TASK DEFINITION: Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
PROBLEM: A bill that would allow trained pharmacists to administer the influenza vaccine to children 12 years and older cleared the General Assembly’s Public Health Committee in a 17-7 vote this year, but it later died on the Senate calendar due to inaction. Bill supporter, Nathan Tinker, CEO of the Connecticut Pharmacists Association, said his organization doesn’t plan to push hard for it again in the next regular legislative session because he is worried the debate over the General Assembly’s efforts to scrap a religious exemption for some vaccines will ultimately spill over into discussions about the flu shot and likely doom the bill in the short, three-month session. “There is a community of people who are concerned about the impact or potential impact, whether real or perceived, about vaccines,” Tinker said. “And they get a lot of attention from legislators and that can make it difficult.” When the new legislative session opens in February, lawmakers are expected to consider ending the state’s longstanding religious exemption after newly released data showed a continued decline in immunization rates for measles, mumps and rubella among kindergarteners. That proposal has already met resistance and some of the concerns raised are like the ones voiced during this year’s discussion of the flu vaccine bill. Legislators were flooded with testimony earlier this year from parents with concerns about whether making the vaccine more convenient could lead to injuries that pharmacists might not be trained recognize. Others questioned the motives of the pharmaceutical industry and necessity of flu shots. Dr. Sandra Carbonari, a primary care pediatrician in Waterbury and the medical director of the Connecticut Chapter of the American Academy of Pediatrics, also opposed the bill, but for different reasons. She questioned whether state regulations for providing the flu vaccine to children who receive Medicaid benefits might ultimately make the shot too expensive, and whether DPH’s vaccine program can handle a large increase in the number of providers. She also noted that immunizing a child can be complicated. “Determining the appropriate vaccine for a pediatric age patient is not simple and requires accurate information about the medical history and current state of health,” she said in written testimony. Supporters of the flu shot bill argue that allowing parents to drop by a pharmacy, rather than make an appointment with a pediatrician, would ultimately lead to higher flu immunization rates. The bill had the support of the state’s Department of Public Health, which noted three children in Connecticut died from flu-related complications during the 2017-18 flu season. Pharmacists in Connecticut are currently allowed to vaccinate people 18 years or older. According to DPH, individuals under 18 can be administered the flu vaccine by advanced practice registered nurses at retail locations, such as a CVS MinuteClinic. Sen. Heather Somers, of Groton, the top Senate Republican on the Public Health Committee who co-sponsored this year’s bill, stressed that the legislation is voluntary and requires the consent of a parent or guardian. Somers contends the legislature just ran out of time to act on the bill earlier this year, and she plans to resurrect it when lawmakers convene again in February for the 2020 session. “This is something that saves lives,” said Somers, who helped to organize a mobile flu clinic in her district last year. “I think accessibility is key in our health care system.”

SOLUTION: Bill allowing pharmacists to give kids the flu shot at risk.

PROBLEM: Scientists dubbed the startling findings “immune amnesia.” The body can rebuild those defenses — but it could take years. And with measles on the rise, “it should be a scary phenomenon,” said Dr. Michael Mina of Harvard’s school of public health, lead author of research published Thursday in the journal Science. “This goes under the radar” because doctors wouldn’t necessarily connect a child’s pneumonia to measles they suffered a year earlier, Mina explained. “But would they have gotten it if they hadn’t gotten measles?” The Harvard team analyzed blood samples taken from 77 children before and after a measles outbreak in an unvaccinated community in the Netherlands. They looked for antibodies, which remember viruses and bacteria they encounter to guard against a repeat infection. After recovering from measles, the youngsters were left with plenty of antibodies against that virus — but ones they’d previously harbored against other germs had plummeted. In the most severe cases, “they’re just as vulnerable as if they were infants,” said study senior author Stephen Elledge, a Harvard geneticist. Elledge is paid by the Howard Hughes Medical Institute, which also supports AP’s Health & Science Department. A separate study, published Thursday in Science Immunology, supported the findings. Researchers from Britain’s Wellcome Sanger Institute used the Dutch blood samples to genetically test antibody-producing cells, and concluded measles is eliminating enough to re-set the immune system to a baby-like state. If protection against the misery — and sometimes life-threatening effects — of measles isn’t enough reason to vaccinate children, specialists said the two studies offer a powerful new rationale. “There really are profound gaps and holes” in someone’s immunity after measles, said Dr. Anthony Fauci of the U.S. National Institutes of Health, which helped fund the Harvard work. “You ultimately recover but after a year or two or sometimes more.” “It’s doubly important to vaccinate children,” agreed Dr. Mark Mulligan of NYU Langone Health, who wasn’t involved with the new research. “It’s a vaccine that protects against the specific target, measles virus, but also against immune suppression.” Measles is one of the world’s most contagious viruses, able to spread through coughs and sneezes for four days before someone develops the characteristic rash. It sometimes leaves children with brain damage or hearing loss, and while deaths are rare in the U.S., measles killed 110,000 people globally in 2017. The vaccine offers powerful protection but a lack of access means measles remains rampant in many lower-income countries. Even the U.S., where most children are immunized, has seen a resurgence fueled by outbreaks in unvaccinated communities that in turn threaten people too young or sick to be immunized. So far this year, the Centers for Disease Control and Prevention has counted more than 1,200 U.S. measles cases, the most since 1992. Doctors have long known that people temporarily experience weakened immunity after measles. Using decades of health records, Mina previously reported that child deaths from other infections jumped after a measles outbreak, increases that lasted two or three years. But no one knew why, until the new study. The Dutch children started out pretty healthy: Technology developed in Elledge’s lab found antibodies in their blood against typical childhood germs. But two months after recovering from measles, the children had lost on average 20 percent of their usual antibody mix. Some lost up to 70 percent of protection against specific bugs, limiting their ability to respond if they encounter that germ again. Importantly, researchers didn’t find loss of antibodies in “control” populations that didn’t get infected with measles — or in children after they received the measles vaccine. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

SOLUTION: Measles saps kids’ ability to fight other germs.

PROBLEM: A few weeks later, all three children were dead, victims of the worst measles outbreak on the Indian Ocean island in decades. Measles cases are on the rise globally, including in wealthy nations such as the United States and Germany, where some parents shun life-saving vaccines due to false theories suggesting links between childhood immunizations and autism. In Madagascar, one of the world’s poorest countries, parents are desperate to vaccinate their children, many trudging for miles to get to clinics for shots. But there are not enough vaccines, the health ministry says, and many people are too poor to afford them. Fisherman Dada – like many Malagasy, he only uses one name – had taken his son Limberaza to be vaccinated once already in their home in the southern district of Fort Dauphin. But a second-dose booster shot cost $15 at a clinic - and the whole family survives on less than $2 a day - so he took the boy to a back-street doctor instead. “I could not afford to take him to the hospital,” Dada said quietly as his young wife silently held Limberaza’s two-year-old brother. In January, Limberaza began to cough. A rash followed. After a week, he died, his body afire with fever. By then Dada’s niece, three-year-old Martina, was also sick. Her weeping mother Martine stroked her face as her fever spiked. She died eight days later. That evening, his other sister Pela’s three-year-old son Mario died as she clutched his hands. “They were so full of life,” Dada said, his voice breaking. The three cousins are among the almost 1,000 people, mostly children, who have died from measles in Madagascar since October. Their deaths show the grim reality for those left unprotected from one of the world’s most contagious diseases. The virus, which can cause blindness, pneumonia, brain swelling and death, is able to survive for up to two hours in the air after a cough or sneeze, where it can easily infect people nearby. Even though there is a highly effective vaccine, globally, around 110,000 people died from measles in 2017, according to the World Health Organization (WHO). Most, like Limberaza and his cousins, were children under the age of five. During 2000 to 2017, the WHO estimates that widespread use of measles vaccinations prevented 21.1 million deaths - making the shots one of what the United Nations’ health agency calls the “best buys in public health.”  Yet misinformation is knocking confidence in the safety of vaccinations and has jeopardized progress against measles - allowing the disease to gain a hold again in places where it was considered almost beaten. Europe last year saw its highest level of measles cases in a decade, and in January, the WHO named “vaccine hesitancy” - the reluctance or refusal to vaccinate - as one of the top ten global health threats for 2019. In Madagascar, poverty is a bigger risk. While wealthy tourists flock to its rainforests to spot wide-eyed lemurs and business people bargain for its luminous sapphires and fragrant vanilla, nearly half of Madagascar’s children are malnourished, the highest rate in Africa. The former French colony has been battered by decades of coups and instability. Foreign aid plummeted after a 2009 coup sparked bitter political street fighting. Corrupt leaders ignored the crumbling healthcare system despite frequent outbreaks of plague, hemorrhagic fevers and deadly viruses. Measles is endemic on the island but the last vaccination drive was in 2004. Nearly two-thirds of children have not been vaccinated, according to the WHO and coverage needs to be around 95 percent to prevent the virus spreading in communities. The country is $3 million short of the $7 million needed for enough measles vaccines to cover its population, the WHO said last month. There are other hurdles. The vaccines must be kept cold, but less than 15 percent of people in Madagascar have electricity. Roads are mostly mud in the tropical country; journeys are arduous and expensive. At least 922 people - mostly children - have died of measles in Madagascar since October, the WHO says, despite an emergency program that has vaccinated 2.2 million of the 26 million population so far. Some of those, like Limberaza, had previously been vaccinated but had only received one shot, and still needed a second booster jab. Madagascar hopes to roll out a free routine two-dose vaccination program this year. Currently, the first shot is free but the booster is not. Despite the difficulties, some parents walk miles seeking shots, said Jean Benoît Mahnes, deputy representative for the United Nations Children’s Fund in Madagascar. But they often arrive to find the clinic closed, or a doctor with no vaccine, or a vaccine that has expired. “Vaccinating a child can be a real obstacle course here,” he said. Lydia Rahariseheno, 33, said she had to walk an hour and a half to a clinic along a road plagued by robbers to get her three children vaccinated. She has only managed to get one shot so far because the doctor is often not there. The health system’s failures mean poverty-stricken parents often take sick children to traditional healers who prescribe a herb, tingotingo, which is boiled and given to them to drink. The children are only brought to a hospital when their condition deteriorates, said Manitra Rakotoarivony, director of health promotion at the Ministry of Public Health. Limberaza’s father hoped a second, cheaper shot would protect him - but it didn’t. His cousins Mario and Martine weren’t vaccinated at all. Now the family is desperate to protect their remaining children. “We did not expect the failure to vaccinate him would kill him,” wept Pela, Mario’s mother. “My other child, for sure, I am going to take him to get vaccinated.”

SOLUTION:
Pardoned felons are allowed to vote.