Johnson and Johnson Vaccine a Valuable Addition to the COVID-19 Toolbox

With the emergency use authorization (EUA) of the Janssen Pharmaceuticals/Johnson & Johnson COVID-19 vaccine, three vaccines are now available in the U.S. to prevent SARS-CoV-2 hospitalizations and death. The newest vaccine, given as a single dose and stable at refrigeration temperatures for at least three months, presents far fewer logistical challenges in getting doses to consumers.

All of the three current U.S. vaccines use a single protein from SARS-CoV-2 to enable the body to react to the whole virus. The Pfizer/BioNTech and Moderna vaccines are messenger RNA vaccines that use a synthetic version of part of the SARS-CoV-2 genome to teach our cells to replicate the spike protein found on the surface of the virus. This copy of the protein then stimulates the immune system to produce antibodies and other cells that will recognize the actual virus if it is encountered in the future.

The new vaccine employs a different mechanism to produce the same result. A human adenovirus, modified to disable its ability to multiply and infect, acts as a “vector” to carry a gene from the spike protein into our own cells, where the protein is replicated and activates the immune system as above.

(The Oxford/AstraZeneca COVID-19 vaccine, currently in use in the UK, Canada, and Australia, is also a vector vaccine. Granted emergency use listing by the World […]

COVID-19 Vaccines Explained

As we in the U.S. struggle to set up systems for the rapid administration of SARS-CoV-2 vaccinations, what do nurses need to know about these vaccines?

Two vaccines have received emergency use authorization (EUA) in the U.S.—one manufactured by Pfizer/BioNTech, the other by Moderna. (A third, manufactured by AstraZeneca, is likely to receive EUA by April.) New, more efficient vaccine technologies along with a huge financial investment by the U.S. government have produced these products in a much shorter time frame than has been typical for other vaccines.

Currently available vaccines.

The two vaccines that are available now are messenger RNA, or mRNA, vaccines. This type of vaccine has been developed and studied for decades for possible use in preventing influenza, Zika, and other infectious diseases. Human mRNA is a strand of genetic material used for cell building and maintenance. For SARS-CoV-2 vaccines, mRNA based on part of the SARS-CoV-2 genome is synthesized and standardized in a lab.

When administered in a vaccine, this mRNA delivers to our cells the instructions  to replicate a “spike protein” found on the surface of the SARS-CoV-2 virus. (Important to know and tell patients: The mRNA never enters the nuclei of our cells, and can’t be incorporated into our own DNA.) After a cell follows these instructions and “posts” the spike protein replica on its surface, the immune system recognizes it as foreign […]

Levels of Weariness Among Nurses

I imagine that nurses throughout the world are constantly being asked “How are things at work these days?”—with the implied question being “How are you holding up with your work situation?” While my colleagues and I in our pediatric hospital have not seen an overwhelming surge of COVID+ patients come through our doors, we have certainly seen some, with an uptick in our COVID+ census as the numbers throughout the country have increased.

When I pause at this point in the conversation, the usual response I get is, “Oh, that’s so good to hear. You’re lucky.” And I agree and reflect this back to whoever I’m speaking with. My heart hurts for my fellow nurses in other parts of the nation who have been utterly overwhelmed by COVID and its cruelty. I recognize that I am indescribably lucky.

At the same time, though it’s hard to articulate why, even nurses who haven’t been hit by the surges seen in other hospitals bear layers of deep weariness by this point in the pandemic. […]

Notes from the AIDS/HIV Epidemic for Nurses Working in the COVID Pandemic

The accounts of nurses working in the midst of this pandemic vividly remind me of my work as a nurse in the early days of the AIDS epidemic. I am reminded of the period when we did not know how the disease was transmitted, when we believed that caring for them involved great personal risk. I remember masking, gowning, and gloving every time I entered a patient room. I still recall the wonderful patients I had the opportunity to care for, and I understand that watching a patient die alone is the probably the most difficult experience that we will ever face as nurses.

I spent years on the front line of the AIDS epidemic and now am teaching future nurses. I am dedicated to helping nurses cope in times of crisis. We have chosen difficult work. Work that is more difficult than we could have possibly understood when we entered nursing school. Work that can also be extremely rewarding. I am proud to be a part of this noble profession, and I hope that it may be useful for me to share some of the things that I have learned.

1. It is extremely important to take care of your physical health.

I remember days I didn’t have […]

Frontline Nurses Speak Out – A Health Care Crisis That ‘Didn’t Have to Be This Way’

Themes of heartbreak, heroics, exhaustion, sadness, and anger.

Previously on this blog, I posted about the Frontline Nurses WikiWisdom Forum, an initiative AJN joined back in March to bring forth the experiences and thoughts of nurses working at the point of care during the COVID-19 pandemic. Together with Cynda Rushton (Johns Hopkins School of Nursing & Berman Institute of Bioethics and AJN editorial board member) and Theresa Brown (nurse, author, and AJN contributing editor) and the folks at New Voice Strategies, we solicited stories from nurses from around the country. Of the many who visited the site, 463 nurses joined and shared their experiences.

Forum moderator Cindy Richards, a professional journalist, worked with four “thought leaders” from the nurses to organize the themes and recommendations from the rich content posted by the nurses.

And while we recognize that the pandemic is far from over (United States cases as of September 20 were over 6.7 million, approaching 200,000 deaths and still on the rise), we felt we had reached a critical mass of content. The stories echoed repetitive themes of heartbreak, heroics, exhaustion, sadness, and anger.

“Nurses often put their patients’ needs before their own. That didn’t change during the pandemic. What did change is that nurses saw the […]

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