the medical supply market also has some suppliers concerned about how long they can stay in business. Scarcity of raw materials and logistical challenges along with the port backlogs have steeply driven up the cost of manufacturing and shipping, creating a volatile market.\u003c/p>\n\u003cp>“(Shipping) containers have gone from $2,000 for rental to anywhere from $15,000 to $20,000 for the same container,” said Steve Yaeger, a Los Angeles-based medical supplier who specializes in respiratory equipment.\u003c/p>\n\u003cp>Since the beginning of the pandemic, Yaeger said his overhead has increased 25%.\u003c/p>\n\u003cp>“When you see the cost of goods go up like that, all of a sudden you’re figuring out, ‘OK are we even going to make any money this year?’”\u003c/p>\n\u003cp>Experts say inflation among medical supplies will result in higher health care costs for patients as hospitals and other providers struggle to maintain adequate profit margins.\u003c/p>\n\u003cp>William Padula, a senior fellow at the USC Schaeffer Center for Health Policy & Economics, said the “supply chain disaster” will result in hospitals negotiating for higher reimbursement rates with insurers and patients paying higher premiums.\u003c/p>\n\u003cp>“The natural consequence on the consumer side is … premiums will go up,” Padula said. [aside tag=\"politics\" label=\"More political coverage\"]\u003c/p>\n\u003cp>Already, the Centers for Medicare and Medicaid Services announced the \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/2022-medicare-parts-b-premiums-and-deductibles2022-medicare-part-d-income-related-monthly-adjustment\">highest premium increase\u003c/a> in the program’s history for Medicare Part B and higher deductibles for other aspects of the program, in part due to increased utilization in the past year.\u003c/p>\n\u003cp>“In their statement, Medicare blamed the increase of premiums on COVID and the cost of that new drug for Alzheimers, which is expected to take off, but COVID is very broad. It really is about the supply chain,” Padula said.\u003c/p>\n\u003cp>Although it’s too soon to tell how much premiums will increase across the board, historically commercial insurers have followed Medicare’s lead.\u003c/p>\n\u003cp>“That gives a lot of commercial payers a pass to increase by a similar amount at a minimum,” Padula said.\u003c/p>\n\u003cp>The resultant cost hikes have also forced small and mid-sized suppliers to rethink which patients they can afford to serve, potentially leading to decreased access for those with Medi-Cal or Medicare, which have fixed reimbursement rates.\u003c/p>\n\u003cp>California has temporarily increased these reimbursement rates for the duration of the \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2021/11/california-covid-state-of-emergency/\">COVID-19 public health emergency\u003c/a>, which is set to expire at the end of March. Beyond that, providers aren’t sure how long they can hold on.\u003c/p>\n\u003cp>Ron Biasca, a medical supplier based in Eureka, said increased costs are forcing his company to reassess what services it provides to Medicare and Medi-Cal patients.\u003c/p>\n\u003cp>“We are evaluating all entitlements right now to look at what we’re making money on. We are going to have to make some hard decisions and just not accept the insurance payment,” Biasca said.\u003c/p>\n\u003cp>Roughly \u003ca href=\"https://calmatters.org/economy/poverty/2017/08/paying-doctors-now-will-treat-poor-californians/\">one-third of all Californians rely on Medi-Cal\u003c/a> for health care and frequently face long wait times and \u003ca href=\"https://www.chcf.org/publication/measuring-up-access-care-medi-cal-compared-other-types-health-insurance-2018/\">difficulty finding doctors\u003c/a> and other providers who will accept their insurance. And the out-of-pocket costs are inaccessible even for people with private health insurance.\u003c/p>\n\u003cfigure id=\"attachment_11897232\" class=\"wp-caption alignnone\" style=\"max-width: 1000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11897232\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01.jpg\" alt=\"The family, mother father and child, are well-dressed. \" width=\"1000\" height=\"1250\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01.jpg 1000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01-800x1000.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01-160x200.jpg 160w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\">\u003cfigcaption class=\"wp-caption-text\">Maya and Dillon Genung hold their son Henry in a family portrait. \u003ccite>( Image courtesy of Maya Genung)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Genung said she has tried to purchase the tracheostomy tubes her son needs online but they cost between $300 to $600 each. “You would be spending thousands and thousands of dollars a month just to purchase it yourself,” she said.\u003c/p>\n\u003cp>Reusing the tubes fills her with worry. Henry’s condition requires him to be immunosuppressed, and reusing tubes increases the risk of infection or breakage as the equipment wears down.\u003c/p>\n\u003cp>“It’s not foolproof because you’re not in a sterile environment. You’re at home, you’re in your kitchen, doing your best to make it work,” Genung said.\u003c/p>\n\u003cp>A week ago, Henry was admitted to Children’s Hospital Los Angeles with pneumonia. Doctors told his parents there’s no way of knowing if the infection was caused by the reuse of tubes.\u003c/p>\n\u003cp>The only small silver lining is that the hospital gave Genung two new tracheostomy tubes, enough to get Henry through another month.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This article was originally published by \u003ca href=\"https://calmatters.org/health/2021/11/medical-supplies-shortage-california/\">CalMatters\u003c/a>. KQED producer Keith Mizuguchi contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Henry Genung was 4 months old, doctors cut a hole in his windpipe and inserted a tube to help him breathe. Born with a rare genetic mutation that blocked his upper airway, Henry, who is now 18 months old, will need the tube for several more years.\u003c/p>\n\u003cp>For three months, Henry hasn’t had a new rubber tracheostomy tube even though doctors recommend that they be replaced weekly to reduce the risk of infection. Instead, Henry’s parents have resorted to soaking his used tubes in hydrogen peroxide and boiling them for five minutes. Their medical supplier and doctor’s office told them they don’t know how soon new supplies will be available.\u003c/p>\n\u003cp>“It’s an ongoing saga of delayed shipments,” said Myah Genung, Henry’s mother, who lives in Los Angeles with her husband Dillon and son.\u003c/p>\n\u003cfigure id=\"attachment_11897227\" class=\"wp-caption alignnone\" style=\"max-width: 1000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11897227\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02.jpg\" alt=\"A baby sitting on a couch smiling, wearing a T-shirt. \" width=\"1000\" height=\"1250\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02.jpg 1000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02-800x1000.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Henry-Genung-CM-02-160x200.jpg 160w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\">\u003cfigcaption class=\"wp-caption-text\">Henry Genung was born with CLAPO syndrome, which causes malformations of the lymph nodes and obstructs his breathing. He had a tracheostomy put in at 4 months and the tube is supposed to be replaced weekly, but the Genung family has been unable to get new tracheostomy tubes since September because of the port logjam and supply chain backlogs. \u003ccite>(Photo courtesy of Maya Genung)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>With upwards of 80 container ships languishing off the coast of Southern California, patients and medical suppliers are worried that stories like Genung’s will become increasingly common.\u003c/p>\n\u003cp>The \u003ca href=\"https://calmatters.org/economy/2021/11/california-ports/\">logjam at the ports of Los Angeles and Long Beach\u003c/a> — which handle \u003ca href=\"https://www.portoflosangeles.org/business/statistics/facts-and-figures\">40% of all waterbound imports\u003c/a> to the U.S. — has triggered shortages of everything from computer chips to paper products to kitchen appliances, and drawn the \u003ca href=\"https://www.washingtonpost.com/business/2021/10/13/biden-port-los-angeles-supply-chain/\">attention of President Joe Biden\u003c/a>. But, while many people are worrying about delayed Christmas gifts, many Californians are grappling with shortages of lifesaving medical supplies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California hospitals say medical supplies are more difficult to acquire now or are taking much longer to be delivered. Although the Hospital Association of Southern California says no one has reported any acute shortages yet, administrators are concerned about the delayed shipments that are anchored off the coast.\u003c/p>\n\u003cp>Experts say the shortages and inflation will drive health care costs up, increasing insurance premiums. In addition, some medical device suppliers are considering cutting off sales to patients on Medi-Cal, the state’s insurance for low-income people, as they look for ways to reduce costs.\u003c/p>\n\u003ch3 id=\"h-where-are-the-medical-supplies\">Where are the medical supplies?\u003c/h3>\n\u003cp>Port gridlock is the latest chapter in a long saga of medical supply chain disruptions during the pandemic. Demand for personal protective equipment and respirators skyrocketed globally at the same time that overseas manufacturers temporarily closed to reduce the spread of COVID-19 among workers.\u003c/p>\n\u003cp>Last winter, hospitals desperate for bed space were sending less-severe COVID-19 patients home on supplemental oxygen. “We couldn’t keep oxygen concentrators on the wall, couldn’t keep them in inventory,” said Terry Racciato, who owns a durable medical equipment supply company in San Diego. “The shipping backlog prevented them from getting into the country, much less getting to patients that need them.”\u003c/p>\n\u003cp>Now, specialized equipment like walkers, canes, wheelchairs, crutches, syringes, needles, catheters, surgical gloves, feeding tubes and suction canisters are increasingly hard to come by.\u003c/p>\n\u003cfigure id=\"attachment_11852807\" class=\"wp-caption alignnone\" style=\"max-width: 1000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11852807\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/1000.jpeg\" alt=\"Phlebotomist lab assistant Jennifer Cukati, right, and Registered Nurse Carina Klescewski, left, care for a COVID-19 patient inside the Sutter Roseville Medical Center ICU in Roseville, Calif.\" width=\"1000\" height=\"665\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/1000.jpeg 1000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/1000-800x532.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/1000-160x106.jpeg 160w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\">\u003cfigcaption class=\"wp-caption-text\">Phlebotomist lab assistant Jennifer Cukati, right, and Registered Nurse Carina Klescewski, left, care for a COVID-19 patient inside the Sutter Roseville Medical Center ICU in Roseville, Calif. \u003ccite>(Renee C. Byer/The Sacramento Bee via AP)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In September, the \u003ca href=\"https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/medical-device-shortages-during-covid-19-public-health-emergency#shortage\">FDA announced\u003c/a> nationwide shortages of ventilators. Specimen collection tubes also have been in short supply since the summer.\u003c/p>\n\u003cp>Compounding the issue, hospitals, which are admitting above-average numbers of patients who delayed care during the pandemic, are trying to stay ahead of any potential winter COVID-19 surge.\u003c/p>\n\u003cp>“A key concern for hospital directors right now is that they’re trying to schedule an enormous backlog of patients that weren’t able to get into facilities in the last year due to COVID patients that might have needed a scheduled surgery in 2019 or 2020 or 2021,” said Dr. William Padula, an assistant professor of pharmaceutical & health economics at the USC Leonard D. Schaeffer Center for Health Policy and Economics. “With the backlog of supplies in the medical sector, they might not be able to get the procedure that they were anticipating, or they might not be able to get the materials that they need to follow up from a procedure for rehabilitative care. So it really creates a concern that those who have already delayed or foregone certain procedures now have to wait more so until the supplies catch up.”\u003c/p>\n\u003cp>Prime Healthcare, which operates hospitals throughout the state, has been able to shift supplies as needed between its hospitals, but has joined other health systems and the California Chamber of Commerce in \u003ca href=\"https://calchamberalert.com/2021/11/05/calchamber-practical-steps-to-ease-supply-chain-crisis/\">requesting help\u003c/a> from Gov. Gavin Newsom and the Legislature to speed up the movement of medical goods.\u003c/p>\n\u003cp>“We have a number of hospitals and health care suppliers saying ‘Hey we’ve got products sitting out there.’ So they’re pretty concerned about that issue in particular,” said Leah Silverthorn, policy advocate for CalChamber, which sent the letter to Newsom and the Legislature.\u003c/p>\n\u003cp>Increased purchasing of all consumer goods coupled with labor shortages, outdated port infrastructure\u003cem>, \u003c/em>and prior disruptions to shipping and manufacturing early in the pandemic have culminated in the \u003ca href=\"https://calmatters.org/economy/2021/11/california-ports/\">offshore traffic jam\u003c/a>.\u003c/p>\n\u003cp>While the two ports have \u003ca href=\"https://www.portoflosangeles.org/references/2021-news-releases/news_111521_dwelpostpone\">reduced the backlog of idling containers by 26%\u003c/a> in the past three weeks by threatening steep fines, more than 40,000 containers have sat at the terminals for at least nine days. Before the pandemic, the average wait was less than four days, according to port operations reports in Los Angeles and Long Beach. Some ships have been anchored off the coast for more than 30 days while they await a spot to dock.\u003c/p>\n\u003cp>“There’s some concern about a winter surge of COVID and having access to those containers,” Silverthorn said.\u003c/p>\n\u003cp>CalChamber is working with its nearly 1,000 health care members to track down the container numbers for delayed shipments and identify the ships.\u003c/p>\n\u003cp>“It’s kind of a bottleneck of data right now,” Silverthorn said. “The data lies with each link of the shipping supply chain, and so trying to aggregate it in a convenient way is challenging.”\u003c/p>\n\u003cp>Currently, no one knows how many containers may be carrying medical supplies or the quantity of goods waiting offshore. Experts say the lack of data is a systemic problem in the supply chain that makes it nearly impossible to prioritize critical health care devices. No information system connects the manufacturers, shipping companies, port terminal operators, suppliers and buyers.\u003c/p>\n\u003cp>“This is already 2021, but shipping companies cannot give an accurate hour-by-hour estimation about when goods will arrive or where they are,” said Tinglong Dai, a professor of operations management and business analytics at Johns Hopkins University who specializes in health care operations.\u003c/p>\n\u003cp>Dai has spent the 20 months of the pandemic advocating for supply chain transparency, particularly when it comes to medical supplies.\u003c/p>\n\u003cp>“What they are producing is very important to public health,” he said, “and public health authorities have no idea exactly how much inventory we’re going to have if and when similar crises will arise in the future.”\u003c/p>\n\u003cp>In response to the letter to Newsom and an earlier \u003ca href=\"https://www.gov.ca.gov/2021/10/20/governor-newsom-signs-executive-order-to-help-tackle-supply-chain-issues/\">executive order\u003c/a>, GO-Biz, the governor’s Office of Business and Economic Development, and other state agencies have been working to identify sites that can be used to store empty, abandoned and slow-moving containers that are exacerbating the backlog, said GO-Biz spokesperson Heather Purcell.\u003c/p>\n\u003cfigure id=\"attachment_11892157\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11892157\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/GettyImages-1344305961-scaled.jpg\" alt=\"Gavin Newsom, wearing a black mask and standing beyond a podium with the Seal of California, scribbles in a tiny notepad.\" width=\"2560\" height=\"1706\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1344305961-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Gov. Gavin Newsom takes notes before speaking at a news conference on Oct. 1, 2021, in San Francisco. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This will free up crowded dock space to move integral medical supplies. Additionally, GO-Biz is directly in coordination with a terminal operator to speed up the movement of medical supplies,” Purcell said.\u003c/p>\n\u003cp>However, Purcell said the state has no way to identify medical supplies other than consulting with individual buyers. Even then, the contents of specific containers are frequently unknown.\u003c/p>\n\u003ch3 id=\"h-shortages-and-delays\">Shortages and delays\u003c/h3>\n\u003cp>Cedars Sinai in Los Angeles has experienced supply chain problems acquiring catheters, syringes and blood collection tubes, communications director Duke Helfand said. However, the hospital has been able to rely on pre-existing reserves and alternate suppliers to avoid any impact on patients.\u003c/p>\n\u003cp>Similarly, Community Medical Centers in the Central Valley have experienced periodic shortages of computers, suction canisters and masks during the pandemic, according to Lucky Malhi, vice president of supply chain management. His team has worked round-the-clock to secure supplies through alternate distributors.\u003c/p>\n\u003cp>But patients requiring supplies for home use, like the Genungs’ son Henry, typically don’t have the option to find alternate suppliers, so they have felt the scarcity much more sharply.\u003c/p>\n\u003cp>Myah Genung said she has turned to Facebook groups where parents of “trach babies” share extra supplies. She has snagged humidifying filters for Henry’s breathing tube through social media, but more often than not, there are more people seeking supplies than there are extras.\u003c/p>\n\u003cp>“We’re just having to make do the best we can,” she said.\u003c/p>\n\u003cp>More than \u003ca href=\"http://rc.rcjournal.com/content/59/6/895#ref-20\">100,000 tracheostomy\u003c/a> procedures are performed annually across the country. Racchiato, whose supply company, SpecialCare, primarily distributes directly to patients, said replacement tubes are one of the most difficult things to acquire right now.\u003c/p>\n\u003cp>“There are people who are trying to sterilize (the tubes) themselves and reuse them. They’re risking serious infection because new supplies aren’t available,” Racciato said.\u003c/p>\n\u003cp>Most tracheostomy tubes are only supposed to be used once, said Dr. Maggie Kuhn, associate professor of otolaryngology at UC Davis Health. Reusing the tubes can cause serious problems, including increased risk of infection and device malfunctioning.\u003c/p>\n\u003cp>“We have observed complications from this practice which can be life-threatening, including mucous plugging and airway trauma,” Kuhn said.\u003c/p>\n\u003cp>Other devices like oxygen concentrators face months-long delays compared to typical delivery times of one to two weeks.\u003c/p>\n\u003cp>Complicating matters, one of the largest manufacturers of continuous positive airway pressure, or CPAP, machines \u003ca href=\"https://www.nytimes.com/2021/08/17/health/cpap-breathing-devices-recall.html\">recalled millions of devices\u003c/a> in June and is reserving its inventory for patients that need replacement machines. As a result, Racciato said she has at least 1,000 patients diagnosed with sleep apnea who have been on a waiting list without treatment for five months.\u003c/p>\n\u003ch3 id=\"h-prices-increase-while-access-decreases\">Prices increase while access decreases\u003c/h3>\n\u003cp>\u003ca href=\"https://www.newyorker.com/news/our-columnists/inflation-and-the-great-global-logjam\">Inflationary pressure\u003c/a> on the medical supply market also has some suppliers concerned about how long they can stay in business. Scarcity of raw materials and logistical challenges along with the port backlogs have steeply driven up the cost of manufacturing and shipping, creating a volatile market.\u003c/p>\n\u003cp>“(Shipping) containers have gone from $2,000 for rental to anywhere from $15,000 to $20,000 for the same container,” said Steve Yaeger, a Los Angeles-based medical supplier who specializes in respiratory equipment.\u003c/p>\n\u003cp>Since the beginning of the pandemic, Yaeger said his overhead has increased 25%.\u003c/p>\n\u003cp>“When you see the cost of goods go up like that, all of a sudden you’re figuring out, ‘OK are we even going to make any money this year?’”\u003c/p>\n\u003cp>Experts say inflation among medical supplies will result in higher health care costs for patients as hospitals and other providers struggle to maintain adequate profit margins.\u003c/p>\n\u003cp>William Padula, a senior fellow at the USC Schaeffer Center for Health Policy & Economics, said the “supply chain disaster” will result in hospitals negotiating for higher reimbursement rates with insurers and patients paying higher premiums.\u003c/p>\n\u003cp>“The natural consequence on the consumer side is … premiums will go up,” Padula said. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Already, the Centers for Medicare and Medicaid Services announced the \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/2022-medicare-parts-b-premiums-and-deductibles2022-medicare-part-d-income-related-monthly-adjustment\">highest premium increase\u003c/a> in the program’s history for Medicare Part B and higher deductibles for other aspects of the program, in part due to increased utilization in the past year.\u003c/p>\n\u003cp>“In their statement, Medicare blamed the increase of premiums on COVID and the cost of that new drug for Alzheimers, which is expected to take off, but COVID is very broad. It really is about the supply chain,” Padula said.\u003c/p>\n\u003cp>Although it’s too soon to tell how much premiums will increase across the board, historically commercial insurers have followed Medicare’s lead.\u003c/p>\n\u003cp>“That gives a lot of commercial payers a pass to increase by a similar amount at a minimum,” Padula said.\u003c/p>\n\u003cp>The resultant cost hikes have also forced small and mid-sized suppliers to rethink which patients they can afford to serve, potentially leading to decreased access for those with Medi-Cal or Medicare, which have fixed reimbursement rates.\u003c/p>\n\u003cp>California has temporarily increased these reimbursement rates for the duration of the \u003ca href=\"https://calmatters.org/newsletters/whatmatters/2021/11/california-covid-state-of-emergency/\">COVID-19 public health emergency\u003c/a>, which is set to expire at the end of March. Beyond that, providers aren’t sure how long they can hold on.\u003c/p>\n\u003cp>Ron Biasca, a medical supplier based in Eureka, said increased costs are forcing his company to reassess what services it provides to Medicare and Medi-Cal patients.\u003c/p>\n\u003cp>“We are evaluating all entitlements right now to look at what we’re making money on. We are going to have to make some hard decisions and just not accept the insurance payment,” Biasca said.\u003c/p>\n\u003cp>Roughly \u003ca href=\"https://calmatters.org/economy/poverty/2017/08/paying-doctors-now-will-treat-poor-californians/\">one-third of all Californians rely on Medi-Cal\u003c/a> for health care and frequently face long wait times and \u003ca href=\"https://www.chcf.org/publication/measuring-up-access-care-medi-cal-compared-other-types-health-insurance-2018/\">difficulty finding doctors\u003c/a> and other providers who will accept their insurance. And the out-of-pocket costs are inaccessible even for people with private health insurance.\u003c/p>\n\u003cfigure id=\"attachment_11897232\" class=\"wp-caption alignnone\" style=\"max-width: 1000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11897232\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01.jpg\" alt=\"The family, mother father and child, are well-dressed. \" width=\"1000\" height=\"1250\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01.jpg 1000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01-800x1000.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/111621-Genung-Family-Portrait-CM-01-160x200.jpg 160w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\">\u003cfigcaption class=\"wp-caption-text\">Maya and Dillon Genung hold their son Henry in a family portrait. \u003ccite>( Image courtesy of Maya Genung)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Genung said she has tried to purchase the tracheostomy tubes her son needs online but they cost between $300 to $600 each. “You would be spending thousands and thousands of dollars a month just to purchase it yourself,” she said.\u003c/p>\n\u003cp>Reusing the tubes fills her with worry. Henry’s condition requires him to be immunosuppressed, and reusing tubes increases the risk of infection or breakage as the equipment wears down.\u003c/p>\n\u003cp>“It’s not foolproof because you’re not in a sterile environment. You’re at home, you’re in your kitchen, doing your best to make it work,” Genung said.\u003c/p>\n\u003cp>A week ago, Henry was admitted to Children’s Hospital Los Angeles with pneumonia. Doctors told his parents there’s no way of knowing if the infection was caused by the reuse of tubes.\u003c/p>\n\u003cp>The only small silver lining is that the hospital gave Genung two new tracheostomy tubes, enough to get Henry through another month.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was originally published by \u003ca href=\"https://calmatters.org/health/2021/11/medical-supplies-shortage-california/\">CalMatters\u003c/a>. KQED producer Keith Mizuguchi contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "hosting-loved-ones-for-thanksgiving-2021-heres-how-to-keep-covid-out",
"title": "Hosting Loved Ones for Thanksgiving 2021? Here's How to Keep COVID Out",
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"content": "\u003cp>Skip to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#unvaccinated\">Should I attend a gathering with unvaccinated people?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#kids\">What should I do if my child isn’t fully vaccinated yet?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#boundaries\">How do I communicate my boundaries or say no to an invite?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#test\">Should I take a rapid COVID test before I visit someone’s house?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>We’ve come a long way since Thanksgiving 2020.\u003c/p>\n\u003cp>A year ago, vaccines had not yet been approved, daily deaths were rising sharply — surging to more than 2,000 a day by December — and many hunkered down and skipped holiday celebrations to reduce their risk.\u003c/p>\n\u003cp>California now \u003ca href=\"https://www.kqed.org/news/11897140/despite-californias-low-covid-case-rates-officials-urge-caution-of-potential-surge-ahead-of-thanksgiving\" target=\"_blank\" rel=\"noopener noreferrer\">has one of the lowest coronavirus infection rates in the country\u003c/a>, with 1.9% of people testing positive for the disease in the last week. Coronavirus hospitalizations in the state have fallen about 14% in the last month.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-october-2021/\" target=\"_blank\" rel=\"noopener noreferrer\">About half of people living in the U.S.\u003c/a> are planning to gather in groups of 10 or more for the holidays, a recent survey found. While many of us are ready to restart our holiday gatherings, officials urge caution because a potential winter spike could overwhelm hospitals in some areas.\u003c/p>\n\u003cp>Nearly two years into this pandemic, we’ve learned a lot about how to reduce the risks of catching and spreading the coronavirus, including the simple steps of masking, hand-washing and taking precautionary COVID tests.\u003c/p>\n\u003cp>Experts warn we still need to keep COVID risk reduction in mind. Even if you and your family are fully vaccinated, young kids, people over 80 and immunocompromised people are still at higher risk of severe COVID. Now, \u003ca href=\"https://www.kqed.org/news/11890031/where-can-i-get-a-pfizer-covid-booster-shot-near-me-heres-whos-eligible\">the Centers for Disease Control and Prevention recommends booster shots for everyone 18 and older\u003c/a>, especially for those 50 and up.[aside postID=news_11890031 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/09/GettyImages-1234768670-scaled.jpg']\u003c/p>\n\u003cp>We wanted to hear directly from our readers and listeners about the frank and even tough conversations they were anticipating having with their loved ones, from setting personal boundaries to even having COVID-safer gatherings outside.\u003c/p>\n\u003cp>Here are some reminders from experts on how to keep your holiday gatherings safe.\u003c/p>\n\u003ch3>\u003ca id=\"boundaries\">\u003c/a>Be transparent about \u003cem>your\u003c/em> personal boundaries for gatherings of \u003cem>any\u003c/em> size or setting\u003c/h3>\n\u003cp>Even in a holiday season without a pandemic to consider, your movements and actions regarding an event like Thanksgiving are always yours to decide. Regardless of what others, like family, friends or strangers, may think, your time and your personal space are completely and utterly your business and yours to direct as you see fit.\u003c/p>\n\u003cp>If you’re weighing whether or not to attend a gathering with loved ones this year or to host a dinner of your own, it’s important to be able to communicate your personal boundaries in a variety of settings, even if it leads to uncomfortable conversations.\u003c/p>\n\u003cp>Dr. Richard Carpiano, a professor of public policy at UC Riverside and speaker on vaccine hesitancy, underlines the importance of checking in with the host (or your guests) and stating what your personal comfort levels are and what precautions you’re taking — whether it’s wearing a mask indoors or preferring to eat outdoors — in a frank way.\u003c/p>\n\u003cp>Ultimately, you can make it about you and your personal preferences. Be specific about your COVID safety choices with hosts or other guests, he says: “It’s very important that people should be willing to speak up and not feel peer-pressured because they have to show up to some place or feel like they’re being put in some sort of undue risk.”\u003c/p>\n\u003cp>Sure, some of these conversations could feel awkward at first. But Carpiano says that ultimately these conversations are with friends and family — and they should support the decision you choose for yourself.\u003c/p>\n\u003cp>Ultimately, you’re making this decision to reduce your family’s risk of contracting and spreading COVID-19, and it’s your way of keeping them safe from harm.\u003c/p>\n\u003cp>“That is an ultimate act of care and we need to focus on that,” \u003ca href=\"https://www.kqed.org/news/11846759/saying-no-to-a-covid-thanksgiving-holidays-how-to-break-it-to-family-or-friends\" target=\"_blank\" rel=\"noopener noreferrer\">says Julia Feldman, a teacher and sex educator in the Bay Area\u003c/a>.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11846759/saying-no-to-a-covid-thanksgiving-holidays-how-to-break-it-to-family-or-friends\">\u003cstrong>Saying No to the Holidays During COVID-19? How to Break It to Family (or Friends)\u003c/strong>\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch3>Be firm and up front about getting vaccination statuses from guests — and don’t feel guilty about asking\u003c/h3>\n\u003cp>Just as much as the ingredients on your shopping list, \u003ca href=\"https://www.kqed.org/news/11892610/the-cdc-emphasizes-covid-vaccinations-as-a-key-to-safe-holiday-gatherings\" target=\"_blank\" rel=\"noopener noreferrer\">knowing the vaccination statuses of other guests is an essential part\u003c/a> of hosting a COVID-safer gathering.\u003c/p>\n\u003cp>While it might feel like trespassing on personal information, Carpiano reminds us that we’re in a pandemic and our fates are intertwined. “This is not something like if somebody has high blood pressure or diabetes where their condition is not affecting other people,” he says. [pullquote size='medium' align='right' citation=\"Dr. William Miller, physician and public health epidemiologist at The Ohio State University College of Public Health\"]“I really do think that it’s perfectly acceptable to say, ‘I’m sorry you’re not vaccinated. You know, Grandma’s here, and by you coming, that increases her risk substantially.'”[/pullquote]\u003c/p>\n\u003cp>He suggests making a plan to communicate to guests what your preferences are and what your stance is — especially if you’re the host.\u003c/p>\n\u003cp>If you’re speaking with someone who still hasn’t been vaccinated, it’s important to lead with the facts and be clear on your priorities for keeping everyone healthy — especially if young people, older people and immunocompromised guests will be attending.\u003c/p>\n\u003cp>Trying to “convince” your loved ones of the pandemic’s devastating seriousness by sending them statistics and literature probably isn’t going to change their minds at this point, Feldman says. So, what can you do? “You just really have to come from an emotional place of being honest,” Feldman says.\u003c/p>\n\u003cp>When navigating a difficult conversation, you might be tempted to stay extra firm and resolute in your communication, in case the recipient interprets any hesitation as a cause for hope that you haven’t really made up your mind. Being firm and specific in what you will and will not do is great, Feldman says, but don’t let that stop you from “expressing [your] sadness and regret,” she says.\u003c/p>\n\u003ch3>\u003ca id=\"unvaccinated\">\u003c/a>Think carefully about how to include unvaccinated family members\u003c/h3>\n\u003cp>Deciding whom to invite to your home is a matter of personal discretion, but experts say at this point in the pandemic it’s pretty clear that a fully vaccinated group is the safest scenario.\u003c/p>\n\u003cp>“I think it’s reasonable for people to require their guests to be immunized,” says \u003ca href=\"https://www.ohsu.edu/providers/judith-a-guzman-cottrill-do\">Judy Guzman-Cottrill\u003c/a>, a pediatric infectious disease expert at Oregon Health and Science University, especially if guests include kids too young to be vaccinated (or who have only received their first shot) or people less likely to have a strong immune response to the vaccine, like the immunocompromised.\u003c/p>\n\u003cp>“Those are the people who we still really need to make sure we keep as safe as possible because this pandemic is not over,” she adds.\u003c/p>\n\u003cp>A vaccine requirement could lead to some hurt feelings or conflict, but physician and public health epidemiologist William Miller of The Ohio State University suggests framing the decision as a way to protect older loved ones.\u003c/p>\n\u003cp>“I really do think that it’s perfectly acceptable to say, ‘I’m sorry you’re not vaccinated. You know, Grandma’s here, and by you coming, that increases her risk substantially,'” Miller says.\u003c/p>\n\u003cp>An alternative is to ask an unvaccinated guest to do a lab-based PCR test 24 to 48 hours before the event (as long as they’re able to get the results back in time) or a rapid antigen COVID test just before their arrival. In addition, Emily Landon, an infectious disease physician at the University of Chicago, recommends asking unvaccinated guests to take extra precautions in the week leading up to the event, including wearing masks in public places and limiting exposure to other unvaccinated people.\u003c/p>\n\u003cp>“We think with the delta variant, most people are getting sick a few days after exposure, but it can take up to a week, maybe a little longer,” Landon explains. “I think it makes the most sense to take precautions for one week prior to having close, unmasked contact with someone who’s at high risk.”\u003c/p>\n\u003ch3>\u003ca id=\"kids\">\u003c/a>Take precautions if your young child is unvaccinated or has had only one shot\u003c/h3>\n\u003cp>Many children age 5 to 11 have received their first of two recommended doses, but won’t be eligible for a second dose until after the Thanksgiving holiday. Immunity builds gradually after vaccination, but it’s not known exactly how much protection just one dose of the COVID vaccine provides to kids, says Guzman-Cottrill.\u003c/p>\n\u003cp>“I know many families find themselves in this annoying state of limbo right now because their kids will not be fully vaccinated by Thanksgiving,” she says. Given this “limbo” state, “it’s really important to just keep in mind that this is not the time for those families to let their guard down,” she says. It’s not a reason to cancel multigenerational gatherings, but it’s a reminder to take precautions.\u003c/p>\n\u003cp>Carpiano says that caregivers should do risk management of sorts and be prepared to bring masks and buy home tests you can take the day of arriving at someone’s house. “What we’re finding right now with testing is that these home tests can be really quite effective in [detecting] if an immediate or recent sort of infection has occurred,” he says. While these home tests might be a little hard to find, they are available at many local drugstores.[aside postID=news_11846759 hero='https://ww2.kqed.org/app/uploads/sites/10/2020/11/pexels-breakingpic-3056.jpg']\u003c/p>\n\u003cp>So, what precautions are recommended for protecting more vulnerable guests from possible exposure due to unvaccinated kids? It depends on the health and age of the relatives who will be attending.\u003c/p>\n\u003cp>“If Grandma is a spry 70-year-old woman who has no medical problems and has two doses of vaccine plus a booster, I don’t think these kids are going to pose a ton of risk,” Landon says. But if the grandparent is over 80 and has medical problems, the risk of a bad outcome is much higher.\u003c/p>\n\u003cp>An easy step to take if you’re concerned about your unvaccinated kids passing the virus to grandparents is to mask up, not only during the visit, but also for a week in advance when in public, especially avoiding crowded, indoor spaces, even if mask mandates are not in effect.\u003c/p>\n\u003cp>She says she would not recommend keeping kids out of school to avoid exposure unless there are extra risks associated with your kids’ school — such as an outbreak of cases or a lack of masking. If the circumstances warrant missing school to protect a high-risk relative, “then that may be a layer you want to add,” Landon says.\u003c/p>\n\u003cp>Another option: If you live in a temperate climate, like many parts of the Bay Area, stay outdoors as much as possible for mixed-generation social events, and maybe choose to not sleep over in the same house with the grandparents.\u003c/p>\n\u003cp>“Just come during the day for the big event and stay at a hotel,” Landon suggests. Or have the grandparents sleep in a hotel, she adds. If a hotel is not financially possible, you might consider asking friends or neighbors if their home is empty over the holiday season and available for you to use.\u003c/p>\n\u003cp>Bottom line: “You have to think about the risk of the individuals involved — about what would happen if they got COVID,” says Landon. And better to err on the side of caution.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11894546/pfizer-covid-vaccine-kids-5-11-near-me\" target=\"_blank\" rel=\"noopener noreferrer\">Where Can I Get a Pfizer COVID Vaccine for Kids Age 5-11 Near Me?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch3>If you’re gathering with grandparents or other older people, realize this: They’re still at risk\u003c/h3>\n\u003cp>Reality check: \u003ca href=\"https://www.npr.org/sections/health-shots/2021/10/20/1047727415/what-to-know-about-the-risk-of-serious-or-fatal-breakthrough-covid-infections\">People over 80 have an elevated risk of dying from COVID\u003c/a>, even if they’re vaccinated.\u003c/p>\n\u003cp>While the vaccines offer strong protection against hospitalization and death, breakthrough infections are a reality. Often, a coronavirus infection following vaccination leads to only mild illness, and sometimes people test positive but show no symptoms at all. However, older people and those with compromised immune systems are at higher risk of getting a severe breakthrough COVID case.\u003c/p>\n\u003cp>Though it’s rare for breakthroughs to lead to hospitalization or death, the chances for one group are higher. As NPR reported, CDC data from August showed that \u003ca href=\"https://www.npr.org/sections/health-shots/2021/10/20/1047727415/what-to-know-about-the-risk-of-serious-or-fatal-breakthrough-covid-infections\" target=\"_blank\" rel=\"noopener noreferrer\">fully vaccinated people age 80 or older were about 13 times more likely to die from COVID\u003c/a> compared to the general vaccinated population (of all ages). That’s one reason \u003ca href=\"https://www.kqed.org/news/11890031/where-can-i-get-a-pfizer-covid-booster-shot-near-me-heres-whos-eligible\" target=\"_blank\" rel=\"noopener noreferrer\">getting boosters is especially important\u003c/a> for older adults.\u003c/p>\n\u003cp>“This is something that we must be conscious of as people are gathering across generations,” Miller says. “Grandpa and Grandma are protected relative to if they hadn’t been vaccinated, but they are still at risk.”\u003c/p>\n\u003cp>That’s why it makes sense to take precautions during travel and in the week leading up to any celebration where older friends and relatives will be present.\u003c/p>\n\u003cp>“I would absolutely encourage people to continue to wear masks” in crowded, indoor places such as grocery stores, Miller says, even if it’s not mandatory. This will reduce the risk of being exposed and passing on the virus. And remember, the\u003ca href=\"https://www.tsa.gov/news/press/releases/2021/08/20/tsa-extends-face-mask-requirement-through-january-18-2022\"> Transportation Security Administration’s face mask requirement\u003c/a> remains in effect through Jan. 18, 2022, requiring masking in airports, aboard commercial airline flights, and on commuter bus and rail systems.\u003c/p>\n\u003cp>So, bottom line, even if everyone invited to your holiday gathering is vaccinated, it’s still important to protect loved ones who are older or immunocompromised.\u003c/p>\n\u003ch3>Get a booster shot if you’re eligible\u003c/h3>\n\u003cp>Federal health agencies now recommend \u003ca href=\"https://www.npr.org/sections/health-shots/2021/11/19/1057280974/cdc-advisers-back-expansion-of-covid-boosters-for-all-adults\">COVID vaccine boosters for all adults\u003c/a> six months after their last shot — and they may be especially important for adults over 50 or any adult with underlying conditions or a high-risk job. Getting one before holiday travel and gatherings could increase your immunity against COVID.\u003c/p>\n\u003cp>The agencies’ decision was based on emerging evidence that immunity can diminish over time and evidence that shows a booster dose can, just as the name implies, boost protection.\u003c/p>\n\u003cp>Some of the \u003ca href=\"https://www.medrxiv.org/content/10.1101/2021.11.15.21266341v1\">most recent real-world data\u003c/a> comes from the U.K. Back in September, the U.K. government introduced a booster program targeting people 50 and older.\u003c/p>\n\u003cp>Dr. Anthony Fauci, White House medical adviser and director of the National Institute of Allergy and Infectious Diseases, said the new analysis points to a significant increase in protection (against symptomatic infection) from a booster dose.\u003c/p>\n\u003cp>“If you look at the third dose in people whose protection has drifted down to about 63%, you boost it back up to at least 94%, which is really quite impressive,” Fauci says. “That’s exactly the kind of thing you want boosters to do.”\u003c/p>\n\u003cp>Fauci says immunity begins to rebound within days after getting a booster shot, though you don’t get the peak of protection for two to four weeks later. He says before joining indoor holiday gatherings, especially in places with high viral transmission, “I would recommend if you are eligible for a boost, go get boosted right now.”\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11890031/where-can-i-get-a-pfizer-covid-booster-shot-near-me-heres-whos-eligible\" target=\"_blank\" rel=\"noopener noreferrer\">Where Can I Get a Moderna, Johnson & Johnson or Pfizer COVID Booster Shot Near Me?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch3>\u003ca id=\"tests\">\u003c/a>Rapid tests can protect your guests. Here’s how to know when to take one\u003c/h3>\n\u003cp>As a risk-reduction measure, you might want to ask your guests to take a COVID test before a large holiday get-together. A year ago, it was hard to get real-time information from COVID testing due to delays in test results and a lack of rapid test options. Now, there are plenty of over-the-counter rapid antigen tests, such as the Abbott BinaxNOW or Orasure InteliSwab, available online and in pharmacies.\u003c/p>\n\u003cp>“A rapid antigen test is an added layer of protection for everyone,” says Guzman-Cottrill, the pediatric infectious disease expert at Oregon Health and Science University.\u003c/p>\n\u003cp>“The antigen tests are a quick snapshot to see if the viral proteins are present in that person’s nose that day,” Guzman-Cottrill explains. So if a person was just exposed and the virus is still incubating, they could get a negative result one day followed by a positive result the next day.\u003c/p>\n\u003cp>The tests are not 100% reliable if someone has just been exposed, agrees Emily Landon, the infectious disease physician at the University of Chicago. “The test really doesn’t pick up really low levels of the virus in your nose, and so it’s not going to pick up a really early infection,” she says. So she recommends taking the test the morning of the gathering, or as close to the start of the gathering as possible.\u003c/p>\n\u003cp>Some families test before they travel, and then again when they get to their destination, depending on the level of risk of the people they’re staying with. (Note: Depending on which test you buy, instructions vary. For instance, \u003ca href=\"https://www.fda.gov/media/147253/download\">BinaxNOW instructs\u003c/a> that people should be tested twice over three days with at least 24 hours between tests for most accurate results.)\u003c/p>\n\u003cp>William Miller of The Ohio State University College of Public Health is on board with a test-to-be-safe strategy, too. “It’s kind of a mindset,” Miller says.\u003c/p>\n\u003cp>It’s a way to signal: Let’s make the visit as safe as it can be.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener noreferrer\">NPR\u003c/a>.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cp>\u003cem>This post includes reporting from KQED’s Alex Gonzalez, Brian Watt, Carly Severn and Lina Blanco. Thank you to our readers and listeners for sharing their questions with us. \u003c/em>\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Skip to:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#unvaccinated\">Should I attend a gathering with unvaccinated people?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#kids\">What should I do if my child isn’t fully vaccinated yet?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#boundaries\">How do I communicate my boundaries or say no to an invite?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#test\">Should I take a rapid COVID test before I visit someone’s house?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>We’ve come a long way since Thanksgiving 2020.\u003c/p>\n\u003cp>A year ago, vaccines had not yet been approved, daily deaths were rising sharply — surging to more than 2,000 a day by December — and many hunkered down and skipped holiday celebrations to reduce their risk.\u003c/p>\n\u003cp>California now \u003ca href=\"https://www.kqed.org/news/11897140/despite-californias-low-covid-case-rates-officials-urge-caution-of-potential-surge-ahead-of-thanksgiving\" target=\"_blank\" rel=\"noopener noreferrer\">has one of the lowest coronavirus infection rates in the country\u003c/a>, with 1.9% of people testing positive for the disease in the last week. Coronavirus hospitalizations in the state have fallen about 14% in the last month.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-october-2021/\" target=\"_blank\" rel=\"noopener noreferrer\">About half of people living in the U.S.\u003c/a> are planning to gather in groups of 10 or more for the holidays, a recent survey found. While many of us are ready to restart our holiday gatherings, officials urge caution because a potential winter spike could overwhelm hospitals in some areas.\u003c/p>\n\u003cp>Nearly two years into this pandemic, we’ve learned a lot about how to reduce the risks of catching and spreading the coronavirus, including the simple steps of masking, hand-washing and taking precautionary COVID tests.\u003c/p>\n\u003cp>Experts warn we still need to keep COVID risk reduction in mind. Even if you and your family are fully vaccinated, young kids, people over 80 and immunocompromised people are still at higher risk of severe COVID. Now, \u003ca href=\"https://www.kqed.org/news/11890031/where-can-i-get-a-pfizer-covid-booster-shot-near-me-heres-whos-eligible\">the Centers for Disease Control and Prevention recommends booster shots for everyone 18 and older\u003c/a>, especially for those 50 and up.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We wanted to hear directly from our readers and listeners about the frank and even tough conversations they were anticipating having with their loved ones, from setting personal boundaries to even having COVID-safer gatherings outside.\u003c/p>\n\u003cp>Here are some reminders from experts on how to keep your holiday gatherings safe.\u003c/p>\n\u003ch3>\u003ca id=\"boundaries\">\u003c/a>Be transparent about \u003cem>your\u003c/em> personal boundaries for gatherings of \u003cem>any\u003c/em> size or setting\u003c/h3>\n\u003cp>Even in a holiday season without a pandemic to consider, your movements and actions regarding an event like Thanksgiving are always yours to decide. Regardless of what others, like family, friends or strangers, may think, your time and your personal space are completely and utterly your business and yours to direct as you see fit.\u003c/p>\n\u003cp>If you’re weighing whether or not to attend a gathering with loved ones this year or to host a dinner of your own, it’s important to be able to communicate your personal boundaries in a variety of settings, even if it leads to uncomfortable conversations.\u003c/p>\n\u003cp>Dr. Richard Carpiano, a professor of public policy at UC Riverside and speaker on vaccine hesitancy, underlines the importance of checking in with the host (or your guests) and stating what your personal comfort levels are and what precautions you’re taking — whether it’s wearing a mask indoors or preferring to eat outdoors — in a frank way.\u003c/p>\n\u003cp>Ultimately, you can make it about you and your personal preferences. Be specific about your COVID safety choices with hosts or other guests, he says: “It’s very important that people should be willing to speak up and not feel peer-pressured because they have to show up to some place or feel like they’re being put in some sort of undue risk.”\u003c/p>\n\u003cp>Sure, some of these conversations could feel awkward at first. But Carpiano says that ultimately these conversations are with friends and family — and they should support the decision you choose for yourself.\u003c/p>\n\u003cp>Ultimately, you’re making this decision to reduce your family’s risk of contracting and spreading COVID-19, and it’s your way of keeping them safe from harm.\u003c/p>\n\u003cp>“That is an ultimate act of care and we need to focus on that,” \u003ca href=\"https://www.kqed.org/news/11846759/saying-no-to-a-covid-thanksgiving-holidays-how-to-break-it-to-family-or-friends\" target=\"_blank\" rel=\"noopener noreferrer\">says Julia Feldman, a teacher and sex educator in the Bay Area\u003c/a>.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11846759/saying-no-to-a-covid-thanksgiving-holidays-how-to-break-it-to-family-or-friends\">\u003cstrong>Saying No to the Holidays During COVID-19? How to Break It to Family (or Friends)\u003c/strong>\u003c/a>\u003c/li>\n\u003c/ul>\n\u003ch3>Be firm and up front about getting vaccination statuses from guests — and don’t feel guilty about asking\u003c/h3>\n\u003cp>Just as much as the ingredients on your shopping list, \u003ca href=\"https://www.kqed.org/news/11892610/the-cdc-emphasizes-covid-vaccinations-as-a-key-to-safe-holiday-gatherings\" target=\"_blank\" rel=\"noopener noreferrer\">knowing the vaccination statuses of other guests is an essential part\u003c/a> of hosting a COVID-safer gathering.\u003c/p>\n\u003cp>While it might feel like trespassing on personal information, Carpiano reminds us that we’re in a pandemic and our fates are intertwined. “This is not something like if somebody has high blood pressure or diabetes where their condition is not affecting other people,” he says. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He suggests making a plan to communicate to guests what your preferences are and what your stance is — especially if you’re the host.\u003c/p>\n\u003cp>If you’re speaking with someone who still hasn’t been vaccinated, it’s important to lead with the facts and be clear on your priorities for keeping everyone healthy — especially if young people, older people and immunocompromised guests will be attending.\u003c/p>\n\u003cp>Trying to “convince” your loved ones of the pandemic’s devastating seriousness by sending them statistics and literature probably isn’t going to change their minds at this point, Feldman says. So, what can you do? “You just really have to come from an emotional place of being honest,” Feldman says.\u003c/p>\n\u003cp>When navigating a difficult conversation, you might be tempted to stay extra firm and resolute in your communication, in case the recipient interprets any hesitation as a cause for hope that you haven’t really made up your mind. Being firm and specific in what you will and will not do is great, Feldman says, but don’t let that stop you from “expressing [your] sadness and regret,” she says.\u003c/p>\n\u003ch3>\u003ca id=\"unvaccinated\">\u003c/a>Think carefully about how to include unvaccinated family members\u003c/h3>\n\u003cp>Deciding whom to invite to your home is a matter of personal discretion, but experts say at this point in the pandemic it’s pretty clear that a fully vaccinated group is the safest scenario.\u003c/p>\n\u003cp>“I think it’s reasonable for people to require their guests to be immunized,” says \u003ca href=\"https://www.ohsu.edu/providers/judith-a-guzman-cottrill-do\">Judy Guzman-Cottrill\u003c/a>, a pediatric infectious disease expert at Oregon Health and Science University, especially if guests include kids too young to be vaccinated (or who have only received their first shot) or people less likely to have a strong immune response to the vaccine, like the immunocompromised.\u003c/p>\n\u003cp>“Those are the people who we still really need to make sure we keep as safe as possible because this pandemic is not over,” she adds.\u003c/p>\n\u003cp>A vaccine requirement could lead to some hurt feelings or conflict, but physician and public health epidemiologist William Miller of The Ohio State University suggests framing the decision as a way to protect older loved ones.\u003c/p>\n\u003cp>“I really do think that it’s perfectly acceptable to say, ‘I’m sorry you’re not vaccinated. You know, Grandma’s here, and by you coming, that increases her risk substantially,'” Miller says.\u003c/p>\n\u003cp>An alternative is to ask an unvaccinated guest to do a lab-based PCR test 24 to 48 hours before the event (as long as they’re able to get the results back in time) or a rapid antigen COVID test just before their arrival. In addition, Emily Landon, an infectious disease physician at the University of Chicago, recommends asking unvaccinated guests to take extra precautions in the week leading up to the event, including wearing masks in public places and limiting exposure to other unvaccinated people.\u003c/p>\n\u003cp>“We think with the delta variant, most people are getting sick a few days after exposure, but it can take up to a week, maybe a little longer,” Landon explains. “I think it makes the most sense to take precautions for one week prior to having close, unmasked contact with someone who’s at high risk.”\u003c/p>\n\u003ch3>\u003ca id=\"kids\">\u003c/a>Take precautions if your young child is unvaccinated or has had only one shot\u003c/h3>\n\u003cp>Many children age 5 to 11 have received their first of two recommended doses, but won’t be eligible for a second dose until after the Thanksgiving holiday. Immunity builds gradually after vaccination, but it’s not known exactly how much protection just one dose of the COVID vaccine provides to kids, says Guzman-Cottrill.\u003c/p>\n\u003cp>“I know many families find themselves in this annoying state of limbo right now because their kids will not be fully vaccinated by Thanksgiving,” she says. Given this “limbo” state, “it’s really important to just keep in mind that this is not the time for those families to let their guard down,” she says. It’s not a reason to cancel multigenerational gatherings, but it’s a reminder to take precautions.\u003c/p>\n\u003cp>Carpiano says that caregivers should do risk management of sorts and be prepared to bring masks and buy home tests you can take the day of arriving at someone’s house. “What we’re finding right now with testing is that these home tests can be really quite effective in [detecting] if an immediate or recent sort of infection has occurred,” he says. While these home tests might be a little hard to find, they are available at many local drugstores.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, what precautions are recommended for protecting more vulnerable guests from possible exposure due to unvaccinated kids? It depends on the health and age of the relatives who will be attending.\u003c/p>\n\u003cp>“If Grandma is a spry 70-year-old woman who has no medical problems and has two doses of vaccine plus a booster, I don’t think these kids are going to pose a ton of risk,” Landon says. But if the grandparent is over 80 and has medical problems, the risk of a bad outcome is much higher.\u003c/p>\n\u003cp>An easy step to take if you’re concerned about your unvaccinated kids passing the virus to grandparents is to mask up, not only during the visit, but also for a week in advance when in public, especially avoiding crowded, indoor spaces, even if mask mandates are not in effect.\u003c/p>\n\u003cp>She says she would not recommend keeping kids out of school to avoid exposure unless there are extra risks associated with your kids’ school — such as an outbreak of cases or a lack of masking. If the circumstances warrant missing school to protect a high-risk relative, “then that may be a layer you want to add,” Landon says.\u003c/p>\n\u003cp>Another option: If you live in a temperate climate, like many parts of the Bay Area, stay outdoors as much as possible for mixed-generation social events, and maybe choose to not sleep over in the same house with the grandparents.\u003c/p>\n\u003cp>“Just come during the day for the big event and stay at a hotel,” Landon suggests. Or have the grandparents sleep in a hotel, she adds. If a hotel is not financially possible, you might consider asking friends or neighbors if their home is empty over the holiday season and available for you to use.\u003c/p>\n\u003cp>Bottom line: “You have to think about the risk of the individuals involved — about what would happen if they got COVID,” says Landon. And better to err on the side of caution.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11894546/pfizer-covid-vaccine-kids-5-11-near-me\" target=\"_blank\" rel=\"noopener noreferrer\">Where Can I Get a Pfizer COVID Vaccine for Kids Age 5-11 Near Me?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch3>If you’re gathering with grandparents or other older people, realize this: They’re still at risk\u003c/h3>\n\u003cp>Reality check: \u003ca href=\"https://www.npr.org/sections/health-shots/2021/10/20/1047727415/what-to-know-about-the-risk-of-serious-or-fatal-breakthrough-covid-infections\">People over 80 have an elevated risk of dying from COVID\u003c/a>, even if they’re vaccinated.\u003c/p>\n\u003cp>While the vaccines offer strong protection against hospitalization and death, breakthrough infections are a reality. Often, a coronavirus infection following vaccination leads to only mild illness, and sometimes people test positive but show no symptoms at all. However, older people and those with compromised immune systems are at higher risk of getting a severe breakthrough COVID case.\u003c/p>\n\u003cp>Though it’s rare for breakthroughs to lead to hospitalization or death, the chances for one group are higher. As NPR reported, CDC data from August showed that \u003ca href=\"https://www.npr.org/sections/health-shots/2021/10/20/1047727415/what-to-know-about-the-risk-of-serious-or-fatal-breakthrough-covid-infections\" target=\"_blank\" rel=\"noopener noreferrer\">fully vaccinated people age 80 or older were about 13 times more likely to die from COVID\u003c/a> compared to the general vaccinated population (of all ages). That’s one reason \u003ca href=\"https://www.kqed.org/news/11890031/where-can-i-get-a-pfizer-covid-booster-shot-near-me-heres-whos-eligible\" target=\"_blank\" rel=\"noopener noreferrer\">getting boosters is especially important\u003c/a> for older adults.\u003c/p>\n\u003cp>“This is something that we must be conscious of as people are gathering across generations,” Miller says. “Grandpa and Grandma are protected relative to if they hadn’t been vaccinated, but they are still at risk.”\u003c/p>\n\u003cp>That’s why it makes sense to take precautions during travel and in the week leading up to any celebration where older friends and relatives will be present.\u003c/p>\n\u003cp>“I would absolutely encourage people to continue to wear masks” in crowded, indoor places such as grocery stores, Miller says, even if it’s not mandatory. This will reduce the risk of being exposed and passing on the virus. And remember, the\u003ca href=\"https://www.tsa.gov/news/press/releases/2021/08/20/tsa-extends-face-mask-requirement-through-january-18-2022\"> Transportation Security Administration’s face mask requirement\u003c/a> remains in effect through Jan. 18, 2022, requiring masking in airports, aboard commercial airline flights, and on commuter bus and rail systems.\u003c/p>\n\u003cp>So, bottom line, even if everyone invited to your holiday gathering is vaccinated, it’s still important to protect loved ones who are older or immunocompromised.\u003c/p>\n\u003ch3>Get a booster shot if you’re eligible\u003c/h3>\n\u003cp>Federal health agencies now recommend \u003ca href=\"https://www.npr.org/sections/health-shots/2021/11/19/1057280974/cdc-advisers-back-expansion-of-covid-boosters-for-all-adults\">COVID vaccine boosters for all adults\u003c/a> six months after their last shot — and they may be especially important for adults over 50 or any adult with underlying conditions or a high-risk job. Getting one before holiday travel and gatherings could increase your immunity against COVID.\u003c/p>\n\u003cp>The agencies’ decision was based on emerging evidence that immunity can diminish over time and evidence that shows a booster dose can, just as the name implies, boost protection.\u003c/p>\n\u003cp>Some of the \u003ca href=\"https://www.medrxiv.org/content/10.1101/2021.11.15.21266341v1\">most recent real-world data\u003c/a> comes from the U.K. Back in September, the U.K. government introduced a booster program targeting people 50 and older.\u003c/p>\n\u003cp>Dr. Anthony Fauci, White House medical adviser and director of the National Institute of Allergy and Infectious Diseases, said the new analysis points to a significant increase in protection (against symptomatic infection) from a booster dose.\u003c/p>\n\u003cp>“If you look at the third dose in people whose protection has drifted down to about 63%, you boost it back up to at least 94%, which is really quite impressive,” Fauci says. “That’s exactly the kind of thing you want boosters to do.”\u003c/p>\n\u003cp>Fauci says immunity begins to rebound within days after getting a booster shot, though you don’t get the peak of protection for two to four weeks later. He says before joining indoor holiday gatherings, especially in places with high viral transmission, “I would recommend if you are eligible for a boost, go get boosted right now.”\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11890031/where-can-i-get-a-pfizer-covid-booster-shot-near-me-heres-whos-eligible\" target=\"_blank\" rel=\"noopener noreferrer\">Where Can I Get a Moderna, Johnson & Johnson or Pfizer COVID Booster Shot Near Me?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003ch3>\u003ca id=\"tests\">\u003c/a>Rapid tests can protect your guests. Here’s how to know when to take one\u003c/h3>\n\u003cp>As a risk-reduction measure, you might want to ask your guests to take a COVID test before a large holiday get-together. A year ago, it was hard to get real-time information from COVID testing due to delays in test results and a lack of rapid test options. Now, there are plenty of over-the-counter rapid antigen tests, such as the Abbott BinaxNOW or Orasure InteliSwab, available online and in pharmacies.\u003c/p>\n\u003cp>“A rapid antigen test is an added layer of protection for everyone,” says Guzman-Cottrill, the pediatric infectious disease expert at Oregon Health and Science University.\u003c/p>\n\u003cp>“The antigen tests are a quick snapshot to see if the viral proteins are present in that person’s nose that day,” Guzman-Cottrill explains. So if a person was just exposed and the virus is still incubating, they could get a negative result one day followed by a positive result the next day.\u003c/p>\n\u003cp>The tests are not 100% reliable if someone has just been exposed, agrees Emily Landon, the infectious disease physician at the University of Chicago. “The test really doesn’t pick up really low levels of the virus in your nose, and so it’s not going to pick up a really early infection,” she says. So she recommends taking the test the morning of the gathering, or as close to the start of the gathering as possible.\u003c/p>\n\u003cp>Some families test before they travel, and then again when they get to their destination, depending on the level of risk of the people they’re staying with. (Note: Depending on which test you buy, instructions vary. For instance, \u003ca href=\"https://www.fda.gov/media/147253/download\">BinaxNOW instructs\u003c/a> that people should be tested twice over three days with at least 24 hours between tests for most accurate results.)\u003c/p>\n\u003cp>William Miller of The Ohio State University College of Public Health is on board with a test-to-be-safe strategy, too. “It’s kind of a mindset,” Miller says.\u003c/p>\n\u003cp>It’s a way to signal: Let’s make the visit as safe as it can be.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener noreferrer\">NPR\u003c/a>.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cp>\u003cem>This post includes reporting from KQED’s Alex Gonzalez, Brian Watt, Carly Severn and Lina Blanco. Thank you to our readers and listeners for sharing their questions with us. \u003c/em>\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">After a review process from the Food and Drug Administration and the Centers for Disease Control and Prevention, pediatric COVID-19 shots are now available for kids ages 5-11. \u003c/span>\u003c/p>\n\u003cp>It’s a long time coming for many kids and families who have been waiting for nearly a year. Today, we talk about what this means and answer some listeners’ big questions about the rollout.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Guest\u003c/strong>: \u003ca href=\"https://twitter.com/TeacupInTheBay\">Carly Severn\u003c/a>, Senior Engagement Editor for KQED\u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11894546/pfizer-covid-vaccine-kids-5-11-near-me\">\u003ci>\u003cspan style=\"font-weight: 400\">More information about where to get a Pfizer COVID-19 Vaccine for kids\u003c/span>\u003c/i>\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/superamazing_110821_final.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11895578\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/superamazing_110821_final.png\" alt=\"Cartoon: a boy dressed as a superhero under a sign that reads, "Superamazing Boy! Helping defeat a deadly pandemic with his supercharged immune system!" Kids in the background say, "I can't wait to get the shot, too!"\" width=\"1920\" height=\"1332\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/superamazing_110821_final.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/superamazing_110821_final-800x555.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/superamazing_110821_final-1020x708.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/superamazing_110821_final-160x111.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/superamazing_110821_final-1536x1066.png 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003cp>Health providers, counties and clinics are rolling out COVID vaccines for kids age 5-11 across the Bay Area.\u003c/p>\n\u003cp>\u003ca href=\"https://bit.ly/fiorekidvaccinestickers\">Here’s a handy guide with more information about where to get the Pfizer vaccine\u003c/a>.\u003c/p>\n\u003cp>And once those kids get their shot, \u003ca href=\"https://www.kqed.org/news/11895373/hey-kids-your-i-got-vaccinated-stickers-are-here\">they deserve a sticker\u003c/a>!\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cp>Since children 5-11 are now eligible for the COVID-19 vaccine, I decided to create a selection of “I got vaccinated” stickers for kids.\u003c/p>\n\u003cp>\u003ca href=\"https://bit.ly/fiorekidvaccinestickers\">Here is a handy guide that details where kids can get their first Pfizer COVID-19 vaccine shot\u003c/a>.\u003c/p>\n\u003cp>First the vaccine, then the sticker, then let’s hope we’ll really have coronavirus on the run!\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/vaccinesticker001.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11895378\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/vaccinesticker001.png\" alt='Cartoon: a smiley face sticker that reads, \"I got my COVID-19 vaccine!\"' width=\"500\" height=\"500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/vaccinesticker001.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/vaccinesticker001-800x800.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/vaccinesticker001-1020x1020.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/vaccinesticker001-160x160.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/vaccinesticker001-1536x1536.png 1536w\" sizes=\"auto, (max-width: 500px) 100vw, 500px\">\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/vaccinesticker002.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11895379\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/vaccinesticker002.png\" alt='Cartoon: a sticker that reads \"I (heart) science! 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"content": "\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/amateurod_110421_final.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11895185\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/amateurod_110421_final.png\" alt='Cartoon: a bright red COVID character hovers over the street as a monstrous \"fentanyl\" character looks at COVID and says \"amateur.\" We see homeless tents and \"o.d.\" in the San Francisco background.' width=\"1920\" height=\"1339\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-800x558.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-1020x711.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-160x112.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-1536x1071.png 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003cp>More than twice as many people died from overdoses in San Francisco in 2020 than from COVID-19, and this year may be just as bad.\u003c/p>\n\u003cp>\u003ca href=\"https://bit.ly/sfoverdosessort\">The city’s Street Overdose Response Team is working to change that\u003c/a>.\u003c/p>\n\u003cp>Most of these overdose deaths are tied to fentanyl, a synthetic opioid that is much more powerful than heroin.\u003c/p>\n\u003cp>Seven hundred and twelve people overdosed and died in San Francisco in 2020, and data from 2021 points to a similar tragic trend.\u003c/p>\n\u003cp>(Keep in mind that those numbers would be much higher were it not for Narcan, a drug that can reverse the effects of an overdose.)\u003c/p>\n\u003cp>While the vast majority of residents in the Bay Area have been focused on COVID-19, dedicated people working with San Francisco’s health and fire departments have also been saving the lives of people who have overdosed on city streets, and in apartments and hotels.\u003c/p>\n\u003cp>\u003cem>Full disclosure: I am friends with \u003ca href=\"https://bit.ly/sfoverdosessort\">Capt. Michael Mason, who was interviewed for this story,\u003c/a> and I think he’s a saint.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/amateurod_110421_final.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11895185\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/amateurod_110421_final.png\" alt='Cartoon: a bright red COVID character hovers over the street as a monstrous \"fentanyl\" character looks at COVID and says \"amateur.\" We see homeless tents and \"o.d.\" in the San Francisco background.' width=\"1920\" height=\"1339\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final.png 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-800x558.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-1020x711.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-160x112.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/amateurod_110421_final-1536x1071.png 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003c/p>\n\u003cp>More than twice as many people died from overdoses in San Francisco in 2020 than from COVID-19, and this year may be just as bad.\u003c/p>\n\u003cp>\u003ca href=\"https://bit.ly/sfoverdosessort\">The city’s Street Overdose Response Team is working to change that\u003c/a>.\u003c/p>\n\u003cp>Most of these overdose deaths are tied to fentanyl, a synthetic opioid that is much more powerful than heroin.\u003c/p>\n\u003cp>Seven hundred and twelve people overdosed and died in San Francisco in 2020, and data from 2021 points to a similar tragic trend.\u003c/p>\n\u003cp>(Keep in mind that those numbers would be much higher were it not for Narcan, a drug that can reverse the effects of an overdose.)\u003c/p>\n\u003cp>While the vast majority of residents in the Bay Area have been focused on COVID-19, dedicated people working with San Francisco’s health and fire departments have also been saving the lives of people who have overdosed on city streets, and in apartments and hotels.\u003c/p>\n\u003cp>\u003cem>Full disclosure: I am friends with \u003ca href=\"https://bit.ly/sfoverdosessort\">Capt. Michael Mason, who was interviewed for this story,\u003c/a> and I think he’s a saint.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "'To Also Celebrate the Living': Día de los Muertos Returns to the Mission",
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"content": "\u003cp>Hundreds of residents filled the streets of the Mission District in San Francisco on Tuesday evening to honor and celebrate the dead on Día de los Muertos. The sidewalks of 24th Street, from Mission Street to Potrero Avenue, were packed with families, some holding candles, others wearing delicately crafted dresses, face paint and hair arrangements made out of cempasúchil, or marigolds.\u003c/p>\n\u003cfigure id=\"attachment_11894971\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894971 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A person wears an elaborate head garment, face paint and purple, ribboned dress as they dance in the streets.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Daniela Zurita walks during Dia de los Muertos in San Francisco on Nov. 2, 2021, in memory of her mother who passed away in August due to COVID-19. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Photos and paintings of loved ones who had died were placed on tables or pinned on trees, surrounded by food, water, sage and cempasúchil.\u003c/p>\n\u003cp>On the corner of 24th and Capp streets, outside the Calle 24 Latino Cultural District building, a celebration honoring the lives of deceased womxn, queer and trans people of color, or QTPOC, and youth included dance performances by the the Mission-based Danza Azteca Mixcoatl Anahuac and readings by members of the Young Women’s Freedom Center.\u003c/p>\n\u003cp>(“\u003ca href=\"https://thebutlercollegian.com/2021/03/women-womxn-womyn/\">Womxn\u003c/a>” is an alternative spelling used to include those who feel excluded by the spellings “women” or “womyn,” particularly trans and nonbinary women.)\u003c/p>\n\u003cfigure id=\"attachment_11894963\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894963 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A person wearing traditional Aztec dance regalia lifts their hands up in prayer in front of a poster that shares some of the statistics on violence committed against women and queer and trans people of color.\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A member of the group Danza Azteca Mixcoatl Anahuac opens a community healing vigil and living ofrenda celebration with a blessing outside Calle 24 on 24th and Capp streets in San Francisco on Nov. 2, 2021. The event honored the memory of womxn, QTPOC, and children lost to violence. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As has become tradition over the decades, musicians, artists and vendors gathered at intersections, parking lots and other available open space, transforming 24th Street into a living ofrenda — or place of offering — a powerful reminder that honoring the dead need not always be somber ritual, but also can be one of joy and creative expression.\u003c/p>\n\u003cfigure id=\"attachment_11894962\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894962 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A group of people carries a bright orange banner down the middle of a street.\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A group walks along 24th Street under colorful rows of papel picado while carrying a sign that says “38th Annual Dia de los Muertos San Francisco Mission District,” during a Day of the Dead celebration in San Francisco on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Día de los Muertos is not just about celebrating the dead, but to also celebrate the living,” Jorge Molina, a bearer of Indigenous knowledge and self-described “journeyman,” said after performing a blessing at the new Mission Cultural Center for Latino Arts exhibit, “Ni Tanto Ni Tan Muertos, En Nuestra Memoria — Neither So Many, Nor So Dead, in Our Memories.”\u003c/p>\n\u003cfigure id=\"attachment_11894964\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894964 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A woman wearing face paint and cemaspúchil in her hair sings to a crowd on the sidewalk.\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Berta Hernández speaks during a community healing vigil and living ofrenda celebration on 24th and Capp streets in San Francisco on Nov. 2, 2021. The event honored the memory of womxn, QTPOC, and children lost to violence. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the vigil organized by Calle 24, Berta Hernández, a community health worker and educator, performed a spoken-word piece as part of a larger tribute to Evelyn Hernández, a San Francisco resident whose body was found floating in the Bay in 2002. Her young son, Alex, is still missing, \u003ca href=\"https://www.sanfranciscopolice.org/stay-safe/ongoing-investigations/homicides-and-cold-cases\">according to the San Francisco Police Department\u003c/a>.\u003c/p>\n\u003cp>Hernández first met Evelyn when the latter was a student in a youth theater group at the Mission Recreation Center in the mid-1990s. Evelyn was then 14 and had recently migrated from El Salvador. Over the years, Berta and her family grew very close with Evelyn, and were deeply affected by her death.\u003c/p>\n\u003cfigure id=\"attachment_11894972\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894972 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"Two people wear face paint and flowers in their hair and look at the camera.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Mariah Cativo (left) and Lucy Molina pause for a portrait as they walk along 24th Street in San Francisco’s Mission District during a Dia de los Muertos celebration on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“That loss still hurts,” Hernández said in Spanish, noting that it has taken her 19 years to feel comfortable enough to “offer this small tribute.” She, along with others who knew Evelyn, performed a rendition of “Canción Sin Miedo,” an anthem that denounces gender-based violence and demands justice for femicides.\u003c/p>\n\u003cp>“Cantamos sin miedo, pedimos justicia. Gritamos por cada desaparecida. Que resuene fuerte ‘¡nos queremos vivas!’ Que caiga con fuerza el feminicida,” they sang. \u003cem>We sing without fear, we ask for justice. We yell for each woman that has dissappeared. Let it be heard that we want each of us alive and that there be an end to femicide.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11894973\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894973 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A collage of photos with pink, green, and yellow paper flowers stands next a small mortar that carries burning sage. A few candles are nearby.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">An altar made by the Young Women’s Freedom Center for people lost to police brutality and gender violence, as well as people who passed through the program, at a Dia de los Muertos celebration in San Francisco on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hernández pointed to the increase in cases of gender-based violence in the U.S. and Latin America during the pandemic, \u003ca href=\"https://apnews.com/article/pandemics-health-violence-coronavirus-cfb40ca690c9f556b742bd39e1e8e9b6\">especially against Indigenous and migrant women\u003c/a>, as one of the key reasons Evelyn’s death is especially relevant now. The vigil also honored the lives of multiple other Bay Area women who were victims of violence.\u003c/p>\n\u003cp>“Dia de Muertos is about the dead, yes,” Hernández said. “But at the same time, it always is a denuncia social — an act of resistance.”\u003c/p>\n\u003cfigure id=\"attachment_11894967\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894967 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A man wearing a hat and a pink jacket holds a box that includes many photos of a woman, candles and lights.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Alfonso Ochoa Salas wears an altar for artist Yolanda López at the Mission Cultural Center for Latino Arts exhibit ‘Ni Tanto Ni Tan Muertos, En Nuestra Memoria — Neither So Many, Nor So Dead, in Our Memories,’ on the 35th annual Day of the Dead celebration at the center in San Francisco on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hundreds of residents filled the streets of the Mission District in San Francisco on Tuesday evening to honor and celebrate the dead on Día de los Muertos. The sidewalks of 24th Street, from Mission Street to Potrero Avenue, were packed with families, some holding candles, others wearing delicately crafted dresses, face paint and hair arrangements made out of cempasúchil, or marigolds.\u003c/p>\n\u003cfigure id=\"attachment_11894971\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894971 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A person wears an elaborate head garment, face paint and purple, ribboned dress as they dance in the streets.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52348_030_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Daniela Zurita walks during Dia de los Muertos in San Francisco on Nov. 2, 2021, in memory of her mother who passed away in August due to COVID-19. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Photos and paintings of loved ones who had died were placed on tables or pinned on trees, surrounded by food, water, sage and cempasúchil.\u003c/p>\n\u003cp>On the corner of 24th and Capp streets, outside the Calle 24 Latino Cultural District building, a celebration honoring the lives of deceased womxn, queer and trans people of color, or QTPOC, and youth included dance performances by the the Mission-based Danza Azteca Mixcoatl Anahuac and readings by members of the Young Women’s Freedom Center.\u003c/p>\n\u003cp>(“\u003ca href=\"https://thebutlercollegian.com/2021/03/women-womxn-womyn/\">Womxn\u003c/a>” is an alternative spelling used to include those who feel excluded by the spellings “women” or “womyn,” particularly trans and nonbinary women.)\u003c/p>\n\u003cfigure id=\"attachment_11894963\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894963 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A person wearing traditional Aztec dance regalia lifts their hands up in prayer in front of a poster that shares some of the statistics on violence committed against women and queer and trans people of color.\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52324_004_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A member of the group Danza Azteca Mixcoatl Anahuac opens a community healing vigil and living ofrenda celebration with a blessing outside Calle 24 on 24th and Capp streets in San Francisco on Nov. 2, 2021. The event honored the memory of womxn, QTPOC, and children lost to violence. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As has become tradition over the decades, musicians, artists and vendors gathered at intersections, parking lots and other available open space, transforming 24th Street into a living ofrenda — or place of offering — a powerful reminder that honoring the dead need not always be somber ritual, but also can be one of joy and creative expression.\u003c/p>\n\u003cfigure id=\"attachment_11894962\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894962 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A group of people carries a bright orange banner down the middle of a street.\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52321_001_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A group walks along 24th Street under colorful rows of papel picado while carrying a sign that says “38th Annual Dia de los Muertos San Francisco Mission District,” during a Day of the Dead celebration in San Francisco on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Día de los Muertos is not just about celebrating the dead, but to also celebrate the living,” Jorge Molina, a bearer of Indigenous knowledge and self-described “journeyman,” said after performing a blessing at the new Mission Cultural Center for Latino Arts exhibit, “Ni Tanto Ni Tan Muertos, En Nuestra Memoria — Neither So Many, Nor So Dead, in Our Memories.”\u003c/p>\n\u003cfigure id=\"attachment_11894964\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894964 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A woman wearing face paint and cemaspúchil in her hair sings to a crowd on the sidewalk.\" width=\"1920\" height=\"1278\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52331_011_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1022.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Berta Hernández speaks during a community healing vigil and living ofrenda celebration on 24th and Capp streets in San Francisco on Nov. 2, 2021. The event honored the memory of womxn, QTPOC, and children lost to violence. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the vigil organized by Calle 24, Berta Hernández, a community health worker and educator, performed a spoken-word piece as part of a larger tribute to Evelyn Hernández, a San Francisco resident whose body was found floating in the Bay in 2002. Her young son, Alex, is still missing, \u003ca href=\"https://www.sanfranciscopolice.org/stay-safe/ongoing-investigations/homicides-and-cold-cases\">according to the San Francisco Police Department\u003c/a>.\u003c/p>\n\u003cp>Hernández first met Evelyn when the latter was a student in a youth theater group at the Mission Recreation Center in the mid-1990s. Evelyn was then 14 and had recently migrated from El Salvador. Over the years, Berta and her family grew very close with Evelyn, and were deeply affected by her death.\u003c/p>\n\u003cfigure id=\"attachment_11894972\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894972 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"Two people wear face paint and flowers in their hair and look at the camera.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52357_037_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Mariah Cativo (left) and Lucy Molina pause for a portrait as they walk along 24th Street in San Francisco’s Mission District during a Dia de los Muertos celebration on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“That loss still hurts,” Hernández said in Spanish, noting that it has taken her 19 years to feel comfortable enough to “offer this small tribute.” She, along with others who knew Evelyn, performed a rendition of “Canción Sin Miedo,” an anthem that denounces gender-based violence and demands justice for femicides.\u003c/p>\n\u003cp>“Cantamos sin miedo, pedimos justicia. Gritamos por cada desaparecida. Que resuene fuerte ‘¡nos queremos vivas!’ Que caiga con fuerza el feminicida,” they sang. \u003cem>We sing without fear, we ask for justice. We yell for each woman that has dissappeared. Let it be heard that we want each of us alive and that there be an end to femicide.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11894973\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894973 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A collage of photos with pink, green, and yellow paper flowers stands next a small mortar that carries burning sage. A few candles are nearby.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52341_022_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">An altar made by the Young Women’s Freedom Center for people lost to police brutality and gender violence, as well as people who passed through the program, at a Dia de los Muertos celebration in San Francisco on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hernández pointed to the increase in cases of gender-based violence in the U.S. and Latin America during the pandemic, \u003ca href=\"https://apnews.com/article/pandemics-health-violence-coronavirus-cfb40ca690c9f556b742bd39e1e8e9b6\">especially against Indigenous and migrant women\u003c/a>, as one of the key reasons Evelyn’s death is especially relevant now. The vigil also honored the lives of multiple other Bay Area women who were victims of violence.\u003c/p>\n\u003cp>“Dia de Muertos is about the dead, yes,” Hernández said. “But at the same time, it always is a denuncia social — an act of resistance.”\u003c/p>\n\u003cfigure id=\"attachment_11894967\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11894967 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut.jpg\" alt=\"A man wearing a hat and a pink jacket holds a box that includes many photos of a woman, candles and lights.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/RS52344_025_SanFrancisco_DiadelosMuertos_11022021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Alfonso Ochoa Salas wears an altar for artist Yolanda López at the Mission Cultural Center for Latino Arts exhibit ‘Ni Tanto Ni Tan Muertos, En Nuestra Memoria — Neither So Many, Nor So Dead, in Our Memories,’ on the 35th annual Day of the Dead celebration at the center in San Francisco on Nov. 2, 2021. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "how-san-franciscos-street-overdose-response-team-is-trying-to-bring-clinical-care-to-the-streets",
"title": "San Francisco's Street Overdose Response Team Is Trying to Bring Clinical Care to the Streets",
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"headTitle": "San Francisco’s Street Overdose Response Team Is Trying to Bring Clinical Care to the Streets | KQED",
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"content": "\u003cp>It’s a sun-filled, fall day and Nicholas is strapped to an ambulance gurney near 8th and Market streets in downtown San Francisco, dazed and barely conscious. Plastic IV tubes snake around his left hand where L-O-V-E is tattooed just below his knuckles.\u003c/p>\n\u003cp>“Nicholas, try to wake up a little bit for me, come on,” paramedic Paula Fartash coaxes, as she unsuccessfully tries to rouse him.\u003c/p>\n\u003cp>Nicholas (we’re not using his last name because of the stigma of addiction) tells Fartash that when he started getting high in nearby U.N. Plaza park, he assumed he was smoking his drug of choice.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This gentleman thought that he was doing meth,” the veteran San Francisco Fire Department paramedic says. “And turned out he was actually doing fentanyl as well,” the synthetic opioid many times more powerful than heroin. “So he walked over to someone and they gave him some Narcan.”\u003c/p>\n\u003cp>That’s the brand name for naloxone, the emergency nasal spray drug used to try to reverse an otherwise potentially fatal overdose. That someone who administered a life-saving antidote was a nearby volunteer and street cleaner carrying Narcan, \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">part of a city-supported program\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11895057\" class=\"wp-caption alignnone\" style=\"max-width: 1224px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895057 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-9.jpg\" alt=\"The inside of an ambulance, where only the arm and tattooed hand and a bit of the torso of someone who is receiving care is visible. The person receiving care has many tattoos.\" width=\"1224\" height=\"816\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9.jpg 1224w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9-160x107.jpg 160w\" sizes=\"auto, (max-width: 1224px) 100vw, 1224px\">\u003cfigcaption class=\"wp-caption-text\">A man named Nicholas gets care in an ambulance after overdosing in San Francisco’s Civic Center. He told members of the emergency response team that when he started getting high, he assumed he was smoking meth. However, it turned out that he was unknowingly consuming fentanyl as well. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>San Francisco has among the highest per capita drug overdose death rates of any city in the U.S.\u003c/h3>\n\u003cp>Faced with a stunning rise in drug overdose deaths the last few years, the vast majority tied to fentanyl, San Francisco has launched mobile teams made up of paramedics and nurses. The new Street Overdose Response Team (SORT), a collaboration between the city’s health and fire departments, aims to deliver a broad range of support and care directly following an overdose.[aside postID=\"news_11890421\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/fentanylteststrips_annelisefinney-1020x765.jpg\"]“Fentanyl is a game changer,” \u003ca href=\"https://sfmayor.org/article/mayor-london-breed-announces-new-director-behavioral-health-services-and-mental-health-sf\">Dr. Hillary Kunins\u003c/a>, the city’s director of behavioral and mental health services, says of the opioid that’s 80 to 100 times stronger than morphine. “It requires a new way of thinking and resourcing.” It also, she says, “requires people to learn to work across disciplines and sometimes across organizations.”\u003c/p>\n\u003cp>Kunins previously led New York City’s response to its overdose and substance abuse crisis. She concedes they aren’t sure what combination of tools, ultimately, will work best here to not only reduce fentanyl- and other drug-related deaths but also to boost treatment success rates.\u003c/p>\n\u003cp>So the street overdose pilot project is part of a broad and ambitious strategy of interventions across city agencies.\u003c/p>\n\u003cp>“There is no single approach that’s going to solve this complex problem,” Kunins says. “What’s exciting and important about the work is that it is really part of a movement across the country to rethink how we address people who are at risk of overdose, who have ongoing other challenges: mental health, housing, food. And we must do this work to scale.”\u003c/p>\n\u003ch3>\u003cstrong>Fentanyl forced city officials to change how they approached harm reduction\u003c/strong>\u003c/h3>\n\u003cp>Capt. Michael Mason, a paramedic, is the fire department’s point person on the new program. As he races to the call for Nicholas’s overdose, he’s simultaneously coordinating with other paramedics.\u003c/p>\n\u003cp>“So starting directly at the scene of this overdose, we can start trying to direct this guy’s care in the best direction possible,” Mason says.[aside postID=\"news_11874651\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2021/05/RS48996_006_MountainView_RobinDosskey_05122021-qut.jpg\"]That direct engagement could include helping to find a shelter bed, reaching out to friends or a doctor, helping with food or, most importantly, seeing if a person wants to start treatment with buprenorphine or suboxone, a medication-assisted therapy for opioid dependence.\u003c/p>\n\u003cp>“Get this individual suboxone, stabilize him at the [emergency department], by that afternoon they can be in a treatment program,” Mason says, “All in the context of a 911 incident.”\u003c/p>\n\u003cp>For many years San Francisco has championed a harm-reduction public health approach to lowering drug deaths and injury. The city, known for its relative tolerance of illicit drug use, was a trailblazer of clean syringe access and distribution of life-saving naloxone kits, as well as boosting access to the treatment drugs methadone and buprenorphine.\u003c/p>\n\u003cp>But when fentanyl hit hard here starting a few years ago, the overdose crisis spiraled and the city was forced to rethink its approach. Free Narcan and syringes weren’t enough.\u003c/p>\n\u003cp>“If fentanyl is in the drugs that you’re using, your risk of overdose triples,” Capt. Mason says, adding that the drug is now tainting most every street narcotic here: meth, cocaine, heroin and fake opioid pills.\u003c/p>\n\u003cfigure id=\"attachment_11895039\" class=\"wp-caption alignnone\" style=\"max-width: 1228px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895039 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-3.jpg\" alt=\"A person knocks on the front door of an apartment on the second, outdoor floor of a multistory building.\" width=\"1228\" height=\"920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3.jpg 1228w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3-160x120.jpg 160w\" sizes=\"auto, (max-width: 1228px) 100vw, 1228px\">\u003cfigcaption class=\"wp-caption-text\">San Francisco Department of Public Health nurses with the city’s new mobile outreach teams say following up with people who’ve recently survived a drug overdose is a key part of the program. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Surviving an overdose\u003c/h3>\n\u003cp>Pandemic isolation and lockdowns — people using alone with no one to administer life-saving Narcan — only partially explain the historic rise in overdose deaths here.\u003c/p>\n\u003cp>The \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">drug death rate, in fact, had been trending higher\u003c/a> well before that, city medical examiner data show. In mid-2018 the numbers began to skyrocket, reaching 441 deaths in 2019. And in 2020, \u003ca href=\"https://sf.gov/data/covid-19-cases-and-deaths#total-cases-and-deaths\">a whopping 712 people fatally overdosed\u003c/a>, more than double the number of people here who died from COVID-19 during that same period.\u003c/p>\n\u003cp>The vast majority of those deaths — almost three-quarters —involved fentanyl.\u003c/p>\n\u003cp>The death toll would have been even higher if not for \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">the wide availability of Narcan here\u003c/a>. Well over 3,000 people said they used Narcan in the city in 2020, a self-reported figure. Officials say the real figure is probably far higher.\u003c/p>\n\u003cp>But health and fire department officials here, Mason says, noticed something else important: Almost half of all who died of an overdose were treated or revived by a paramedic crew in the days or weeks before their deaths, a big signal they were headed for repeat trouble.\u003c/p>\n\u003cp>“Surviving a nonfatal overdose is one of the best predictors of future mortality. Anyone who survives a nonfatal overdose is a huge red flag for us, and that is what this program is about,” he says.\u003c/p>\n\u003cp>A key goal is trying to bring the clinic to the patients: rapid, face-to-face follow-up outreach on the street.\u003c/p>\n\u003cp>“We go out, we look for them, we say, ‘Hey, let’s talk about yesterday,'” says city health department nurse practitioner Kevin Lagor, as he drives through the Tenderloin neighborhood, where many of his clients live. He’s a program lead with SORT’s outreach arm.\u003c/p>\n\u003cp>The goal is to reach back out within 24 to 72 hours of an overdose to try to assist the person with everything from housing to treatment.\u003c/p>\n\u003cp>“That could be providing medical care to address their mental illness. Maybe they’re out of their meds, or maybe they want to start something to address their substance use disorder,” he says. “Just kind of, basically, meeting them where they are and seeing what they need and how we can help them.”\u003c/p>\n\u003cp>But to meet them where they are, the nurse teams first have to find them.\u003c/p>\n\u003cp>It’s a huge challenge. Many of them are unhoused, living in tents on the street or in and out of shelters.\u003c/p>\n\u003cp>The overdose and substance use disorder crisis is directly linked to the city’s epic struggles with homelessness and related challenges including mental illness. Almost 30% of all overdose deaths here are among people experiencing homelessness or people “with no fixed address.” \u003ca href=\"https://www.npr.org/2020/10/19/924146486/removing-cops-from-behavioral-crisis-calls-we-need-to-change-the-model\">SORT collaborates closely with the city’s other programs\u003c/a>, including street medicine and new mental health and homeless street crisis response units.\u003c/p>\n\u003cfigure id=\"attachment_11895030\" class=\"wp-caption aligncenter\" style=\"max-width: 1224px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895030 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-5.jpg\" alt=\"A person stands in the middle of a crosswalk looking up the street and at a row of tents on each sidewalk.\" width=\"1224\" height=\"918\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5.jpg 1224w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5-160x120.jpg 160w\" sizes=\"auto, (max-width: 1224px) 100vw, 1224px\">\u003cfigcaption class=\"wp-caption-text\">People live in tents that line a side street in the Tenderloin District. More than 40% of all drug overdoses are in the Tenderloin and neighboring SoMa districts, according to city data. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>City data shows that men were almost four times more likely to die of an accidental overdose than women. And unhoused people, older San Franciscans and communities of color were disproportionately affected by the death rate: Almost a quarter of all overdose deaths were among Black San Franciscans, who make up just under 6% of the city’s population.\u003c/p>\n\u003cp>More than 40% of all overdose deaths in the last year have been concentrated in two neighborhoods: the South of Market area and the Tenderloin, according to data from the city and county chief medical examiner’s office. Those areas make up just 7% of the city’s population.\u003c/p>\n\u003cp>While drug deaths hit every sector of society, many who overdosed were found in city-funded hotel rooms for unhoused residents and in apartment buildings for those with low incomes.\u003c/p>\n\u003cp>“We have to remember that this is a social crisis at the intersection, particularly in San Francisco, of a housing crisis, of a mental health crisis, of people living at the margins of society,” says Dr. Dan Ciccarone, a professor and researcher at University of California, San Francisco.\u003c/p>\n\u003cp>Open-air drug use and dealing in the Tenderloin, an area long challenged by poverty, homelessness and addiction crises, has only worsened during the pandemic. It’s common, day or night, to see people smoking or shooting up opioids or nodding out from drug use.\u003c/p>\n\u003cp>One 32-year-old man named Neil (we’re not using his last name because of the stigma of addiction) says he’s been living on the streets, mainly in the Tenderloin, for three years now.\u003c/p>\n\u003cp>He says he uses fentanyl “to take the edge off” of his depression and chronic stomach pain. He occasionally sells drugs, he says, to get money to support his habit. He soon crushes a small amount of fentanyl into a piece of tinfoil and begins to smoke the drug.\u003c/p>\n\u003cfigure id=\"attachment_11895055\" class=\"wp-caption alignnone\" style=\"max-width: 1229px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895055 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-6.jpg\" alt=\"Two people wearing face masks stand outside a white van parked alongside a mural as they look through papers and plastic bags in their hands. It looks like early morning.\" width=\"1229\" height=\"921\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6.jpg 1229w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6-160x120.jpg 160w\" sizes=\"auto, (max-width: 1229px) 100vw, 1229px\">\u003cfigcaption class=\"wp-caption-text\">City public health department nurses Kevin Lagor and Louise Bisby, part of new mobile outreach teams, get supplies out of their SUV to bring to people who have recently survived a drug overdose. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Follow-up work by nurses is full of challenges\u003c/h3>\n\u003cp>On a recent day, nurse Lagor has half a dozen clients listed on his clipboard. He can’t find a single person.\u003c/p>\n\u003cp>“So we’ll just kind of keep following up with the staff at the shelter,” he says in the lobby of one facility, having been unable to find a client.\u003c/p>\n\u003cp>The same happens at a makeshift tent encampment behind a local Best Buy.\u003c/p>\n\u003cp>Outside another shelter, Lagor and his team strike out again trying to find a young man they thought they were making progress with. They’d recently written him a prescription for a supply of buprenorphine.\u003c/p>\n\u003cp>“He hasn’t been here in a couple of days,” Lagor says, disappointed.\u003c/p>\n\u003cp>“It is a bad sign. Sometimes folks disappear for a couple days and then resurface,” he says. “Then they disappear, or it just falls apart.”\u003c/p>\n\u003cp>And when it all falls apart, it can hit Lagor and the rest of his team hard.\u003c/p>\n\u003cp>“It’s a lot of death and they’re not strangers. You know, we’ve had a couple of deaths this week and we’ve, we shed tears together,” Lagor says. “It’s hard not to care about someone when you’re really trying to help them.”\u003c/p>\n\u003cp>Addiction and public health experts say these mobile, nonpolice teams mark a much-needed pivot for the city.\u003c/p>\n\u003cp>“It’s bold and it’s innovative. I like it,” says Ciccarone, a professor of medicine at UC San Francisco and a leading expert on drug use, people who use drugs and heroin. “We need to bring in some innovations here because fentanyl is a wild card and it has caught us all by surprise. That’s what we need to do in a crisis situation: Think creatively.”\u003c/p>\n\u003cp>But Ciccarone cautions that the ravages of fentanyl and its complex stew of related challenges mean the city needs to scale up this new street overdose response program and continue to try to break down obstacles to treatment that include bureaucratic silos, turf battles and funding woes.\u003c/p>\n\u003cp>“It’s definitely not enough,” he says. “We have to make sure that harm reduction is adequately funded, that our mental health system, our substance treatment system, our housing systems are adequately funded.”\u003c/p>\n\u003cp>So far, just two months since the program’s launch, 10% of those encountered by the SORT teams who’ve overdosed are now getting medication-assisted treatment for opioid use disorder. That includes buprenorphine or suboxone in collaboration with city’s street medicine nurses.\u003c/p>\n\u003cp>“I’m proud of that number,” Capt. Mason says, “and I very much look forward to increasing that.”\u003c/p>\n\u003cp>To get that number even higher, the fire department has applied to the state EMS agency to allow paramedics to more easily administer and prescribe those treatment drugs directly in the field.\u003c/p>\n\u003cp>Despite a recent slight drop in monthly fatalities the city looks to end 2021 with \u003ca href=\"https://sf.gov/sites/default/files/2021-10/2021%2010_OCME%20Overdose%20Report.pdf\">more than 700 overdose deaths for the second year in a row.\u003c/a> Unfortunately, Kunins, the city’s director of behavioral health services, says San Francisco is “on track to continue this really tragic loss of life.”\u003c/p>\n\u003cfigure id=\"attachment_11895040\" class=\"wp-caption alignnone\" style=\"max-width: 1224px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895040 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-8.jpg\" alt=\"A uniformed man in black pants, black boots, and a white short-sleeved shirt with a red-and-yellow insignia sewn on the sleeve opens the back door of an ambulance parked in the middle of a street.\" width=\"1224\" height=\"918\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8.jpg 1224w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8-160x120.jpg 160w\" sizes=\"auto, (max-width: 1224px) 100vw, 1224px\">\u003cfigcaption class=\"wp-caption-text\">Fire Department Capt. Michael Mason with the city’s Street Overdose Response Team arrives at the scene of a reported drug overdose in downtown San Francisco. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Paramedics on the team look for small victories\u003c/h3>\n\u003cp>Back on the street, another call comes in from the 911 dispatcher for a possible overdose. A middle-aged woman has been found slumped over in a McDonald’s bathroom across town in the Fillmore district.\u003c/p>\n\u003cp>Capt. Mason’s occasional staccato siren squawks aren’t working on a handful of drivers and pedestrians in heavy rush-hour traffic. So he hits his lights and sirens full bore.\u003c/p>\n\u003cp>When they arrive, the woman tells the paramedics she has relapsed after several months of sobriety.\u003c/p>\n\u003cp>The heroin she bought, Mason says, was likely laced with fentanyl. Narcan saved her.\u003c/p>\n\u003cp>Inside the ambulance, Mason says, the woman handed paramedics a crumpled, greasy brown fast-food bag and asked that they get rid of it.\u003c/p>\n\u003cp>“There were some clean syringes in there and what appeared to be small bags of heroin,” he says.\u003c/p>\n\u003cp>Mason finds out she was already part of a medication-assisted treatment program using suboxone. He says she told them that she wants to get sober again.\u003c/p>\n\u003cp>“She was feeling extreme shame from experiencing a relapse,” he says. “Substance use disorder impacts millions of Americans. There’s no shame in having a relapse.”\u003c/p>\n\u003cp>He hopes she restarts her suboxone treatment quickly.\u003c/p>\n\u003cp>“As for today,” Mason says, “and as for surrendering those items and requesting they be disposed of, my hat’s off to her.”\u003c/p>\n\u003cp>The paramedics and nurses involved in this pilot project are dedicated to this difficult work. But all say working across multiple city agencies, treatment centers, health providers and nonprofits can be exhausting.\u003c/p>\n\u003cp>“It’s complicated,” Mason says with a sigh, “it takes work from dozens of folks in a single encounter.”\u003c/p>\n\u003cp>How does he handle the strain of 12-hour shifts filled racing from overdose to overdose, including to some who seemingly don’t want help and others who don’t survive?\u003c/p>\n\u003cp>“For my own mental health, I have to kind of remain an optimistic warrior,” he says, driving his fire department pickup through rush hour traffic. “There’s a quote in the Talmud that says — I won’t get it exactly right — but essentially says, ‘You don’t have to end this work, but you do have to start it.'”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Facing an unprecedented increase in overdose deaths, specifically due to fentanyl, emergency response teams in San Francisco are working together to offer a broad range of support directly following an overdose.",
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"title": "San Francisco's Street Overdose Response Team Is Trying to Bring Clinical Care to the Streets | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s a sun-filled, fall day and Nicholas is strapped to an ambulance gurney near 8th and Market streets in downtown San Francisco, dazed and barely conscious. Plastic IV tubes snake around his left hand where L-O-V-E is tattooed just below his knuckles.\u003c/p>\n\u003cp>“Nicholas, try to wake up a little bit for me, come on,” paramedic Paula Fartash coaxes, as she unsuccessfully tries to rouse him.\u003c/p>\n\u003cp>Nicholas (we’re not using his last name because of the stigma of addiction) tells Fartash that when he started getting high in nearby U.N. Plaza park, he assumed he was smoking his drug of choice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This gentleman thought that he was doing meth,” the veteran San Francisco Fire Department paramedic says. “And turned out he was actually doing fentanyl as well,” the synthetic opioid many times more powerful than heroin. “So he walked over to someone and they gave him some Narcan.”\u003c/p>\n\u003cp>That’s the brand name for naloxone, the emergency nasal spray drug used to try to reverse an otherwise potentially fatal overdose. That someone who administered a life-saving antidote was a nearby volunteer and street cleaner carrying Narcan, \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">part of a city-supported program\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11895057\" class=\"wp-caption alignnone\" style=\"max-width: 1224px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895057 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-9.jpg\" alt=\"The inside of an ambulance, where only the arm and tattooed hand and a bit of the torso of someone who is receiving care is visible. The person receiving care has many tattoos.\" width=\"1224\" height=\"816\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9.jpg 1224w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-9-160x107.jpg 160w\" sizes=\"auto, (max-width: 1224px) 100vw, 1224px\">\u003cfigcaption class=\"wp-caption-text\">A man named Nicholas gets care in an ambulance after overdosing in San Francisco’s Civic Center. He told members of the emergency response team that when he started getting high, he assumed he was smoking meth. However, it turned out that he was unknowingly consuming fentanyl as well. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>San Francisco has among the highest per capita drug overdose death rates of any city in the U.S.\u003c/h3>\n\u003cp>Faced with a stunning rise in drug overdose deaths the last few years, the vast majority tied to fentanyl, San Francisco has launched mobile teams made up of paramedics and nurses. The new Street Overdose Response Team (SORT), a collaboration between the city’s health and fire departments, aims to deliver a broad range of support and care directly following an overdose.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Fentanyl is a game changer,” \u003ca href=\"https://sfmayor.org/article/mayor-london-breed-announces-new-director-behavioral-health-services-and-mental-health-sf\">Dr. Hillary Kunins\u003c/a>, the city’s director of behavioral and mental health services, says of the opioid that’s 80 to 100 times stronger than morphine. “It requires a new way of thinking and resourcing.” It also, she says, “requires people to learn to work across disciplines and sometimes across organizations.”\u003c/p>\n\u003cp>Kunins previously led New York City’s response to its overdose and substance abuse crisis. She concedes they aren’t sure what combination of tools, ultimately, will work best here to not only reduce fentanyl- and other drug-related deaths but also to boost treatment success rates.\u003c/p>\n\u003cp>So the street overdose pilot project is part of a broad and ambitious strategy of interventions across city agencies.\u003c/p>\n\u003cp>“There is no single approach that’s going to solve this complex problem,” Kunins says. “What’s exciting and important about the work is that it is really part of a movement across the country to rethink how we address people who are at risk of overdose, who have ongoing other challenges: mental health, housing, food. And we must do this work to scale.”\u003c/p>\n\u003ch3>\u003cstrong>Fentanyl forced city officials to change how they approached harm reduction\u003c/strong>\u003c/h3>\n\u003cp>Capt. Michael Mason, a paramedic, is the fire department’s point person on the new program. As he races to the call for Nicholas’s overdose, he’s simultaneously coordinating with other paramedics.\u003c/p>\n\u003cp>“So starting directly at the scene of this overdose, we can start trying to direct this guy’s care in the best direction possible,” Mason says.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>That direct engagement could include helping to find a shelter bed, reaching out to friends or a doctor, helping with food or, most importantly, seeing if a person wants to start treatment with buprenorphine or suboxone, a medication-assisted therapy for opioid dependence.\u003c/p>\n\u003cp>“Get this individual suboxone, stabilize him at the [emergency department], by that afternoon they can be in a treatment program,” Mason says, “All in the context of a 911 incident.”\u003c/p>\n\u003cp>For many years San Francisco has championed a harm-reduction public health approach to lowering drug deaths and injury. The city, known for its relative tolerance of illicit drug use, was a trailblazer of clean syringe access and distribution of life-saving naloxone kits, as well as boosting access to the treatment drugs methadone and buprenorphine.\u003c/p>\n\u003cp>But when fentanyl hit hard here starting a few years ago, the overdose crisis spiraled and the city was forced to rethink its approach. Free Narcan and syringes weren’t enough.\u003c/p>\n\u003cp>“If fentanyl is in the drugs that you’re using, your risk of overdose triples,” Capt. Mason says, adding that the drug is now tainting most every street narcotic here: meth, cocaine, heroin and fake opioid pills.\u003c/p>\n\u003cfigure id=\"attachment_11895039\" class=\"wp-caption alignnone\" style=\"max-width: 1228px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895039 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-3.jpg\" alt=\"A person knocks on the front door of an apartment on the second, outdoor floor of a multistory building.\" width=\"1228\" height=\"920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3.jpg 1228w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-3-160x120.jpg 160w\" sizes=\"auto, (max-width: 1228px) 100vw, 1228px\">\u003cfigcaption class=\"wp-caption-text\">San Francisco Department of Public Health nurses with the city’s new mobile outreach teams say following up with people who’ve recently survived a drug overdose is a key part of the program. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Surviving an overdose\u003c/h3>\n\u003cp>Pandemic isolation and lockdowns — people using alone with no one to administer life-saving Narcan — only partially explain the historic rise in overdose deaths here.\u003c/p>\n\u003cp>The \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">drug death rate, in fact, had been trending higher\u003c/a> well before that, city medical examiner data show. In mid-2018 the numbers began to skyrocket, reaching 441 deaths in 2019. And in 2020, \u003ca href=\"https://sf.gov/data/covid-19-cases-and-deaths#total-cases-and-deaths\">a whopping 712 people fatally overdosed\u003c/a>, more than double the number of people here who died from COVID-19 during that same period.\u003c/p>\n\u003cp>The vast majority of those deaths — almost three-quarters —involved fentanyl.\u003c/p>\n\u003cp>The death toll would have been even higher if not for \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">the wide availability of Narcan here\u003c/a>. Well over 3,000 people said they used Narcan in the city in 2020, a self-reported figure. Officials say the real figure is probably far higher.\u003c/p>\n\u003cp>But health and fire department officials here, Mason says, noticed something else important: Almost half of all who died of an overdose were treated or revived by a paramedic crew in the days or weeks before their deaths, a big signal they were headed for repeat trouble.\u003c/p>\n\u003cp>“Surviving a nonfatal overdose is one of the best predictors of future mortality. Anyone who survives a nonfatal overdose is a huge red flag for us, and that is what this program is about,” he says.\u003c/p>\n\u003cp>A key goal is trying to bring the clinic to the patients: rapid, face-to-face follow-up outreach on the street.\u003c/p>\n\u003cp>“We go out, we look for them, we say, ‘Hey, let’s talk about yesterday,'” says city health department nurse practitioner Kevin Lagor, as he drives through the Tenderloin neighborhood, where many of his clients live. He’s a program lead with SORT’s outreach arm.\u003c/p>\n\u003cp>The goal is to reach back out within 24 to 72 hours of an overdose to try to assist the person with everything from housing to treatment.\u003c/p>\n\u003cp>“That could be providing medical care to address their mental illness. Maybe they’re out of their meds, or maybe they want to start something to address their substance use disorder,” he says. “Just kind of, basically, meeting them where they are and seeing what they need and how we can help them.”\u003c/p>\n\u003cp>But to meet them where they are, the nurse teams first have to find them.\u003c/p>\n\u003cp>It’s a huge challenge. Many of them are unhoused, living in tents on the street or in and out of shelters.\u003c/p>\n\u003cp>The overdose and substance use disorder crisis is directly linked to the city’s epic struggles with homelessness and related challenges including mental illness. Almost 30% of all overdose deaths here are among people experiencing homelessness or people “with no fixed address.” \u003ca href=\"https://www.npr.org/2020/10/19/924146486/removing-cops-from-behavioral-crisis-calls-we-need-to-change-the-model\">SORT collaborates closely with the city’s other programs\u003c/a>, including street medicine and new mental health and homeless street crisis response units.\u003c/p>\n\u003cfigure id=\"attachment_11895030\" class=\"wp-caption aligncenter\" style=\"max-width: 1224px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895030 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-5.jpg\" alt=\"A person stands in the middle of a crosswalk looking up the street and at a row of tents on each sidewalk.\" width=\"1224\" height=\"918\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5.jpg 1224w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-5-160x120.jpg 160w\" sizes=\"auto, (max-width: 1224px) 100vw, 1224px\">\u003cfigcaption class=\"wp-caption-text\">People live in tents that line a side street in the Tenderloin District. More than 40% of all drug overdoses are in the Tenderloin and neighboring SoMa districts, according to city data. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>City data shows that men were almost four times more likely to die of an accidental overdose than women. And unhoused people, older San Franciscans and communities of color were disproportionately affected by the death rate: Almost a quarter of all overdose deaths were among Black San Franciscans, who make up just under 6% of the city’s population.\u003c/p>\n\u003cp>More than 40% of all overdose deaths in the last year have been concentrated in two neighborhoods: the South of Market area and the Tenderloin, according to data from the city and county chief medical examiner’s office. Those areas make up just 7% of the city’s population.\u003c/p>\n\u003cp>While drug deaths hit every sector of society, many who overdosed were found in city-funded hotel rooms for unhoused residents and in apartment buildings for those with low incomes.\u003c/p>\n\u003cp>“We have to remember that this is a social crisis at the intersection, particularly in San Francisco, of a housing crisis, of a mental health crisis, of people living at the margins of society,” says Dr. Dan Ciccarone, a professor and researcher at University of California, San Francisco.\u003c/p>\n\u003cp>Open-air drug use and dealing in the Tenderloin, an area long challenged by poverty, homelessness and addiction crises, has only worsened during the pandemic. It’s common, day or night, to see people smoking or shooting up opioids or nodding out from drug use.\u003c/p>\n\u003cp>One 32-year-old man named Neil (we’re not using his last name because of the stigma of addiction) says he’s been living on the streets, mainly in the Tenderloin, for three years now.\u003c/p>\n\u003cp>He says he uses fentanyl “to take the edge off” of his depression and chronic stomach pain. He occasionally sells drugs, he says, to get money to support his habit. He soon crushes a small amount of fentanyl into a piece of tinfoil and begins to smoke the drug.\u003c/p>\n\u003cfigure id=\"attachment_11895055\" class=\"wp-caption alignnone\" style=\"max-width: 1229px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895055 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-6.jpg\" alt=\"Two people wearing face masks stand outside a white van parked alongside a mural as they look through papers and plastic bags in their hands. It looks like early morning.\" width=\"1229\" height=\"921\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6.jpg 1229w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-6-160x120.jpg 160w\" sizes=\"auto, (max-width: 1229px) 100vw, 1229px\">\u003cfigcaption class=\"wp-caption-text\">City public health department nurses Kevin Lagor and Louise Bisby, part of new mobile outreach teams, get supplies out of their SUV to bring to people who have recently survived a drug overdose. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Follow-up work by nurses is full of challenges\u003c/h3>\n\u003cp>On a recent day, nurse Lagor has half a dozen clients listed on his clipboard. He can’t find a single person.\u003c/p>\n\u003cp>“So we’ll just kind of keep following up with the staff at the shelter,” he says in the lobby of one facility, having been unable to find a client.\u003c/p>\n\u003cp>The same happens at a makeshift tent encampment behind a local Best Buy.\u003c/p>\n\u003cp>Outside another shelter, Lagor and his team strike out again trying to find a young man they thought they were making progress with. They’d recently written him a prescription for a supply of buprenorphine.\u003c/p>\n\u003cp>“He hasn’t been here in a couple of days,” Lagor says, disappointed.\u003c/p>\n\u003cp>“It is a bad sign. Sometimes folks disappear for a couple days and then resurface,” he says. “Then they disappear, or it just falls apart.”\u003c/p>\n\u003cp>And when it all falls apart, it can hit Lagor and the rest of his team hard.\u003c/p>\n\u003cp>“It’s a lot of death and they’re not strangers. You know, we’ve had a couple of deaths this week and we’ve, we shed tears together,” Lagor says. “It’s hard not to care about someone when you’re really trying to help them.”\u003c/p>\n\u003cp>Addiction and public health experts say these mobile, nonpolice teams mark a much-needed pivot for the city.\u003c/p>\n\u003cp>“It’s bold and it’s innovative. I like it,” says Ciccarone, a professor of medicine at UC San Francisco and a leading expert on drug use, people who use drugs and heroin. “We need to bring in some innovations here because fentanyl is a wild card and it has caught us all by surprise. That’s what we need to do in a crisis situation: Think creatively.”\u003c/p>\n\u003cp>But Ciccarone cautions that the ravages of fentanyl and its complex stew of related challenges mean the city needs to scale up this new street overdose response program and continue to try to break down obstacles to treatment that include bureaucratic silos, turf battles and funding woes.\u003c/p>\n\u003cp>“It’s definitely not enough,” he says. “We have to make sure that harm reduction is adequately funded, that our mental health system, our substance treatment system, our housing systems are adequately funded.”\u003c/p>\n\u003cp>So far, just two months since the program’s launch, 10% of those encountered by the SORT teams who’ve overdosed are now getting medication-assisted treatment for opioid use disorder. That includes buprenorphine or suboxone in collaboration with city’s street medicine nurses.\u003c/p>\n\u003cp>“I’m proud of that number,” Capt. Mason says, “and I very much look forward to increasing that.”\u003c/p>\n\u003cp>To get that number even higher, the fire department has applied to the state EMS agency to allow paramedics to more easily administer and prescribe those treatment drugs directly in the field.\u003c/p>\n\u003cp>Despite a recent slight drop in monthly fatalities the city looks to end 2021 with \u003ca href=\"https://sf.gov/sites/default/files/2021-10/2021%2010_OCME%20Overdose%20Report.pdf\">more than 700 overdose deaths for the second year in a row.\u003c/a> Unfortunately, Kunins, the city’s director of behavioral health services, says San Francisco is “on track to continue this really tragic loss of life.”\u003c/p>\n\u003cfigure id=\"attachment_11895040\" class=\"wp-caption alignnone\" style=\"max-width: 1224px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11895040 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/NPR-fentanyl-8.jpg\" alt=\"A uniformed man in black pants, black boots, and a white short-sleeved shirt with a red-and-yellow insignia sewn on the sleeve opens the back door of an ambulance parked in the middle of a street.\" width=\"1224\" height=\"918\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8.jpg 1224w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/NPR-fentanyl-8-160x120.jpg 160w\" sizes=\"auto, (max-width: 1224px) 100vw, 1224px\">\u003cfigcaption class=\"wp-caption-text\">Fire Department Capt. Michael Mason with the city’s Street Overdose Response Team arrives at the scene of a reported drug overdose in downtown San Francisco. \u003ccite>(Rachel Bujalski for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Paramedics on the team look for small victories\u003c/h3>\n\u003cp>Back on the street, another call comes in from the 911 dispatcher for a possible overdose. A middle-aged woman has been found slumped over in a McDonald’s bathroom across town in the Fillmore district.\u003c/p>\n\u003cp>Capt. Mason’s occasional staccato siren squawks aren’t working on a handful of drivers and pedestrians in heavy rush-hour traffic. So he hits his lights and sirens full bore.\u003c/p>\n\u003cp>When they arrive, the woman tells the paramedics she has relapsed after several months of sobriety.\u003c/p>\n\u003cp>The heroin she bought, Mason says, was likely laced with fentanyl. Narcan saved her.\u003c/p>\n\u003cp>Inside the ambulance, Mason says, the woman handed paramedics a crumpled, greasy brown fast-food bag and asked that they get rid of it.\u003c/p>\n\u003cp>“There were some clean syringes in there and what appeared to be small bags of heroin,” he says.\u003c/p>\n\u003cp>Mason finds out she was already part of a medication-assisted treatment program using suboxone. He says she told them that she wants to get sober again.\u003c/p>\n\u003cp>“She was feeling extreme shame from experiencing a relapse,” he says. “Substance use disorder impacts millions of Americans. There’s no shame in having a relapse.”\u003c/p>\n\u003cp>He hopes she restarts her suboxone treatment quickly.\u003c/p>\n\u003cp>“As for today,” Mason says, “and as for surrendering those items and requesting they be disposed of, my hat’s off to her.”\u003c/p>\n\u003cp>The paramedics and nurses involved in this pilot project are dedicated to this difficult work. But all say working across multiple city agencies, treatment centers, health providers and nonprofits can be exhausting.\u003c/p>\n\u003cp>“It’s complicated,” Mason says with a sigh, “it takes work from dozens of folks in a single encounter.”\u003c/p>\n\u003cp>How does he handle the strain of 12-hour shifts filled racing from overdose to overdose, including to some who seemingly don’t want help and others who don’t survive?\u003c/p>\n\u003cp>“For my own mental health, I have to kind of remain an optimistic warrior,” he says, driving his fire department pickup through rush hour traffic. “There’s a quote in the Talmud that says — I won’t get it exactly right — but essentially says, ‘You don’t have to end this work, but you do have to start it.'”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "covid-vaccines-kids-why-doctors-say-dont-wait-and-other-faqs",
"title": "COVID Vaccines and Kids: Why Doctors Say Don't Wait, and Other FAQ",
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"content": "\u003cp>\u003cem>This story will be updated as more of your questions come in. \u003ca href=\"#ask\">Tell us what you need to know.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11894546/pfizer-covid-vaccine-kids-5-11-near-me\">Pediatric COVID vaccines for kids age 5-11\u003c/a> are finally here. And naturally, parents and caregivers have a lot of questions when it comes to vaccinating their children.\u003c/p>\n\u003cp>We talked to pediatricians and looked at the data to provide answers to common questions on families’ minds right now.\u003c/p>\n\u003cp>\u003cstrong>Skip to the answers for common questions:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#impact\">How does getting COVID actually affect kids?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#efficacy\">How well does the COVID-19 vaccine work for kids?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#sideeffects\">What are the common side effects, and which should I worry about?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#wait\">Should I wait to vaccinate my kid?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#eleven\">If my kid is 11, should we wait to get them the higher, adult dose at age 12?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Don’t see your question answered in this story? \u003ca href=\"#ask\">Send us your question.\u003c/a>\u003c/p>\n\u003ch3>\u003ca id=\"impact\">\u003c/a>I’ve heard COVID is mild for most kids. Do they really need to be vaccinated?\u003c/h3>\n\u003cp>It’s true that most children infected with the virus have only mild symptoms and that children rarely die from the disease. But scientists and health officials recommending the shot emphasize that vaccination could prevent many infections, as well as disruptions to schooling, hospitalizations and rare but severe complications of the disease.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-11-2-3/03-COVID-Jefferson-508.pdf\">More than 8,300\u003c/a> kids age 5 to 11 have been hospitalized with COVID-19 because of serious illness. According to a CDC analysis, the number of children and adolescents \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7036e2.htm\">admitted to the hospital increased nearly fivefold\u003c/a> over the summer months amid the delta surge.\u003cspan style=\"font-weight: 400\">[aside postID=news_11894546 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/11/RS52294_GettyImages-1234717012-qut.jpg']\u003c/span>\u003c/p>\n\u003cp>In addition, more than \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#mis-national-surveillance\">5,200 children and teens have developed MIS-C\u003c/a>, or multisystem inflammatory syndrome in children, a condition linked to COVID-19 that often leads to ICU admission. The median age of kids getting MIS-C is 9 years old.\u003c/p>\n\u003cp>It’s hard to predict which kids who get COVID-19 will be struck with severe COVID-19 or MIS-C. In one \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778347\">CDC analysis of hospitalization records\u003c/a>, roughly 30% of kids hospitalized with COVID-19 had no underlying health conditions that would have put them at increased risk.\u003c/p>\n\u003cp>“Everything about this virus is unpredictable,” says \u003ca href=\"https://providerdirectory.uabmedicine.org/provider/David+Kimberlin/570550\">Dr. David Kimberlin\u003c/a>, an infectious disease pediatrician at the University of Alabama at Birmingham. “And we need to do everything we can to protect ourselves and to protect our children against what this virus is very capable of doing.”\u003c/p>\n\u003cp>Black, Native American and Latino children were three times more likely to be hospitalized than white children, \u003ca href=\"https://www.fda.gov/media/153508/download\">according to the CDC\u003c/a>.\u003c/p>\n\u003cp>At least \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#demographics\">791 children have died \u003c/a>from COVID-19, including 172 children age 5 to 11. “I have sat beside the bed of patients who are struggling to breathe,” says Kimberlin. His hospital has treated many adolescents who were old enough to be vaccinated but hadn’t been and then ended up on ventilators or ECMO, extracorporeal membrane oxygenation. In this situation, he says, parents are grieving. “And in the back of their mind, they also know [it] could have been prevented,” Kimberlin says.\u003c/p>\n\u003cp>For some clinicians, the argument for vaccination comes down to the idea that no child should ever die from a disease that could have been prevented by simply getting a shot. “COVID-19 is now a vaccine-preventable disease from my perspective,” said \u003ca href=\"https://www.fda.gov/media/136851/download\">Dr. Amanda Cohn\u003c/a>, during last week’s FDA advisory committee that voted in favor of authorizing the vaccine for younger kids.\u003c/p>\n\u003cp>“It’s the \u003ca href=\"https://www.fda.gov/media/153508/download\">eighth highest killer\u003c/a> of kids in this age group over the past year,” Cohn said. “The use of this vaccine will prevent deaths, ICU admissions and will prevent significant long-term adverse outcomes in children.”\u003c/p>\n\u003ch3>\u003ca id=\"efficacy\">\u003c/a>How well does the COVID-19 vaccine work for kids?\u003c/h3>\n\u003cp>A clinical trial conducted by Pfizer and BioNTech studied a 10-microgram vaccine dose in children age 5 to 11. This is a third of the dose given to adults and children 12 and older. The lower dose was chosen to minimize side effects but still prompt a strong immune response, according to the vaccine makers.\u003c/p>\n\u003cp>The data the drug companies presented to the FDA showed that the vaccine was 90.7% effective against symptomatic COVID-19. The antibody response to the vaccine was comparable to the one seen in people 16 to 25 years old.\u003c/p>\n\u003cp>Pediatricians also point to real-world data on the effectiveness of the vaccines in 12- to 17-year-olds. Amid the recent delta surge, hospitalization rates were \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7036e2.htm\">about 10 times higher\u003c/a> in unvaccinated adolescents than vaccinated ones, according to a recent CDC analysis.\u003c/p>\n\u003ch3>\u003ca id=\"sideeffects\">\u003c/a>What are the common side effects?\u003c/h3>\n\u003cp>No new safety problems were identified in the companies’ studies of this vaccine.\u003c/p>\n\u003cp>The most \u003ca href=\"https://www.fda.gov/media/153510/download\">common side effects\u003c/a> documented in the study were similar to those other age groups have had with COVID-19 vaccines. The most common were pain at the injection site, fatigue and headache and muscle aches. Kids who get the vaccine feel “ultimately fine in two or three days,” says \u003ca href=\"https://www.dukehealth.org/find-doctors-physicians/ibukunoluwa-c-kalu-md\">Dr. Ibukunoluwa Kalu\u003c/a>, a pediatrician and infectious disease specialist at Duke University.\u003c/p>\n\u003cp>When it comes to rare immediate allergic reactions to the COVID-19 vaccine, UCSF infectious disease specialist Dr. Peter Chin-Hong says there are already checks in place to catch these: namely, the 15-minute observation period after your child’s COVID vaccination, during which you and your child will be asked to stay at the vaccination site.\u003c/p>\n\u003cp>Back at home, at what point should a parent or caregiver call a child’s pediatrician about side effects after the COVID vaccine? Chin-Hong says to look for symptoms that persist for more than a day and get worse, not better — especially if it’s a fever.\u003c/p>\n\u003ch3>Should I be concerned about serious side effects, especially myocarditis?\u003c/h3>\n\u003cp>In very rare cases, following vaccination with mRNA vaccines made by Pfizer and Moderna, people have developed inflammation of the heart muscle, which is known as myocarditis. In Pfizer’s clinical trial for 5- to 11-year-olds, there were no cases of myocarditis, although the company acknowledged that the trials were not big enough to pick up such rare events.\u003c/p>\n\u003cp>Myocarditis after vaccination is “very, very rare,” explains Kimberlin. And it’s usually short-lived. In most instances, adolescents who’ve developed myocarditis have improved quickly. “The management of it usually is taking some ibuprofen — some Advil,” Kimberlin says.\u003c/p>\n\u003cp>Rates of post-vaccination myocarditis are expected to be lower in young kids than those observed in teens. Myocarditis, which can also occur after bacterial and viral infections, including COVID-19, is generally significantly less common among younger children. That’s partly because the condition is linked with puberty hormones, explains pediatrician \u003ca href=\"https://drnicolebaldwin.com/\">Nicole Baldwin\u003c/a>, who practices in Cincinnati.\u003c/p>\n\u003cp>And the smaller dose size for younger kids may also reduce the risk, Kalu adds. “The physiology behind why they saw some of the post-vaccine myocarditis seems to be related to how the immune system is reacting to the vaccine. It’s mounting a protective level of antibody, but maybe a little overzealous in those efforts,” she says.\u003c/p>\n\u003cp>Of 877 reports of vaccine-related myocarditis in people under 30, no deaths have been confirmed, according to data presented at the CDC’s advisory meeting Tuesday. Dr. Matthew Oster, who studies myocarditis for the CDC and is a pediatric cardiologist at Children’s Healthcare of Atlanta, explained that COVID-19 itself can cause myocarditis and other heart-related issues, as well as MIS-C, which often affects the heart.\u003c/p>\n\u003cp>“The bottom line is, getting COVID, I think, is much riskier to the heart than getting this vaccine,” Oster said.\u003c/p>\n\u003ch3>\u003ca id=\"wait\">\u003c/a>Can’t I just wait a bit to see how vaccinations go before I vaccinate my kid?\u003c/h3>\n\u003cp>Many pediatricians urge parents not to wait — first of all because their children will still be at risk for getting sick from COVID-19. “You can’t wait until millions and millions of doses are given before you decide, because this virus is going to take every opportunity it can to infect someone,” says \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=17154\">Dr. Tina Tan\u003c/a>, pediatrician and infectious disease specialist at Northwestern and Lurie Children’s Hospital of Chicago.\u003c/p>\n\u003cp>Even though COVID-19 cases are trending downward, 90% of counties in the U.S. are still classified by the CDC as \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#county-view\">having “high” or “substantial” viral spread\u003c/a>.\u003c/p>\n\u003cp>“Because the delta variant is that much more transmissible, kids can get delta and can get quite sick from it,” says Tan. “You cannot predict — in a normal healthy child — who’s going to get very sick and who’s not. [Vaccinating] is the best way to protect your child against getting severe COVID illness.”\u003c/p>\n\u003cp>Acting FDA Commissioner Janet Woodcock made a similar point when she was asked about parents who wanted to wait to vaccinate their kids in a \u003ca href=\"https://www.youtube.com/watch?v=WLbGnS-kqTY\">press conference Friday\u003c/a>. “As a parent, if I had young children in this age group, I would get them vaccinated now,” she said.\u003c/p>\n\u003ch3>Are there some kids who might be at higher risk and want to hurry to get vaccinated?\u003c/h3>\n\u003cp>Certain families should consider getting in the front of the line for shots, Kalu says.\u003c/p>\n\u003cp>One group that should not delay, she says, are “kids that have conditions that may put them at higher risk for severe disease — and that could be as simple as obesity, chronic respiratory conditions, maybe even kidney disease or high blood pressure.”\u003c/p>\n\u003cp>For families with babies or grandparents or other vulnerable people — like an immunocompromised family member — at home, vaccinating your young children as soon as they’re eligible will help keep those people safe.\u003c/p>\n\u003cp>And if you live in an area where the weather is getting chilly, that’s going to mean people being indoors more often, which raises your risk of catching COVID-19.\u003c/p>\n\u003cp>Especially if you are having family members or friends in for the holidays, keep in mind that “it is safer to gather in a fully vaccinated environment than not,” Kalu says. “So even in just the interest of keeping your small community safe as you gather over the holidays, it may be good to get kids vaccinated prior to that.”\u003c/p>\n\u003cp>Baldwin agrees. “If we’re getting these kids vaccinated now before they go hug Grandma and Grandpa [during the holidays], that can offer additional protection to our more vulnerable population,” she says.\u003c/p>\n\u003ch3>If my child already had COVID-19, do they need this shot? Don’t they have immunity?\u003c/h3>\n\u003cp>Even for kids who’ve already had COVID-19, pediatricians say it’s still beneficial to get the vaccine. “We don’t yet really understand the duration of immunity when it comes to kids,” Baldwin explains. Often kids get mild infections, so “we don’t know what that correlates to in terms of antibody levels and how long [they are] going to be protected,” she says.\u003c/p>\n\u003cp>For kids who’ve had a very recent COVID-19 infection, she says, she understands why parents may not be the first to rush out and get the vaccine. It’s probable that their children have immunity in the months following the illness. But, ultimately, she says the vaccine is the best way to ensure strong and lasting protection against the virus.\u003c/p>\n\u003cp>Some parents might be tempted to get their child’s antibody levels tested, but Dr. Kate Russell Woodworth, a medical epidemiologist with the CDC, said at a CDC advisers’ meeting Tuesday that those tests aren’t a reliable way to determine whether a person is protected from reinfection. The CDC \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html\">recommends against\u003c/a> using them for vaccination decisions.\u003c/p>\n\u003ch3>\u003ca id=\"eleven\">\u003c/a>If my kid is 11, should we wait to get them the higher, adult dose at age 12?\u003c/h3>\n\u003cp>“I would not advise waiting,” says Baldwin. “I think it’s important for parents to understand [that in clinical trials] the lower dosage provided as robust an immune response as the higher dosage did in older kids with less side effects.”\u003c/p>\n\u003cp>Baldwin says if your child has a 12th birthday coming up very soon, she says it’s OK to wait, but the dose provided in the children’s formulation is enough to protect them from the virus.\u003c/p>\n\u003cp>If your child turns 12 between their first and second dose, the \u003ca href=\"https://www.aappublications.org/news/2021/10/29/townhall102921\">American Academy of Pediatrics suggests\u003c/a> sticking with the lower, 10-microgram dose for both shots.\u003c/p>\n\u003ch3>What if my child is used to wearing a mask by now? Can’t I just rely on that for prevention?\u003c/h3>\n\u003cp>Masks have proven to be a key tool for preventing outbreaks in schools, but some experts point out that indoor masking can’t go on forever.\u003c/p>\n\u003cp>“We actually have to open back up,” \u003ca href=\"https://profiles.stanford.edu/hayley-gans\">Dr. Hayley Gans\u003c/a>, pediatrician and infectious disease specialist at Stanford University and \u003ca href=\"https://www.stanfordchildrens.org/\">Lucile Packard Children’s Hospital\u003c/a>, said during the FDA advisory meeting. “We can’t forever have mitigation — particularly in schools — and children need to return to a more open life, as we all do.”\u003c/p>\n\u003cp>As cases continue to drop across the country, mask mandates may be lifted, which could increase the likelihood that — especially unvaccinated — kids could get COVID-19.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>\u003ca id=\"ask\">\u003c/a>Tell us: What else do you need to know about COVID vaccines for kids?\u003c/h3>\n\u003cp>[hearken id=\"8833\" src=\"https://modules.wearehearken.com/kqed/embed/8833.js\"]\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+parents+want+to+wait+to+vaccinate+their+kids.+Here%27s+why+doctors+say+do+it+now&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003cem>This story contains additional reporting by KQED’s Carly Severn\u003c/em>\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "What you need to know about the safety and efficacy of the COVID vaccine for kids age 5-11, and how to think about the risks and benefits of vaccinating your child.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story will be updated as more of your questions come in. \u003ca href=\"#ask\">Tell us what you need to know.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11894546/pfizer-covid-vaccine-kids-5-11-near-me\">Pediatric COVID vaccines for kids age 5-11\u003c/a> are finally here. And naturally, parents and caregivers have a lot of questions when it comes to vaccinating their children.\u003c/p>\n\u003cp>We talked to pediatricians and looked at the data to provide answers to common questions on families’ minds right now.\u003c/p>\n\u003cp>\u003cstrong>Skip to the answers for common questions:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#impact\">How does getting COVID actually affect kids?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#efficacy\">How well does the COVID-19 vaccine work for kids?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#sideeffects\">What are the common side effects, and which should I worry about?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#wait\">Should I wait to vaccinate my kid?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#eleven\">If my kid is 11, should we wait to get them the higher, adult dose at age 12?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Don’t see your question answered in this story? \u003ca href=\"#ask\">Send us your question.\u003c/a>\u003c/p>\n\u003ch3>\u003ca id=\"impact\">\u003c/a>I’ve heard COVID is mild for most kids. Do they really need to be vaccinated?\u003c/h3>\n\u003cp>It’s true that most children infected with the virus have only mild symptoms and that children rarely die from the disease. But scientists and health officials recommending the shot emphasize that vaccination could prevent many infections, as well as disruptions to schooling, hospitalizations and rare but severe complications of the disease.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-11-2-3/03-COVID-Jefferson-508.pdf\">More than 8,300\u003c/a> kids age 5 to 11 have been hospitalized with COVID-19 because of serious illness. According to a CDC analysis, the number of children and adolescents \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7036e2.htm\">admitted to the hospital increased nearly fivefold\u003c/a> over the summer months amid the delta surge.\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>In addition, more than \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#mis-national-surveillance\">5,200 children and teens have developed MIS-C\u003c/a>, or multisystem inflammatory syndrome in children, a condition linked to COVID-19 that often leads to ICU admission. The median age of kids getting MIS-C is 9 years old.\u003c/p>\n\u003cp>It’s hard to predict which kids who get COVID-19 will be struck with severe COVID-19 or MIS-C. In one \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778347\">CDC analysis of hospitalization records\u003c/a>, roughly 30% of kids hospitalized with COVID-19 had no underlying health conditions that would have put them at increased risk.\u003c/p>\n\u003cp>“Everything about this virus is unpredictable,” says \u003ca href=\"https://providerdirectory.uabmedicine.org/provider/David+Kimberlin/570550\">Dr. David Kimberlin\u003c/a>, an infectious disease pediatrician at the University of Alabama at Birmingham. “And we need to do everything we can to protect ourselves and to protect our children against what this virus is very capable of doing.”\u003c/p>\n\u003cp>Black, Native American and Latino children were three times more likely to be hospitalized than white children, \u003ca href=\"https://www.fda.gov/media/153508/download\">according to the CDC\u003c/a>.\u003c/p>\n\u003cp>At least \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#demographics\">791 children have died \u003c/a>from COVID-19, including 172 children age 5 to 11. “I have sat beside the bed of patients who are struggling to breathe,” says Kimberlin. His hospital has treated many adolescents who were old enough to be vaccinated but hadn’t been and then ended up on ventilators or ECMO, extracorporeal membrane oxygenation. In this situation, he says, parents are grieving. “And in the back of their mind, they also know [it] could have been prevented,” Kimberlin says.\u003c/p>\n\u003cp>For some clinicians, the argument for vaccination comes down to the idea that no child should ever die from a disease that could have been prevented by simply getting a shot. “COVID-19 is now a vaccine-preventable disease from my perspective,” said \u003ca href=\"https://www.fda.gov/media/136851/download\">Dr. Amanda Cohn\u003c/a>, during last week’s FDA advisory committee that voted in favor of authorizing the vaccine for younger kids.\u003c/p>\n\u003cp>“It’s the \u003ca href=\"https://www.fda.gov/media/153508/download\">eighth highest killer\u003c/a> of kids in this age group over the past year,” Cohn said. “The use of this vaccine will prevent deaths, ICU admissions and will prevent significant long-term adverse outcomes in children.”\u003c/p>\n\u003ch3>\u003ca id=\"efficacy\">\u003c/a>How well does the COVID-19 vaccine work for kids?\u003c/h3>\n\u003cp>A clinical trial conducted by Pfizer and BioNTech studied a 10-microgram vaccine dose in children age 5 to 11. This is a third of the dose given to adults and children 12 and older. The lower dose was chosen to minimize side effects but still prompt a strong immune response, according to the vaccine makers.\u003c/p>\n\u003cp>The data the drug companies presented to the FDA showed that the vaccine was 90.7% effective against symptomatic COVID-19. The antibody response to the vaccine was comparable to the one seen in people 16 to 25 years old.\u003c/p>\n\u003cp>Pediatricians also point to real-world data on the effectiveness of the vaccines in 12- to 17-year-olds. Amid the recent delta surge, hospitalization rates were \u003ca href=\"https://www.cdc.gov/mmwr/volumes/70/wr/mm7036e2.htm\">about 10 times higher\u003c/a> in unvaccinated adolescents than vaccinated ones, according to a recent CDC analysis.\u003c/p>\n\u003ch3>\u003ca id=\"sideeffects\">\u003c/a>What are the common side effects?\u003c/h3>\n\u003cp>No new safety problems were identified in the companies’ studies of this vaccine.\u003c/p>\n\u003cp>The most \u003ca href=\"https://www.fda.gov/media/153510/download\">common side effects\u003c/a> documented in the study were similar to those other age groups have had with COVID-19 vaccines. The most common were pain at the injection site, fatigue and headache and muscle aches. Kids who get the vaccine feel “ultimately fine in two or three days,” says \u003ca href=\"https://www.dukehealth.org/find-doctors-physicians/ibukunoluwa-c-kalu-md\">Dr. Ibukunoluwa Kalu\u003c/a>, a pediatrician and infectious disease specialist at Duke University.\u003c/p>\n\u003cp>When it comes to rare immediate allergic reactions to the COVID-19 vaccine, UCSF infectious disease specialist Dr. Peter Chin-Hong says there are already checks in place to catch these: namely, the 15-minute observation period after your child’s COVID vaccination, during which you and your child will be asked to stay at the vaccination site.\u003c/p>\n\u003cp>Back at home, at what point should a parent or caregiver call a child’s pediatrician about side effects after the COVID vaccine? Chin-Hong says to look for symptoms that persist for more than a day and get worse, not better — especially if it’s a fever.\u003c/p>\n\u003ch3>Should I be concerned about serious side effects, especially myocarditis?\u003c/h3>\n\u003cp>In very rare cases, following vaccination with mRNA vaccines made by Pfizer and Moderna, people have developed inflammation of the heart muscle, which is known as myocarditis. In Pfizer’s clinical trial for 5- to 11-year-olds, there were no cases of myocarditis, although the company acknowledged that the trials were not big enough to pick up such rare events.\u003c/p>\n\u003cp>Myocarditis after vaccination is “very, very rare,” explains Kimberlin. And it’s usually short-lived. In most instances, adolescents who’ve developed myocarditis have improved quickly. “The management of it usually is taking some ibuprofen — some Advil,” Kimberlin says.\u003c/p>\n\u003cp>Rates of post-vaccination myocarditis are expected to be lower in young kids than those observed in teens. Myocarditis, which can also occur after bacterial and viral infections, including COVID-19, is generally significantly less common among younger children. That’s partly because the condition is linked with puberty hormones, explains pediatrician \u003ca href=\"https://drnicolebaldwin.com/\">Nicole Baldwin\u003c/a>, who practices in Cincinnati.\u003c/p>\n\u003cp>And the smaller dose size for younger kids may also reduce the risk, Kalu adds. “The physiology behind why they saw some of the post-vaccine myocarditis seems to be related to how the immune system is reacting to the vaccine. It’s mounting a protective level of antibody, but maybe a little overzealous in those efforts,” she says.\u003c/p>\n\u003cp>Of 877 reports of vaccine-related myocarditis in people under 30, no deaths have been confirmed, according to data presented at the CDC’s advisory meeting Tuesday. Dr. Matthew Oster, who studies myocarditis for the CDC and is a pediatric cardiologist at Children’s Healthcare of Atlanta, explained that COVID-19 itself can cause myocarditis and other heart-related issues, as well as MIS-C, which often affects the heart.\u003c/p>\n\u003cp>“The bottom line is, getting COVID, I think, is much riskier to the heart than getting this vaccine,” Oster said.\u003c/p>\n\u003ch3>\u003ca id=\"wait\">\u003c/a>Can’t I just wait a bit to see how vaccinations go before I vaccinate my kid?\u003c/h3>\n\u003cp>Many pediatricians urge parents not to wait — first of all because their children will still be at risk for getting sick from COVID-19. “You can’t wait until millions and millions of doses are given before you decide, because this virus is going to take every opportunity it can to infect someone,” says \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=17154\">Dr. Tina Tan\u003c/a>, pediatrician and infectious disease specialist at Northwestern and Lurie Children’s Hospital of Chicago.\u003c/p>\n\u003cp>Even though COVID-19 cases are trending downward, 90% of counties in the U.S. are still classified by the CDC as \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#county-view\">having “high” or “substantial” viral spread\u003c/a>.\u003c/p>\n\u003cp>“Because the delta variant is that much more transmissible, kids can get delta and can get quite sick from it,” says Tan. “You cannot predict — in a normal healthy child — who’s going to get very sick and who’s not. [Vaccinating] is the best way to protect your child against getting severe COVID illness.”\u003c/p>\n\u003cp>Acting FDA Commissioner Janet Woodcock made a similar point when she was asked about parents who wanted to wait to vaccinate their kids in a \u003ca href=\"https://www.youtube.com/watch?v=WLbGnS-kqTY\">press conference Friday\u003c/a>. “As a parent, if I had young children in this age group, I would get them vaccinated now,” she said.\u003c/p>\n\u003ch3>Are there some kids who might be at higher risk and want to hurry to get vaccinated?\u003c/h3>\n\u003cp>Certain families should consider getting in the front of the line for shots, Kalu says.\u003c/p>\n\u003cp>One group that should not delay, she says, are “kids that have conditions that may put them at higher risk for severe disease — and that could be as simple as obesity, chronic respiratory conditions, maybe even kidney disease or high blood pressure.”\u003c/p>\n\u003cp>For families with babies or grandparents or other vulnerable people — like an immunocompromised family member — at home, vaccinating your young children as soon as they’re eligible will help keep those people safe.\u003c/p>\n\u003cp>And if you live in an area where the weather is getting chilly, that’s going to mean people being indoors more often, which raises your risk of catching COVID-19.\u003c/p>\n\u003cp>Especially if you are having family members or friends in for the holidays, keep in mind that “it is safer to gather in a fully vaccinated environment than not,” Kalu says. “So even in just the interest of keeping your small community safe as you gather over the holidays, it may be good to get kids vaccinated prior to that.”\u003c/p>\n\u003cp>Baldwin agrees. “If we’re getting these kids vaccinated now before they go hug Grandma and Grandpa [during the holidays], that can offer additional protection to our more vulnerable population,” she says.\u003c/p>\n\u003ch3>If my child already had COVID-19, do they need this shot? Don’t they have immunity?\u003c/h3>\n\u003cp>Even for kids who’ve already had COVID-19, pediatricians say it’s still beneficial to get the vaccine. “We don’t yet really understand the duration of immunity when it comes to kids,” Baldwin explains. Often kids get mild infections, so “we don’t know what that correlates to in terms of antibody levels and how long [they are] going to be protected,” she says.\u003c/p>\n\u003cp>For kids who’ve had a very recent COVID-19 infection, she says, she understands why parents may not be the first to rush out and get the vaccine. It’s probable that their children have immunity in the months following the illness. But, ultimately, she says the vaccine is the best way to ensure strong and lasting protection against the virus.\u003c/p>\n\u003cp>Some parents might be tempted to get their child’s antibody levels tested, but Dr. Kate Russell Woodworth, a medical epidemiologist with the CDC, said at a CDC advisers’ meeting Tuesday that those tests aren’t a reliable way to determine whether a person is protected from reinfection. The CDC \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html\">recommends against\u003c/a> using them for vaccination decisions.\u003c/p>\n\u003ch3>\u003ca id=\"eleven\">\u003c/a>If my kid is 11, should we wait to get them the higher, adult dose at age 12?\u003c/h3>\n\u003cp>“I would not advise waiting,” says Baldwin. “I think it’s important for parents to understand [that in clinical trials] the lower dosage provided as robust an immune response as the higher dosage did in older kids with less side effects.”\u003c/p>\n\u003cp>Baldwin says if your child has a 12th birthday coming up very soon, she says it’s OK to wait, but the dose provided in the children’s formulation is enough to protect them from the virus.\u003c/p>\n\u003cp>If your child turns 12 between their first and second dose, the \u003ca href=\"https://www.aappublications.org/news/2021/10/29/townhall102921\">American Academy of Pediatrics suggests\u003c/a> sticking with the lower, 10-microgram dose for both shots.\u003c/p>\n\u003ch3>What if my child is used to wearing a mask by now? Can’t I just rely on that for prevention?\u003c/h3>\n\u003cp>Masks have proven to be a key tool for preventing outbreaks in schools, but some experts point out that indoor masking can’t go on forever.\u003c/p>\n\u003cp>“We actually have to open back up,” \u003ca href=\"https://profiles.stanford.edu/hayley-gans\">Dr. Hayley Gans\u003c/a>, pediatrician and infectious disease specialist at Stanford University and \u003ca href=\"https://www.stanfordchildrens.org/\">Lucile Packard Children’s Hospital\u003c/a>, said during the FDA advisory meeting. “We can’t forever have mitigation — particularly in schools — and children need to return to a more open life, as we all do.”\u003c/p>\n\u003cp>As cases continue to drop across the country, mask mandates may be lifted, which could increase the likelihood that — especially unvaccinated — kids could get COVID-19.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003ca id=\"ask\">\u003c/a>Tell us: What else do you need to know about COVID vaccines for kids?\u003c/h3>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2021 NPR. To see more, visit npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+parents+want+to+wait+to+vaccinate+their+kids.+Here%27s+why+doctors+say+do+it+now&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003cem>This story contains additional reporting by KQED’s Carly Severn\u003c/em>\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Where Can I Get a Pfizer COVID Vaccine for Kids Age 5-11 Near Me? ",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/11894855/cdc-recommends-pfizers-covid-vaccine-for-children-ages-5-to-11\">Pfizer COVID vaccines are now available for children\u003c/a> age 5-11 in California.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered\">Looking for COVID vaccines for adults or young people age 12 or over instead? \u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Following \u003ca href=\"https://www.kqed.org/news/11894855/cdc-recommends-pfizers-covid-vaccine-for-children-ages-5-to-11\">a thorough in-depth review process from the Food and Drug Administration and the Centers for Disease Control and Prevention\u003c/a>, these pediatric shots are being rolled out around the state. Read on for what parents and caregivers need to know about finding a COVID vaccine for kids age 5-11.\u003c/p>\n\u003cp>\u003cstrong>Skip to:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#where\">Where can I find a COVID vaccine for a kid age 5-11 near me?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#ask\">Don’t see your question answered here? Tell us what you need to know.\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Whether it’s a child’s shot, an adult’s shot or a booster shot, a COVID vaccine will always be free. You or your child do not need health insurance to be vaccinated.\u003c/p>\n\u003cp>You or your child also will not be asked for proof of citizenship or about your immigration status. Getting a COVID vaccine \u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">does not make you or your child a public charge\u003c/a> and won’t affect any current or future green card applications.\u003c/p>\n\u003ch3>What to know about Pfizer COVID vaccines for kids age 5-11\u003c/h3>\n\u003cp>\u003cstrong>Kids in this age group can only get Pfizer … for now.\u003c/strong>\u003c/p>\n\u003cp>Currently, \u003ca href=\"https://www.kqed.org/news/11894855/cdc-recommends-pfizers-covid-vaccine-for-children-ages-5-to-11\">only the Pfizer COVID vaccine has been authorized\u003c/a> by the FDA and the CDC for use in children age 5-11.\u003c/p>\n\u003cp>You may see the Pfizer-BioNTech COVID-19 vaccine also referred to as Comirnaty. This is the brand name of this particular vaccine.\u003c/p>\n\u003cp>\u003cstrong>The COVID vaccine dose for kids age 5-11 is lower\u003c/strong>\u003c/p>\n\u003cp>Children in this age group will be offered a lower dose of the Pfizer COVID vaccine than the dose offered to adults and young people over 12. This lower dose — which you might hear being called the pediatric dose — is one-third of the adult dose.[aside postID=news_11894983 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/11/ap_21294837037646-bc68994bd87165627b4ab20dd7f8cf49248798ec-1020x765.jpg']\u003c/p>\n\u003cp>If you’re wondering why the lower dose of Pfizer’s COVID vaccine is given according to a child’s age, and not their body mass — as with some other pediatric medicines — it’s actually all about the age of a kid’s \u003cem>immune system\u003c/em>, says Dr. Peter Chin-Hong, an infectious disease specialist at UCSF. And generally, over the age of six months, a young immune system is “more agile,” he says.\u003c/p>\n\u003cp>“If you have a larger kid and a smaller kid [age 2-5], that immune system is going to be very, very responsive regardless of their weight,” says Dr. Chin-Hong.\u003c/p>\n\u003cfigure id=\"attachment_11894592\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11894592\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252.jpg\" alt=\"A woman helps a young girl put on a black cloth face mask with cat whiskers.\" width=\"1920\" height=\"1281\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">COVID vaccines for kids age 5-11are finally here. \u003ccite>(August de Richelieu/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Kids 5-11 will get two doses of the COVID vaccine\u003c/strong>\u003c/p>\n\u003cp>Like the adult version, the Pfizer COVID vaccine for kids age 5-11 is given in two doses, three weeks (or 21 days) apart. This means that when you make an appointment for a first dose of the Pfizer COVID vaccine for a child age 5-11, you’ll also make an appointment for another dose three weeks later. Make sure you know when and where your child will be getting that second dose.\u003c/p>\n\u003cp>\u003cstrong>It’s safe for kids to get other vaccinations at the same time\u003c/strong>\u003c/p>\n\u003cp>If you feel your child will be comfortable receiving more than one vaccination in a single sitting, \u003ca href=\"https://www.kqed.org/news/11887909/when-to-get-your-2021-flu-shot-and-how-it-works-with-covid-vaccines\">the CDC says it’s safe to receive the COVID vaccine and other vaccinations\u003c/a> — like a flu shot — at the same time.\u003c/p>\n\u003cp>\u003cstrong>Like in adults, mild side effects can happen …\u003c/strong>\u003cb>\u003c/b>\u003c/p>\n\u003cp>In the initial trials, says Dr. Chin-Hong, the lower dose of the Pfizer COVID vaccines for kids age 5-11 actually appears to have resulted in \u003cem>lower\u003c/em> instances of side effects. That said, parents and caregivers should still expect that their child might experience some of \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html\">the usual COVID vaccine side effects often experienced by adults\u003c/a> — redness and soreness in the arm, fatigue, fever, chills and headache — “though at a lower prevalence,” says Chin-Hong.\u003c/p>\n\u003cp>The 15-minute observation period after a child’s COVID vaccination, during which you and your child will be asked to stay at the vaccination site, is intended to catch any rare allergic responses.\u003c/p>\n\u003cp>At what point should a parent or caregiver call a child’s pediatrician about side effects back at home after the COVID vaccine? Chin-Hong says to look for symptoms that persist for more than a day and get worse, not better — especially if it’s a fever.\u003c/p>\n\u003cp>… \u003cstrong>and the severe side effects you may have heard about are highly rare.\u003c/strong>\u003c/p>\n\u003cp>The “really, really rare” side effect of the COVID vaccine in younger adults, says Chin-Hong, is \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html\">myocarditis and pericarditis\u003c/a>: “inflammation of the heart muscle and the lining of the heart that will be manifested in kids as potential chest pain or palpitations.” But he stresses that the rareness of the side effect means that it’s “not a source of worry.”\u003c/p>\n\u003cp>“With a lower dose, I’m not really sure it’s going to be happening,” says Chin-Hong. \u003ca href=\"https://www.nytimes.com/2021/11/01/health/covid-kids-children.html\">Read more from the New York Times about the rareness of heart problems after COVID vaccination.\u003c/a>\u003c/p>\n\u003cp>Have more questions about kids and the COVID vaccine?\u003ca href=\"https://www.kqed.org/news/11894983/covid-vaccines-kids-why-doctors-say-dont-wait-and-other-faqs\"> Read answers to FAQs direct from medical experts.\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11890217\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11890217 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/GettyImages-1234768450-scaled.jpg\" alt=\"A close-up of a hand gripping a vaccination card and writing on it with a pen.\" width=\"2560\" height=\"1704\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-1920x1278.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">A nurse marks a coronavirus vaccination card with a third, booster dose of Pfizer, at a vaccine clinic in Pasadena, California, on Aug. 19, 2021. \u003ccite>(Robyn Beck/AFP via Getty Images))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003ca id=\"where\">\u003c/a>Where can I find a Pfizer COVID vaccine for kids age 5-11?\u003c/h3>\n\u003cp>There are several ways to find your child a Pfizer COVID vaccine. Don’t assume you’ll be proactively contacted about your child’s COVID vaccine.\u003c/p>\n\u003cp>Different providers, clinics and counties are rolling out COVID vaccines for kids at different speeds — so if you’re finding the process of trying to get an appointment for your child confusing, or are frustrated by initial lack of availability, you’re not alone. Availability will hopefully improve as providers receive more pediatric doses.\u003c/p>\n\u003cp>Demand for kids’ COVID vaccines will be high, especially in the first few weeks. It may also take certain websites and clinics a little while to make appointments available in these first few days. If you don’t see appointments available at your chosen pharmacy, clinic or vaccination site, keep checking back.\u003c/p>\n\u003cp>Remember, your child will need two doses of the Pfizer COVID vaccine, three weeks apart. When making an appointment for their first dose, be sure that you and your child will be able to attend that second appointment. This is especially important as the November and December holidays get closer, and many families choose to travel during this period.\u003c/p>\n\u003cp>If you have the choice, \u003cem>where\u003c/em> should you get your child vaccinated against COVID? You know your kid best, so you might consider choosing an environment that you think will work best for them and their comfort level. That could be a large vaccine clinic where they can see grown-ups also getting their shots; a small exam room for more privacy; or in a vehicle in a drive-up appointment, where your child may not even have to unbuckle their seat belt.\u003c/p>\n\u003cp>What if your child is nervous about getting their COVID vaccine? \u003cb>\u003c/b>“Just like we talked to kids about why they should wear masks, I think having buy-in and a discussion before the vaccination could be helpful,” advises UCSF’s Dr. Chin-Hong. He notes that some children might be most at ease getting their shot from a trusted, regular provider like their usual pediatrician.\u003c/p>\n\u003cp>Chin-Hong also recommends considering “normalizing” a child’s booster shot by getting your own adult COVID booster shot at the same time, if you’re eligible — or even another vaccination like the flu shot.\u003c/p>\n\u003cp>\u003cb>\u003c/b>\u003cem>“\u003c/em>And of course, there’s always the lollipop and leftover Halloween candy and nice Band-Aids with Dora the Explorer,” he says.\u003c/p>\n\u003cp>\u003cstrong>1. Find a Pfizer COVID vaccine for kids 5-11 through your child’s pediatrician or health care provider.\u003c/strong>\u003c/p>\n\u003cp>If your family has health insurance, check with your child’s pediatrician or your health care provider to see whether they can offer your child the Pfizer COVID vaccine shot. If you don’t have health insurance but get medical care through a city- or county-run provider, you can check with that location.\u003c/p>\n\u003cp>As well as trying to talk with your health care provider directly, check the website of your provider (for example, Kaiser Permanente) to see whether they’re offering the ability to make appointments, and sign up for any available notifications.\u003c/p>\n\u003cp>\u003cstrong>2. Find a Pfizer COVID vaccine for kids 5-11 through a local pharmacy.\u003c/strong>\u003c/p>\n\u003cp>Several pharmacy chains are offering online appointments for the Pfizer COVID vaccine for kids age 5-11.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.cvs.com/immunizations/covid-19-vaccine?icid=cvs-home-hero1-banner-1-link2-coronavirus-vaccine\">CVS COVID-19 vaccine appointments \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.riteaid.com/pharmacy/covid-qualifier?utm_source=state&utm_medium=web&utm_campaign=Covid19&utm_content=Covid19scheduler_CA_2_12_21\">Rite Aid COVID-19 vaccine appointments\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.mhealthappointments.com/covidappt\">Safeway (Albertsons) COVID-19 vaccine appointments\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.walgreens.com/findcare/vaccination/covid-19?ban=covid_vaccine_landing_schedule\">Walgreens COVID-19 vaccine appointments\u003c/a>, or call (800) WALGREENS/(800) 925-4733\u003c/li>\n\u003cli>\u003ca href=\"https://costcorx.appointment-plus.com/appointments/book?section=typeOfVaccine&workflow=default\">Costco’s COVID-19 vaccine appointments\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Some pharmacies may later also offer walk-in vaccinations with no appointment according to availability.\u003c/p>\n\u003cfigure id=\"attachment_11893854\" class=\"wp-caption alignnone\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11893854\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/GettyImages-1232892937.jpg\" alt=\"A teen girl wearing glasses and a mask, sleeve rolled up, looks past a nurse with blue gloves who grips her shoulder with one hand and injects her with the other.\" width=\"1024\" height=\"683\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">The FDA and CDC have authorized the Pfizer COVID-19 vaccine for kids ages 5 to 11. Teens, like the 17-year-old pictured, are already eligible for the vaccine. \u003ccite>(Patrick T. Fallon/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>3. Find a Pfizer COVID vaccine for kids 5-11 through My Turn.\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://myturn.ca.gov/\">My Turn is the state’s tool\u003c/a> that allows Californians to schedule vaccination appointments, as supplies allow. Appointments for kids age 5-11 will be available on My Turn starting November 4.\u003c/p>\n\u003cp>\u003ca href=\"https://myturn.ca.gov/\">Visit the My Turn page\u003c/a> and select “Make an Appointment.” My Turn will ask for your child’s information, and then for a ZIP code or location you’d like to use to search for vaccine appointments. You can give your home location, or you can input other locations to see which sites are available farther from your home.\u003c/p>\n\u003cp>When you find and schedule an appointment for a vaccination site through My Turn, the California Department of Public Health says you don’t necessarily need to be a resident in that particular county where the vaccination site is based. So don’t worry if My Turn is suggesting appointments in a county other than the one where you live or work.\u003c/p>\n\u003cp>If you can’t travel to a clinic for your child’s COVID vaccine because of health or transportation issues, you can note this when registering on My Turn, and representatives from the California Department of Public Health will call you to arrange an in-home visit or transportation.\u003c/p>\n\u003cp>If you’re trying to find an appointment at a certain location and can’t see it in the search results, try searching on My Turn for that site’s \u003cem>exact\u003c/em> ZIP code, rather than your own. Remember that if you’re not seeing a specific site in the search results, it might just be because of low supply or lack of available appointments. You’ll also be shown a lot of pharmacy results: Keep scrolling through them to make sure you’re not missing clinic results hidden among them.\u003c/p>\n\u003cp>My Turn will ask you to provide a cellphone number and an email address. The state says this is so you can use two-factor authentication to doubly confirm your identity and make your appointment, and to prevent bots from automatically scooping up available appointments online.\u003c/p>\n\u003cp>If you don’t have an email address or a cellphone number, or you have questions, you can call the California COVID-19 hotline at (833) 422-4255 (Monday-Friday 8 a.m.-8 p.m., Saturday and Sunday 8 a.m.-5 p.m PT) and sign up over the phone. Both English-speaking and Spanish-speaking operators are available. Callers needing information in other languages will be connected to a translation service that offers assistance in over 250 languages.\u003c/p>\n\u003cp>\u003cstrong>4. Find a Pfizer COVID vaccine for kids 5-11 through your county’s public health website.\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered#county\">Visit your county’s public health website \u003c/a>to learn how your county is vaccinating its residents, and if they’ve begun to offer COVID vaccines to kids age 5-11 yet . The availability of vaccination appointments will be based on the doses that the state has supplied to your county. Your county may also be offering in-school vaccinations for kids.\u003c/p>\n\u003cp>You can sign up to receive notifications via email from your county to know when there is greater appointment availability. \u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered#county\">Find your Bay Area county in our list:\u003c/a>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid-19.acgov.org/vaccines\">Alameda County COVID-19 Vaccines\u003c/a> (you can also call the Alameda County Community Vaccination POD hotline: 510-208-4VAX [4829])\u003c/li>\n\u003cli>\u003ca href=\"https://www.cityofberkeley.info/covid19-vaccine/\">City of Berkeley COVID-19 Vaccines \u003c/a>(please note: the city of Berkeley has its own public health department, but also \u003ca href=\"https://www.cityofberkeley.info/covid19-vaccine/#signup\">recommends residents\u003c/a> sign up for Alameda County’s notifications.)\u003c/li>\n\u003cli>\u003ca href=\"https://covidvaccine.cchealth.org/COVIDVaccine/\">Contra Costa County COVID-19 Vaccines \u003c/a>(or call Contra Costa Health Services: 1-833-829-2626)\u003c/li>\n\u003cli>\u003ca href=\"https://coronavirus.marinhhs.org/vaccine/pediatrics\">Marin County’s Pediatric COVID-19 Vaccines \u003c/a>(Marin residents without internet access can call 833-641-1988, and Marin says that people eligible to get help from this call center are ages 65 or older, living with disabilities and ages 18 or older, in need of home care or personal assistance, need language interpretation including ASL, have limited or no internet access or need help arranging transportation.)\u003c/li>\n\u003cli>\u003ca href=\"https://www.countyofnapa.org/3096/COVID-19-Vaccines\">Napa County COVID-19 Vaccines\u003c/a> (or call the Napa County Public Information Call Center: 707-253-4540.)\u003c/li>\n\u003cli>\u003ca href=\"https://sf.gov/covid-19-vaccine-san-francisco\">City and County of San Francisco COVID-19 Vaccines\u003c/a> (or call the San Francisco call center designed to help people who are 65 and older and those with disabilities who are unable to easily access the internet or schedule an appointment through their provider: 628-652-2700.)\u003c/li>\n\u003cli>\u003ca href=\"https://www.smchealth.org/covid-19-vaccination-program-overview\">San Mateo County COVID-19 Vaccines\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://covid19.sccgov.org/covid-19-vaccine-information\">Santa Clara County COVID-19 Vaccines\u003c/a> (contains links to \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/COVID19-vaccine-information-for-public.aspx#myturn\">vaccine sign-up pages \u003c/a>and phone numbers for various local medical providers.)\u003c/li>\n\u003cli>\u003ca href=\"https://solanocounty.com/depts/ph/coronavirus_links/covid_19_vaccines.asp\">Solano County COVID-19 Vaccines\u003c/a> (contains \u003ca href=\"https://solanocounty.com/depts/ph/coronavirus_links/covid_19_vaccines.asp\">a provider-by-provider list of phone numbers\u003c/a> to call about COVID-19 vaccines.)\u003c/li>\n\u003cli>\u003ca href=\"https://socoemergency.org/emergency/novel-coronavirus/vaccine-information/\">Sonoma County COVID-19 Vaccines\u003c/a> (contains \u003ca href=\"https://socoemergency.org/emergency/novel-coronavirus/vaccine-information/clinics/\">a provider-by-provider list of phone numbers\u003c/a> to call about COVID-19 vaccines.)\u003c/li>\n\u003c/ul>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>\u003ca id=\"ask\">\u003c/a>Tell us: What else do you need to know about COVID vaccines for kids?\u003c/h3>\n\u003cp>[hearken id=\"8833\" src=\"https://modules.wearehearken.com/kqed/embed/8833.js\"]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "From Walgreens and CVS to your own county, Pfizer COVID vaccines for kids age 5-11 are now being offered in California. Here's how to find a pediatric COVID vaccine for children under 12 near you.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/11894855/cdc-recommends-pfizers-covid-vaccine-for-children-ages-5-to-11\">Pfizer COVID vaccines are now available for children\u003c/a> age 5-11 in California.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered\">Looking for COVID vaccines for adults or young people age 12 or over instead? \u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Following \u003ca href=\"https://www.kqed.org/news/11894855/cdc-recommends-pfizers-covid-vaccine-for-children-ages-5-to-11\">a thorough in-depth review process from the Food and Drug Administration and the Centers for Disease Control and Prevention\u003c/a>, these pediatric shots are being rolled out around the state. Read on for what parents and caregivers need to know about finding a COVID vaccine for kids age 5-11.\u003c/p>\n\u003cp>\u003cstrong>Skip to:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#where\">Where can I find a COVID vaccine for a kid age 5-11 near me?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#ask\">Don’t see your question answered here? Tell us what you need to know.\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Whether it’s a child’s shot, an adult’s shot or a booster shot, a COVID vaccine will always be free. You or your child do not need health insurance to be vaccinated.\u003c/p>\n\u003cp>You or your child also will not be asked for proof of citizenship or about your immigration status. Getting a COVID vaccine \u003ca href=\"https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources\">does not make you or your child a public charge\u003c/a> and won’t affect any current or future green card applications.\u003c/p>\n\u003ch3>What to know about Pfizer COVID vaccines for kids age 5-11\u003c/h3>\n\u003cp>\u003cstrong>Kids in this age group can only get Pfizer … for now.\u003c/strong>\u003c/p>\n\u003cp>Currently, \u003ca href=\"https://www.kqed.org/news/11894855/cdc-recommends-pfizers-covid-vaccine-for-children-ages-5-to-11\">only the Pfizer COVID vaccine has been authorized\u003c/a> by the FDA and the CDC for use in children age 5-11.\u003c/p>\n\u003cp>You may see the Pfizer-BioNTech COVID-19 vaccine also referred to as Comirnaty. This is the brand name of this particular vaccine.\u003c/p>\n\u003cp>\u003cstrong>The COVID vaccine dose for kids age 5-11 is lower\u003c/strong>\u003c/p>\n\u003cp>Children in this age group will be offered a lower dose of the Pfizer COVID vaccine than the dose offered to adults and young people over 12. This lower dose — which you might hear being called the pediatric dose — is one-third of the adult dose.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you’re wondering why the lower dose of Pfizer’s COVID vaccine is given according to a child’s age, and not their body mass — as with some other pediatric medicines — it’s actually all about the age of a kid’s \u003cem>immune system\u003c/em>, says Dr. Peter Chin-Hong, an infectious disease specialist at UCSF. And generally, over the age of six months, a young immune system is “more agile,” he says.\u003c/p>\n\u003cp>“If you have a larger kid and a smaller kid [age 2-5], that immune system is going to be very, very responsive regardless of their weight,” says Dr. Chin-Hong.\u003c/p>\n\u003cfigure id=\"attachment_11894592\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11894592\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252.jpg\" alt=\"A woman helps a young girl put on a black cloth face mask with cat whiskers.\" width=\"1920\" height=\"1281\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/11/pexels-august-de-richelieu-4261252-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">COVID vaccines for kids age 5-11are finally here. \u003ccite>(August de Richelieu/Pexels)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Kids 5-11 will get two doses of the COVID vaccine\u003c/strong>\u003c/p>\n\u003cp>Like the adult version, the Pfizer COVID vaccine for kids age 5-11 is given in two doses, three weeks (or 21 days) apart. This means that when you make an appointment for a first dose of the Pfizer COVID vaccine for a child age 5-11, you’ll also make an appointment for another dose three weeks later. Make sure you know when and where your child will be getting that second dose.\u003c/p>\n\u003cp>\u003cstrong>It’s safe for kids to get other vaccinations at the same time\u003c/strong>\u003c/p>\n\u003cp>If you feel your child will be comfortable receiving more than one vaccination in a single sitting, \u003ca href=\"https://www.kqed.org/news/11887909/when-to-get-your-2021-flu-shot-and-how-it-works-with-covid-vaccines\">the CDC says it’s safe to receive the COVID vaccine and other vaccinations\u003c/a> — like a flu shot — at the same time.\u003c/p>\n\u003cp>\u003cstrong>Like in adults, mild side effects can happen …\u003c/strong>\u003cb>\u003c/b>\u003c/p>\n\u003cp>In the initial trials, says Dr. Chin-Hong, the lower dose of the Pfizer COVID vaccines for kids age 5-11 actually appears to have resulted in \u003cem>lower\u003c/em> instances of side effects. That said, parents and caregivers should still expect that their child might experience some of \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html\">the usual COVID vaccine side effects often experienced by adults\u003c/a> — redness and soreness in the arm, fatigue, fever, chills and headache — “though at a lower prevalence,” says Chin-Hong.\u003c/p>\n\u003cp>The 15-minute observation period after a child’s COVID vaccination, during which you and your child will be asked to stay at the vaccination site, is intended to catch any rare allergic responses.\u003c/p>\n\u003cp>At what point should a parent or caregiver call a child’s pediatrician about side effects back at home after the COVID vaccine? Chin-Hong says to look for symptoms that persist for more than a day and get worse, not better — especially if it’s a fever.\u003c/p>\n\u003cp>… \u003cstrong>and the severe side effects you may have heard about are highly rare.\u003c/strong>\u003c/p>\n\u003cp>The “really, really rare” side effect of the COVID vaccine in younger adults, says Chin-Hong, is \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html\">myocarditis and pericarditis\u003c/a>: “inflammation of the heart muscle and the lining of the heart that will be manifested in kids as potential chest pain or palpitations.” But he stresses that the rareness of the side effect means that it’s “not a source of worry.”\u003c/p>\n\u003cp>“With a lower dose, I’m not really sure it’s going to be happening,” says Chin-Hong. \u003ca href=\"https://www.nytimes.com/2021/11/01/health/covid-kids-children.html\">Read more from the New York Times about the rareness of heart problems after COVID vaccination.\u003c/a>\u003c/p>\n\u003cp>Have more questions about kids and the COVID vaccine?\u003ca href=\"https://www.kqed.org/news/11894983/covid-vaccines-kids-why-doctors-say-dont-wait-and-other-faqs\"> Read answers to FAQs direct from medical experts.\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_11890217\" class=\"wp-caption alignnone\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11890217 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/GettyImages-1234768450-scaled.jpg\" alt=\"A close-up of a hand gripping a vaccination card and writing on it with a pen.\" width=\"2560\" height=\"1704\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/GettyImages-1234768450-1920x1278.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">A nurse marks a coronavirus vaccination card with a third, booster dose of Pfizer, at a vaccine clinic in Pasadena, California, on Aug. 19, 2021. \u003ccite>(Robyn Beck/AFP via Getty Images))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003ca id=\"where\">\u003c/a>Where can I find a Pfizer COVID vaccine for kids age 5-11?\u003c/h3>\n\u003cp>There are several ways to find your child a Pfizer COVID vaccine. Don’t assume you’ll be proactively contacted about your child’s COVID vaccine.\u003c/p>\n\u003cp>Different providers, clinics and counties are rolling out COVID vaccines for kids at different speeds — so if you’re finding the process of trying to get an appointment for your child confusing, or are frustrated by initial lack of availability, you’re not alone. Availability will hopefully improve as providers receive more pediatric doses.\u003c/p>\n\u003cp>Demand for kids’ COVID vaccines will be high, especially in the first few weeks. It may also take certain websites and clinics a little while to make appointments available in these first few days. If you don’t see appointments available at your chosen pharmacy, clinic or vaccination site, keep checking back.\u003c/p>\n\u003cp>Remember, your child will need two doses of the Pfizer COVID vaccine, three weeks apart. When making an appointment for their first dose, be sure that you and your child will be able to attend that second appointment. This is especially important as the November and December holidays get closer, and many families choose to travel during this period.\u003c/p>\n\u003cp>If you have the choice, \u003cem>where\u003c/em> should you get your child vaccinated against COVID? You know your kid best, so you might consider choosing an environment that you think will work best for them and their comfort level. That could be a large vaccine clinic where they can see grown-ups also getting their shots; a small exam room for more privacy; or in a vehicle in a drive-up appointment, where your child may not even have to unbuckle their seat belt.\u003c/p>\n\u003cp>What if your child is nervous about getting their COVID vaccine? \u003cb>\u003c/b>“Just like we talked to kids about why they should wear masks, I think having buy-in and a discussion before the vaccination could be helpful,” advises UCSF’s Dr. Chin-Hong. He notes that some children might be most at ease getting their shot from a trusted, regular provider like their usual pediatrician.\u003c/p>\n\u003cp>Chin-Hong also recommends considering “normalizing” a child’s booster shot by getting your own adult COVID booster shot at the same time, if you’re eligible — or even another vaccination like the flu shot.\u003c/p>\n\u003cp>\u003cb>\u003c/b>\u003cem>“\u003c/em>And of course, there’s always the lollipop and leftover Halloween candy and nice Band-Aids with Dora the Explorer,” he says.\u003c/p>\n\u003cp>\u003cstrong>1. Find a Pfizer COVID vaccine for kids 5-11 through your child’s pediatrician or health care provider.\u003c/strong>\u003c/p>\n\u003cp>If your family has health insurance, check with your child’s pediatrician or your health care provider to see whether they can offer your child the Pfizer COVID vaccine shot. If you don’t have health insurance but get medical care through a city- or county-run provider, you can check with that location.\u003c/p>\n\u003cp>As well as trying to talk with your health care provider directly, check the website of your provider (for example, Kaiser Permanente) to see whether they’re offering the ability to make appointments, and sign up for any available notifications.\u003c/p>\n\u003cp>\u003cstrong>2. Find a Pfizer COVID vaccine for kids 5-11 through a local pharmacy.\u003c/strong>\u003c/p>\n\u003cp>Several pharmacy chains are offering online appointments for the Pfizer COVID vaccine for kids age 5-11.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://www.cvs.com/immunizations/covid-19-vaccine?icid=cvs-home-hero1-banner-1-link2-coronavirus-vaccine\">CVS COVID-19 vaccine appointments \u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.riteaid.com/pharmacy/covid-qualifier?utm_source=state&utm_medium=web&utm_campaign=Covid19&utm_content=Covid19scheduler_CA_2_12_21\">Rite Aid COVID-19 vaccine appointments\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.mhealthappointments.com/covidappt\">Safeway (Albertsons) COVID-19 vaccine appointments\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.walgreens.com/findcare/vaccination/covid-19?ban=covid_vaccine_landing_schedule\">Walgreens COVID-19 vaccine appointments\u003c/a>, or call (800) WALGREENS/(800) 925-4733\u003c/li>\n\u003cli>\u003ca href=\"https://costcorx.appointment-plus.com/appointments/book?section=typeOfVaccine&workflow=default\">Costco’s COVID-19 vaccine appointments\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Some pharmacies may later also offer walk-in vaccinations with no appointment according to availability.\u003c/p>\n\u003cfigure id=\"attachment_11893854\" class=\"wp-caption alignnone\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11893854\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/GettyImages-1232892937.jpg\" alt=\"A teen girl wearing glasses and a mask, sleeve rolled up, looks past a nurse with blue gloves who grips her shoulder with one hand and injects her with the other.\" width=\"1024\" height=\"683\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/GettyImages-1232892937-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">The FDA and CDC have authorized the Pfizer COVID-19 vaccine for kids ages 5 to 11. Teens, like the 17-year-old pictured, are already eligible for the vaccine. \u003ccite>(Patrick T. Fallon/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>3. Find a Pfizer COVID vaccine for kids 5-11 through My Turn.\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://myturn.ca.gov/\">My Turn is the state’s tool\u003c/a> that allows Californians to schedule vaccination appointments, as supplies allow. Appointments for kids age 5-11 will be available on My Turn starting November 4.\u003c/p>\n\u003cp>\u003ca href=\"https://myturn.ca.gov/\">Visit the My Turn page\u003c/a> and select “Make an Appointment.” My Turn will ask for your child’s information, and then for a ZIP code or location you’d like to use to search for vaccine appointments. You can give your home location, or you can input other locations to see which sites are available farther from your home.\u003c/p>\n\u003cp>When you find and schedule an appointment for a vaccination site through My Turn, the California Department of Public Health says you don’t necessarily need to be a resident in that particular county where the vaccination site is based. So don’t worry if My Turn is suggesting appointments in a county other than the one where you live or work.\u003c/p>\n\u003cp>If you can’t travel to a clinic for your child’s COVID vaccine because of health or transportation issues, you can note this when registering on My Turn, and representatives from the California Department of Public Health will call you to arrange an in-home visit or transportation.\u003c/p>\n\u003cp>If you’re trying to find an appointment at a certain location and can’t see it in the search results, try searching on My Turn for that site’s \u003cem>exact\u003c/em> ZIP code, rather than your own. Remember that if you’re not seeing a specific site in the search results, it might just be because of low supply or lack of available appointments. You’ll also be shown a lot of pharmacy results: Keep scrolling through them to make sure you’re not missing clinic results hidden among them.\u003c/p>\n\u003cp>My Turn will ask you to provide a cellphone number and an email address. The state says this is so you can use two-factor authentication to doubly confirm your identity and make your appointment, and to prevent bots from automatically scooping up available appointments online.\u003c/p>\n\u003cp>If you don’t have an email address or a cellphone number, or you have questions, you can call the California COVID-19 hotline at (833) 422-4255 (Monday-Friday 8 a.m.-8 p.m., Saturday and Sunday 8 a.m.-5 p.m PT) and sign up over the phone. Both English-speaking and Spanish-speaking operators are available. Callers needing information in other languages will be connected to a translation service that offers assistance in over 250 languages.\u003c/p>\n\u003cp>\u003cstrong>4. Find a Pfizer COVID vaccine for kids 5-11 through your county’s public health website.\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered#county\">Visit your county’s public health website \u003c/a>to learn how your county is vaccinating its residents, and if they’ve begun to offer COVID vaccines to kids age 5-11 yet . The availability of vaccination appointments will be based on the doses that the state has supplied to your county. Your county may also be offering in-school vaccinations for kids.\u003c/p>\n\u003cp>You can sign up to receive notifications via email from your county to know when there is greater appointment availability. \u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered#county\">Find your Bay Area county in our list:\u003c/a>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://covid-19.acgov.org/vaccines\">Alameda County COVID-19 Vaccines\u003c/a> (you can also call the Alameda County Community Vaccination POD hotline: 510-208-4VAX [4829])\u003c/li>\n\u003cli>\u003ca href=\"https://www.cityofberkeley.info/covid19-vaccine/\">City of Berkeley COVID-19 Vaccines \u003c/a>(please note: the city of Berkeley has its own public health department, but also \u003ca href=\"https://www.cityofberkeley.info/covid19-vaccine/#signup\">recommends residents\u003c/a> sign up for Alameda County’s notifications.)\u003c/li>\n\u003cli>\u003ca href=\"https://covidvaccine.cchealth.org/COVIDVaccine/\">Contra Costa County COVID-19 Vaccines \u003c/a>(or call Contra Costa Health Services: 1-833-829-2626)\u003c/li>\n\u003cli>\u003ca href=\"https://coronavirus.marinhhs.org/vaccine/pediatrics\">Marin County’s Pediatric COVID-19 Vaccines \u003c/a>(Marin residents without internet access can call 833-641-1988, and Marin says that people eligible to get help from this call center are ages 65 or older, living with disabilities and ages 18 or older, in need of home care or personal assistance, need language interpretation including ASL, have limited or no internet access or need help arranging transportation.)\u003c/li>\n\u003cli>\u003ca href=\"https://www.countyofnapa.org/3096/COVID-19-Vaccines\">Napa County COVID-19 Vaccines\u003c/a> (or call the Napa County Public Information Call Center: 707-253-4540.)\u003c/li>\n\u003cli>\u003ca href=\"https://sf.gov/covid-19-vaccine-san-francisco\">City and County of San Francisco COVID-19 Vaccines\u003c/a> (or call the San Francisco call center designed to help people who are 65 and older and those with disabilities who are unable to easily access the internet or schedule an appointment through their provider: 628-652-2700.)\u003c/li>\n\u003cli>\u003ca href=\"https://www.smchealth.org/covid-19-vaccination-program-overview\">San Mateo County COVID-19 Vaccines\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://covid19.sccgov.org/covid-19-vaccine-information\">Santa Clara County COVID-19 Vaccines\u003c/a> (contains links to \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/COVID19-vaccine-information-for-public.aspx#myturn\">vaccine sign-up pages \u003c/a>and phone numbers for various local medical providers.)\u003c/li>\n\u003cli>\u003ca href=\"https://solanocounty.com/depts/ph/coronavirus_links/covid_19_vaccines.asp\">Solano County COVID-19 Vaccines\u003c/a> (contains \u003ca href=\"https://solanocounty.com/depts/ph/coronavirus_links/covid_19_vaccines.asp\">a provider-by-provider list of phone numbers\u003c/a> to call about COVID-19 vaccines.)\u003c/li>\n\u003cli>\u003ca href=\"https://socoemergency.org/emergency/novel-coronavirus/vaccine-information/\">Sonoma County COVID-19 Vaccines\u003c/a> (contains \u003ca href=\"https://socoemergency.org/emergency/novel-coronavirus/vaccine-information/clinics/\">a provider-by-provider list of phone numbers\u003c/a> to call about COVID-19 vaccines.)\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003ca id=\"ask\">\u003c/a>Tell us: What else do you need to know about COVID vaccines for kids?\u003c/h3>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Most SF City Employees Met Monday's COVID Vaccine Deadline, But Over 900 Holdouts Risk Losing Their Jobs",
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"content": "\u003cp>Today was the big day.\u003c/p>\n\u003cp>As of Monday, more than 97% of San Francisco’s roughly 35,000 public employees had met the city’s Nov. 1 deadline to get fully vaccinated against the coronavirus, according to the city’s Department of Human Resources.\u003c/p>\n\u003cp>But that also means nearly 950 city employees — many of whom are essential front-line workers — have yet to comply with the mandate. Of those, close to 200 temporary employees are now likely out of a job, and some 750 civil service employees have been placed on paid administrative leave and await due process hearings — likely held within the month — to determine whether they qualify for religious or medical exemptions.\u003c/p>\n\u003cp>Those who don’t qualify could eventually lose their jobs, said Mawuli Tugbenyoh, chief of policy for the city’s Department of Human Resources.\u003c/p>\n\u003cp>“It’s never been the city’s goal at any point in this process to separate anyone from city service,” he said, noting that the city will continue to encourage its permanent employees to get vaccinated, and that there will be no penalty for missing the deadline if they do it soon. “The goal is to make sure we are protecting workplaces and employees, as well as the communities we serve in San Francisco.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Those workers forced to go on leave include almost 100 transit operators, as well as roughly 60 police officers, 20 sheriff’s deputies and 15 fire department staff, according to the mayor’s office.\u003c/p>\n\u003cp>“Muni certainly at this point has the highest number of unvaccinated employees,” Tugbenyoh said.\u003c/p>\n\u003cp>Due to that sudden drop in available MUNI operators, the \u003ca href=\"https://www.sfmta.com/blog/vaccine-related-service-changes-go-effect-november-1\">SFMTA on Monday began temporarily suspending “short” service on four Muni lines \u003c/a>— the buses that run on segments of longer routes. They include: 1 California Short, 14R Mission Rapid Short (weekdays only), 30 Stockton Short, and 49 Van Ness Short (weekends only).\u003c/p>\n\u003cp>Roger Marenco, president of the Transport Workers Union Local 250A, said the union has been doing everything it can to educate its members with facts, not opinions, about the vaccine, and is optimistic the number of unvaccinated transit operators will be sliced in half by the end of the month.\u003c/p>\n\u003cp>“There are some members who have yet to have their exemptions heard,” said Marenco. “Once that the process is over, we will have a much clearer number on who is left.”[aside postID=news_11890407,news_11893011,news_11892080 label='Related Posts']The deadline comes four months after \u003ca href=\"https://www.nytimes.com/2021/06/24/world/san-francisco-vaccine-mandate.html\">San Francisco became one of the first major cities in the country to announce a vaccine mandate for all city workers\u003c/a>.\u003c/p>\n\u003cp>Since then, the employee vaccination rate has jumped by 30%, Mayor London Breed said in a statement on Friday.\u003c/p>\n\u003cp>“This mandate is all about protecting the health of the public and of our workforce, and it is working,” Breed said.\u003c/p>\n\u003cp>Fully vaccinated city-employed office workers are now required to return to the office for at least two days a week. Breed said she hopes their return, along with the city’s high vaccination rate and relaxed mask mandate, will encourage the private sector to bring their employees back as well.\u003c/p>\n\u003cp>“We will continue to work with our labor partners to get the last remaining people vaccinated, but we are confident a fully vaccinated workforce is in the best interest of the public, our workers, and the recovery of our City,” Breed said.\u003c/p>\n\u003cp>In light of the deadline, the \u003ca href=\"https://www.blackemployeesalliance.com/\">Black Employees Alliance and Coalition Against Anti-Blackness\u003c/a> on Monday admonished the city’s leadership for denying accommodations to more than 20 of its members who it said should have qualified for medical or religious exemptions.\u003c/p>\n\u003cp>“While we support Mayor Breed’s leadership, we believe her touting of the City’s 97% vaccination rate as a success (while many in her workforce are losing their livelihoods due to the City’s hardlined position requiring vaccinations) – is soulless, callous, and unscrupulous,” the group said in a statement.\u003c/p>\n\u003cp>It said the vaccine mandate has had a “disproportionate impact on the City and County’s Black employees” and called the city’s handling of the situation “egregious, irresponsible, and tragic.”\u003c/p>\n\u003cp>“If they are approving [remote] work for certain people and terminating positions for others, we want to know why,” said Dante King, one of the group’s co-founders. He said his group intends to submit a public records request to see who has been granted or denied exemptions and if there are obvious racial disparities.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s an ethics issue. When you look at Contra Costa County approving [almost all] exemptions requests and San Francisco has approved none for our members,” King added. “The leadership is being immoral.”\u003c/p>\n\n",
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"excerpt": "More than 97% of San Francisco's nearly 35,000 public employees met Monday's deadline. Most city workers who have still not gotten their shots have been placed on paid administrative leave, awaiting hearings to determine their job status.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Today was the big day.\u003c/p>\n\u003cp>As of Monday, more than 97% of San Francisco’s roughly 35,000 public employees had met the city’s Nov. 1 deadline to get fully vaccinated against the coronavirus, according to the city’s Department of Human Resources.\u003c/p>\n\u003cp>But that also means nearly 950 city employees — many of whom are essential front-line workers — have yet to comply with the mandate. Of those, close to 200 temporary employees are now likely out of a job, and some 750 civil service employees have been placed on paid administrative leave and await due process hearings — likely held within the month — to determine whether they qualify for religious or medical exemptions.\u003c/p>\n\u003cp>Those who don’t qualify could eventually lose their jobs, said Mawuli Tugbenyoh, chief of policy for the city’s Department of Human Resources.\u003c/p>\n\u003cp>“It’s never been the city’s goal at any point in this process to separate anyone from city service,” he said, noting that the city will continue to encourage its permanent employees to get vaccinated, and that there will be no penalty for missing the deadline if they do it soon. “The goal is to make sure we are protecting workplaces and employees, as well as the communities we serve in San Francisco.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Those workers forced to go on leave include almost 100 transit operators, as well as roughly 60 police officers, 20 sheriff’s deputies and 15 fire department staff, according to the mayor’s office.\u003c/p>\n\u003cp>“Muni certainly at this point has the highest number of unvaccinated employees,” Tugbenyoh said.\u003c/p>\n\u003cp>Due to that sudden drop in available MUNI operators, the \u003ca href=\"https://www.sfmta.com/blog/vaccine-related-service-changes-go-effect-november-1\">SFMTA on Monday began temporarily suspending “short” service on four Muni lines \u003c/a>— the buses that run on segments of longer routes. They include: 1 California Short, 14R Mission Rapid Short (weekdays only), 30 Stockton Short, and 49 Van Ness Short (weekends only).\u003c/p>\n\u003cp>Roger Marenco, president of the Transport Workers Union Local 250A, said the union has been doing everything it can to educate its members with facts, not opinions, about the vaccine, and is optimistic the number of unvaccinated transit operators will be sliced in half by the end of the month.\u003c/p>\n\u003cp>“There are some members who have yet to have their exemptions heard,” said Marenco. “Once that the process is over, we will have a much clearer number on who is left.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The deadline comes four months after \u003ca href=\"https://www.nytimes.com/2021/06/24/world/san-francisco-vaccine-mandate.html\">San Francisco became one of the first major cities in the country to announce a vaccine mandate for all city workers\u003c/a>.\u003c/p>\n\u003cp>Since then, the employee vaccination rate has jumped by 30%, Mayor London Breed said in a statement on Friday.\u003c/p>\n\u003cp>“This mandate is all about protecting the health of the public and of our workforce, and it is working,” Breed said.\u003c/p>\n\u003cp>Fully vaccinated city-employed office workers are now required to return to the office for at least two days a week. Breed said she hopes their return, along with the city’s high vaccination rate and relaxed mask mandate, will encourage the private sector to bring their employees back as well.\u003c/p>\n\u003cp>“We will continue to work with our labor partners to get the last remaining people vaccinated, but we are confident a fully vaccinated workforce is in the best interest of the public, our workers, and the recovery of our City,” Breed said.\u003c/p>\n\u003cp>In light of the deadline, the \u003ca href=\"https://www.blackemployeesalliance.com/\">Black Employees Alliance and Coalition Against Anti-Blackness\u003c/a> on Monday admonished the city’s leadership for denying accommodations to more than 20 of its members who it said should have qualified for medical or religious exemptions.\u003c/p>\n\u003cp>“While we support Mayor Breed’s leadership, we believe her touting of the City’s 97% vaccination rate as a success (while many in her workforce are losing their livelihoods due to the City’s hardlined position requiring vaccinations) – is soulless, callous, and unscrupulous,” the group said in a statement.\u003c/p>\n\u003cp>It said the vaccine mandate has had a “disproportionate impact on the City and County’s Black employees” and called the city’s handling of the situation “egregious, irresponsible, and tragic.”\u003c/p>\n\u003cp>“If they are approving [remote] work for certain people and terminating positions for others, we want to know why,” said Dante King, one of the group’s co-founders. He said his group intends to submit a public records request to see who has been granted or denied exemptions and if there are obvious racial disparities.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s an ethics issue. When you look at Contra Costa County approving [almost all] exemptions requests and San Francisco has approved none for our members,” King added. “The leadership is being immoral.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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"info": "",
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"tech-nation": {
"id": "tech-nation",
"title": "Tech Nation Radio Podcast",
"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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"ted-radio-hour": {
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"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
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