Working as a porter at a market, 18-year-old Nazir said “poverty has gripped my life as I hardly earn 400 afghani currently, while a bag of 21.5-kg rice was 2,000 afghani a couple of months ago but today it is 2,500 afghani which is beyond the purchasing power of ordinary people.”
“Freezing Afghanistan’s assets in America has led to price hike in the local market as the price of one sack flour (50 kg) was 1,200 afghani (13 U.S. dollars) but today it costs 2,300 afghani (25 U.S. dollars),” Kabul resident Noorzada said.
Accusing the United States of exacerbating the economic woes in Afghanistan, Noorzada said Washington’s antipathy to the Taliban government in Kabul has virtually deprived ordinary Afghans of their daily income.
“Usually, I work hard every day to increase my income but can hardly buy a bag of flour once a month, while in the past I took three flour bags home,” the 30-year-old man said.
People carry relief assistance donated by World Food Programme (WFP) in Kandahar city, Afghanistan, Oct. 7, 2021. (Photo by Sanaullah Seiam/Xinhua)
Following Taliban’s takeover in mid August and announcement of the caretaker government on Sept. 7, the United States has frozen Afghanistan’s assets in U.S. banks after withdrawing U.S. troops and diplomats.
Washington has reportedly frozen some 9.5 billion U.S. dollars in assets of the Afghan central bank on charges of the presence of terrorist groups, such as al-Qaida and the hardliner Islamic State outfit, in the war-torn country.
Rejecting the U.S. accusation, Zabihullah Mujahid, spokesman of the Taliban interim government, has stressed that the Afghan soil will not be used against any country, including the United States.
Echoing Noorzada’s concerns, Kabul resident Nazir also blamed the United States for the skyrocketing prices in the Afghan markets, saying that Washington’s double standard policy has caused economic chaos and growing poverty in the already impoverished country.
“We have no economy, no work and no regular income. In the past months, I earned 1,500 afghani each day but nowadays I can hardly earn 400 afghani daily,” Nazir told Xinhua.
Working as a porter at a local market, 18-year-old Nazir said “poverty has gripped my life as I hardly earn 400 afghani currently, while a bag of 21.5-kg rice was 2,000 afghani a couple of months ago but today it is 2,500 afghani which is beyond the purchasing power of ordinary people.”
Second-hand goods are for sale at a market in Kabul, capital of Afghanistan, on Oct. 13, 2021. (Photo by Saifurahman Safi/Xinhua)
Economic hardship is palpable everywhere in conflict-torn Afghanistan including the capital Kabul, as many Kabul residents are selling their home appliances to survive.
Freezing Afghanistan’s assets by the United States, according to Afghans, has made the new administration unable to pay the monthly salaries of government employees and the lack of income has dismayed almost all Afghans.
“The prices of basic needs particularly the food stuff have gone up almost day by day and the reason for growing inflation is freezing Afghan assets by America,” shopkeeper Sayed Abid, 55, said.
According to Abid, 1 litter petrol costs 76 afghani, 1 litter diesel is 70 afghani and 1 litter liquid gas costs 90 afghani, and the prices will shoot up with depreciating afghani against the U.S. dollar. (1 U.S. dollar equals to 90 afghani)
A 23-year-old Maryland woman pleaded guilty and agreed to testify against her twin sister Friday in connection with the deadly attack on their younger brother in the familys townhouse basement.
The move by Lemae Matthews represents a major development in the long-running and bizarre case in Montgomery County, which has now implicated four people: The twins, one of their boyfriends, and one of the boyfriend’s friends. The victim, Christian Matthews, was beaten and strangled after being roused from his sleep on March 21, 2017. He was 17.
Washington Post photo by Dan Morse
In court Friday, prosecutors read a statement from Lemae Matthews recounting how she was on the main floor during the killing.
“I heard what sounded like furniture being slammed around and Christian yelling, ‘Stop! Stop!'” Matthews said, according to the statement.
She pleaded guilty to accessory after the fact to first-degree murder, and faces up to 10 years in prison.
She agreed to testify, according to prosecutors, if called in the pending first-degree murder trials of her twin sister, Leaundra Matthews, and one of the men who allegedly attacked Christian in the basement, Daniel Howard, who is now 25. The second accused assailant in the basement, Tysean Lipford, was convicted of second-degree murder in 2019 and is serving a 30-year sentence.
In her statement to prosecutors, Lemae Matthews said that around the time of the killing, there was bad blood between her twin sister and younger brother over Lipford, who was the father of Leaundra Matthews’s baby. When Lipford was interrogated by detectives in 2017, he confessed to killing Christian Matthews, according to court records. He said that Christian Matthews had threatened to harm Leaundra and their baby, the records show.
“Leaundra asked our mother to kick Christian out of the house, however our mother did not kick Christian out of the house,” Lemae Matthews told prosecutors.
A short time later, as the twins, Lipford and Howard were discussing Christian, Leaundra Matthews allegedly said she wanted her brother gone.
“By gone, she meant that she wanted him killed,” Lemae recalled in her statement to prosecutors. “I asked her if they could just beat Christian up instead, but Leaundra said she wanted him ‘gone.'”
Brian Shefferman, an attorney for Leaundra Matthews, declined to comment. Aaron Meyers, an attorney listed in court records for Howard, could not be reached for comment Friday. Both of their clients are being held in jail without bond.
Wearing a tan jail jumpsuit and a long white necklace bearing a cross, Lemae Matthews said little during Friday’s court hearing, other than answering standard questions designed to ensure she understood the terms of her guilty plea. Assistant State’s Attorney Patrick Mays read the statement Lemae Matthews gave to prosecutors two months ago,
On the night of the murder, in Montgomery’s Colesville area, Lemae Matthews said, her sister came into her bedroom and asked her to watch her baby while she headed out to pick up Lipford and Howard. “She told me that they were coming over to ‘handle’ Christian,” Lemae Matthews said. “I knew that they wanted to kill Christian but I hoped that they would just beat Christian up instead.”
While her sister was out, Lemae texted and spoke to her by phone. “Leaundra asked me to go to the basement and make sure that Christian was in his room,” Lemae recalled. “I went to the basement and could tell Christian was in his room laying down in bed under a blanket. He appeared to be asleep.”
Lemae Matthews reported that to her sister, and a short time later was told that Lipford and Howard had been dropped off near the townhouse. The men arrived a short time later, Lemae Mathews said, put on disposable gloves and slipped down to the basement.
In previously filed court documents, detectives alleged that Christian Matthews screamed and tried to run upstairs, but Lipford slammed a door to prevent his escape. His shouts became faint, the detectives alleged.
Lemae Matthews said she ran out of the townhouse, still holding the baby, and got into her sister’s car. A few minutes later, she said, Lipford and Howard joined them. “We got him,” they both said, with Howard adding that Christian cried before dying, according to Lemae Matthews’s account to prosecutors.
Leaundra Matthews drove the pair to their friend’s house and dropped them off, according to court records. Lemae Matthews said she wanted to call 911 – hoping that her brother was still alive – but was not allowed to do so until they returned home. When she finally did so, according to her statement to prosecutors, she was vague about what happened because she feared Howard, whom she referred to by his nickname.
“I lied to 911 and the police because I was scared of what Ghost would do if I told the truth,” she said.
Kevin Collins, an attorney for Lemae Matthews, declined to comment Friday. His client was permitted to be released from jail on a $10,000 bond by Judge Jeannie Eun Kyung Cho, who set her sentencing for March 4.
The allegations that one twin went along with the murderous plot of the other twin – even if she didn’t personally agree – is consistent with the behavioral and psychological bonds shared by many twins,Joan A. Friedman, a psychotherapist, author and national twin expert, said in an interview.
“They’re generally in this shared mentality – this kind of us against the world mind-set,” Friedman said. “They don’t question what the other one wants or needs or feels. They don’t think of themselves as individuals. They think of themselves as a pair.”
Friedman suspects the decision made by Lemae Matthews – to agree to testify against her twin sister – was extraordinarily difficult to make.
“They’re usually very loyal to each other, very attached, very secretive,” Friedman added. “Their bond is very strong.”
ROME – Senior leaders of the powerful Group of 20 nations on Friday announced the creation of a new global body for coordinating government responses to the next international pandemic, but the initiative faced immediate criticism because it appears to lack resources.
The G-20’s health and finance ministers, convening in Rome as part of an international summit, said the new “Joint Finance-Health Task Force” would improve planning between the wealthiest nations to respond to pandemics with both additional health-care resources and financing measures.
The G-20 includes nations like the United States, France, Italy, Russia, Brazil, China, India, Japan and a number of others.
But the announcement came without a pledge of any new funding, inviting criticisms from those already furious that the rich nations of the world are doing too little to help poor countries still being ravaged by the coronavirus.
“We remain committed to build on the lessons learned from the covid-19 crisis to increase investment into longer term health capacity,” the G-20 health and finance ministers said in a joint statement. “We expect the Task Force to report on how health and finance collaboration can strengthen efforts to prevent, detect, and respond to future health emergencies with cross-border potential.”
Treasury Secretary Janet L. Yellen and Indonesia’s Minister of Finance Sri Mulyani Indrawati had written the G-20 earlier in the month seeking support for the new initiative. Yellen and Sri Mulyani had asked for the G-20 leaders to commit to “ensuring the financing capacity” of the development banks, such as the World Bank, for meeting pandemic threats.
“The current pandemic revealed a lack of readiness at the country level and a lack of coordination among us,” Yellen and Sri Mulyani said. “For this reason, we strongly support launching a forum where health and finance ministers could begin the work of facilitating global cooperation and coordinating prevention, detection, information sharing, and, if needed, response.”
The coronavirus pandemic, which was detected in China in 2019 but moved quickly across the globe in 2020, exposed major lapses in coordination between countries as they struggled to determine the best responses. Countries also clashed over access to treatments, protective equipment and data.
In January, the G-20 tasked a High Level Independent Panel with proposing the financial framework needed to reduce the world’s vulnerability to future pandemics. In its July report, the panel called for a global governance and financing mechanism that would bolster existing institutions, including the World Health Organization. It called for a public funding increase of at least $75 billion over the next five years, or $15 billion per year. Doubling current spending levels was justified, the panel concluded, because the higher costs were “negligible compared to costs of another major pandemic.” The new G-20 announcement does not include such money.
The forward-looking nature of the announcement and the lack of financing prompted criticism from some economists who said the G-20 stopped far short of what was needed, particularly at a time when the existing pandemic continues to devastate poorer countries. Joseph Stiglitz, a Nobel Prize-winning economist at Columbia University, criticized the wealthy nations of the G-20, saying: “People are dying today – to talk about preparing for ‘the next one’ to me is unforgivable.”
“Covid has shown that pandemics are not just health issues,” said David Miliband, president of the International Rescue Committee and former Foreign Secretary of the United Kingdom, who served on the independent panel. “The World Health Organization is central, but pandemics are economic, national security and political, and they need more than health ministers to get the right kind of response.”
Only heads of state can accomplish the corralling, peer pressure and accountability necessary to take action in real time, Miliband said, recalling how the virus was allowed to spread rapidly in February 2020, in part as a result of inaction at the highest levels.
The ongoing pandemic is also revealing the need for greater coordination across public and private groups by bringing industry, trade and others to the table, said Sara Bennett, a professor of international health at the Johns Hopkins Bloomberg School of Public Health.
“While vaccine funding is essential, in many low income, fragile contexts there are significant challenges in getting shots in arms,” Bennett said. “The need to strengthen health systems drawing upon both public and private actors is key.”
J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies (CSIS), also expressed disappointment in the G-20 announcement, 20 months into the pandemic after “plenty of good analysis about what is failing and what needs to happen.”
The WHO, Morrison said, has demonstrated it does not have the authority and gravitas to tackle these kinds of threats in a fragmented world, in which global powers cannot agree. He also expressed concern that the lack of financing in the G-20 plan will deflate enthusiasm from the Biden administration.
The initiative will shift to a “coalition of the willing” approach, Morrison suggested, noting that the United States and Norway are already in talks at the United Nations.
Lawrence Gostin, a professor of global health law at Georgetown Law, said he was underwhelmed by the announcement.
“This is a document that says all of the right words and provides no clear pathway for a solution,” Gostin said. The G-20 has had an “extraordinarily bad track record” of providing financing for global health preparedness, Gostin said, and has failed to take an all-of-government approach. This new body, which will not be led by heads of state, also lacks political heft, he said.
T is also needed across public and private groups by bringing industry, trade and others to the table, said Sara Bennett, a professor of international health at the Johns Hopkins Bloomberg School of Public Health.
“It’s good that the efforts should strengthen a global health architecture, but we should also recognize that we don’t really have a global health architecture,” Peters wrote in an email. “Architecture implies design. We have global health organizational sprawl, with elements of good architectural ideas within a fragmented and deeply flawed system.”
The pandemic offered an opportunity to unite behind shared goals that has not been met by Friday’s announcement, experts said.
“We are beyond the time of meeting to do careful thinking,” Morrison said. “We know what the issues are. What’s needed is action at a high level.”
Miliband described the G20 response as at the “lower end of expectations for muscularity and impact,” failing to fill gaps in preparedness at the national, regional or global levels.
“There is a real danger with this G20 that people will think future pandemics have been taken care of,” Miliband said. “They haven’t.”
ROME – President Joe Biden sought to smooth over relations with Americas oldest ally on Friday, acknowledging that the U.S. had been “clumsy” in its handling of a weapons agreement that led France to lose a multibillion-dollar contract and has fueled French anger for weeks.
“It was not done with a lot of grace,” Biden said, sitting beside French President Emmanuel Macron in their first face-to-face meeting since the U.S.-French rift erupted in September. He added that “what happened was, to use an English phrase . . . clumsy.”
Biden suggested that he had not realized the French would be blindsided by America’s agreement to share nuclear submarine technology with Australia, a move that cost France a lucrative contract to provide its own submarines to Australia. “I was under the impression that France had been informed long before that the deal was not coming through,” Biden said.
That effort at relationship repair capped a hectic day in Rome for Biden, who traveled across the ancient city via an 85-vehicle motorcade, calling on various top officials here ahead of Saturday’s meeting of the Group of 20 major economic powers.
A highlight for Biden was a 90-minute audience with Pope Francis, who, Biden told reporters, told him he’s “a good Catholic” and affirmed that he should be allowed to receive Communion. Conservative bishops in the United States have said the president’s support for abortion rights should disqualify him from accepting the sacrament.
The president is hoping to use his second trip abroad to reassert American leadership on the global stage, while showing a domestic audience that international cooperation can lead to concrete benefits like defeating the coronavirus and curtailing greenhouse emissions.
The G-20 meeting, which will be immediately followed by a climate summit in Glasgow expected to draw more than 100 world leaders, will provide time for Biden to establish a personal rapport with foreign allies, many of whom he has not yet met face-to-face amid changing regimes and pandemic restrictions. European partners in particular have been shaken by Biden’s early moves, including a messy Afghan withdrawal, an extension of Trump-era tariffs and the delayed lifting of a coronavirus-related travel ban.
The summits this weekend and next week are notable in part for their absences: Chinese leader Xi Jinping and Russian President Vladimir Putin are not coming in person, so Biden will not have a chance to engage directly with either adversary.
A central element of Biden’s foreign policy has been an effort to shift the focus of the Western alliance toward confronting China, and a senior administration official said Biden and Macron on Friday spent a “fair amount of time talking about the challenge posed by the rise of China.” The official, like others, spoke on the condition of anonymity to discuss sensitive diplomatic matters.
Biden’s meeting with Pope Francis went on far longer than expected, White House officials said, citing that as evidence that two men have a strong rapport. Both leaders have taken over from conservative leaders and shifted decisively in a liberal direction, leading to hostility from various groups including U.S. bishops.
A senior administration official said Francis urged Biden to help developing countries get coronavirus vaccines and to “accelerate our ambition” on reducing carbon emissions, the main purpose of Biden’s meetings in Glasgow next week.
Biden’s second trip abroad comes as his domestic agenda is in a delicate phase. He delayed his flight to Italy on Thursday to plead with fellow Democrats to back a deal that would deliver on promises to mitigate climate change, shore up the social safety net and rebuild roads and bridges.
Biden hopes to use climate and tax measures in the deal, which remained in limbo Friday, as a catalyst to spur broad international agreements. While Biden’s domestic challenges could play into his effectiveness as a global leader, his success or failure abroad – particularly at next week’s climate summit – could, in turn, resonate at home.
Biden, who rarely attends more than one public event a day, spent Friday driving through Rome’s narrow, winding streets, moving from one Italian palace to the next. Meetings included separate talks with Italian President Sergio Mattarella and Prime Minister Mario Draghi.
But the most anticipated meeting was the conciliatory talk with Macron. Biden was technically on French territory as he met with Macron at the French Embassy to the Holy See, a carefully choreographed move intended to elevate their meeting beyond a typical bilateral conversation.
When the Biden administration in September agreed to share nuclear submarine technology with Australia, that effectively overrode an earlier deal for Canberra to buy $66 billion worth of diesel-powered submarines from France.
Macron’s government said at the time that the unexpected move raised fundamental questions about the future of transatlantic security cooperation, and France briefly recalled its ambassador from Washington.
Two subsequent phone calls between Macron and Biden appeared to calm tensions, and French officials have taken a more restrained tone since. But the French presidential office has continued to emphasize that it expects concrete steps to rebuild trust between France and the United States.
Macron met Biden at the steps of the Villa Bonaparte, a grand, three-story, pale yellow mansion tucked within a walled compound in the heart of Rome.
The pair went inside the building and briefly allowed reporters to listen to remarks. Biden heaped praise on France, saying that “we have no older” ally and that the country is an “incredible, valued partner” of the United States.
Macron suggested that the relationship had improved. “We clarified together what we had to clarify,” Macron said as reporters were ushered out. “Now what’s important is to be sure that such a situation will not be possible for our future.”
Several hours after the meeting, the two leaders released a three-page statement that outlined broad areas of agreement, including a U.S. recognition of “the importance of a stronger and more capable European defense.” Macron has been eager to bolster a European defense system that would not be as dependent on the United States.
French officials in recent weeks have voiced frustration with Australia and Britain as well, since Britain was included in the submarine deal that angered the French.
After a phone call Thursday between Macron and Australian Prime Minister Scott Morrison, the Élysée Palace released a statement saying that the derailment of the submarine deal “broke the relationship of trust between our two countries.”
“It is now up to the Australian Government to propose tangible actions that embody the political will of Australia’s highest authorities to redefine the basis of our bilateral relationship,” the statement from the French presidential palace added.
Friday’s Biden-Macron meeting came less than six months before presidential elections in France that are increasingly unpredictable. The rise of potential far-right candidate Éric Zemmour has upended calculations within Macron campaign headquarters, as some polls now show him effectively tied with longtime far-right leader Marine Le Pen behind Macron.
A major theme of the campaign message from both Le Pen and Zemmour has been the ostensible decline of the French nation under Macron and some of his predecessors.
In a speech last week, Zemmour suggested that France needed to escape “the shadow” of big powers, namely the United States. He cited the derailed Australian-French submarine deal as evidence of the flawed transatlantic relationship, and he blasted the European Union’s diplomacy as “at best condemned to paralysis, at worst to submission to the United States.”
Zemmour’s U.S. skepticism is falling on fertile ground in France. A Pew Research Center survey this year found that only 31 percent of French respondents said the United States reliably considers the interests of countries like theirs in its international policy decisions.
Macron has sought to balance French skepticism of the United States with the country’s reliance on Washington. In a speech last month, he urged Europeans to “come out of their naivete” on the world stage and assert their independence from the United States.
But in the same speech, Macron acknowledged the United States as “a great historical ally and an ally in terms of values. And that will remain the case.”
Macron’s balancing act may be a reflection of France’s capabilities as a military power that remains a leading force in some ways, including in West Africa, but relies heavily on alliances on other fronts.
Within Europe, France’s security strategy is largely based on its alliances within NATO and the E.U., alliances that have long depended on the United States.
Now France is among several European countries pushing for the continent to pursue “strategic autonomy” from the United States, both out of a fear that a Trump-like leader might return to power, and an anxiety that even traditional American figures like Biden have become more inward-looking.
RICHMOND, Va. – Donald Trump will headline an election-eve tele-rally Monday night for Virginia gubernatorial candidate Glenn Youngkin and other Republicans, according to a Trump ally leading a bus tour meant to whip up support for a ticket thats run hot and cold on the 45th president.
“They need us to win, and that’s why we’re doing this teleconference,” said John Fredericks, a talk radio host and Trump’s former Virginia chairman, who two weeks ago arranged for the former president to phone in to a GOP rally in suburban Richmond.
Washington Post photo by Jabin Botsford
It was not clear that Youngkin wants Trump, who lost Virginia by 10 points last year, to further inject himself into the race – a neck-and-neck battle with Democrat Terry McAuliffe, a former governor who has been raising money off the prospect of a Trump-led rally.
Youngkin’s campaign did not respond to requests for comment on the plan Fredericks described. Earlier in the week, when both Trump and his spokesman Taylor Budowich separately teased that former president might travel to Virginia to stump for Youngkin in person, Youngkin’s spokesman declined to comment.
A Trump adviser, speaking on the condition of anonymity because the event had not been formally announced, on Friday confirmed Trump plans to take part in the tele-rally, which Bloomberg News first reported based on an anonymous source, or on the details Fredericks shared with The Washington Post. Fredericks said Trump, a frequent guest on his radio show, will formally announce the event on his program Monday morning, if not before.
Fredericks said it would be an enormous teleconference, with Trump on the line along with “thousands and thousands” of his Virginia supporters.
“It’s going to be the biggest phone rally in the history of Virginia,” Fredericks said. “The Republican ticket cannot win without Trump’s voter base in Virginia fully engaged and turned out on game day. … We need a huge Election Day turnout, and the only person to put them over the top in Virginia is President Donald J. Trump. Period.”
Youngkin, on a tightrope as he tries to woo Trump fans without alienating moderates in the state’s vote-rich suburbs, had earlier embraced the former president as he sought the GOP nomination – praising Trump by name and indulging Trump’s false claim that President Biden stole the White House.
Since then, Youngkin has tried to shake any explicit association with Trump while still leaning into the culture-war themes popular with the ex-president’s fans, including opposition to critical race theory, an academic concept for studying race that is not actually part of Virginia’s K-12 curriculum.
Trump, who endorsed Youngkin after he won the nomination in May, has not seemed content to let him pivot away. Trump has repeatedly weighed in on the race, at times on Fredericks’s show. In an appearance with Fredericks in September, Trump warned that Youngkin risks losing the Virginia governor’s race by not fully embracing the Make America Great Again movement.
“The only guys that win are the guys that embrace the MAGA movement,” Trump said then. “When they try to go down a railroad track … ‘Oh, yeah, love Trump. Love Trump. OK, let’s go, next subject.’ When they do that, nobody, they don’t – they never win. They never win. They have to embrace it.”
Bob Holsworth, a veteran Richmond political observer, said Trump seems to be walking a fine line of his own when it comes to Youngkin.
“Trump’s playing a double game, too – wanting to take credit if (Youngkin) gets elected and distancing himself if he doesn’t,” Holsworth said.
Like Trump, Fredericks has seemed intent on keeping Youngkin from spinning too far from the ex-president’s orbit. As Youngkin and McAuliffe started rolling across the state on rival bus tours, Fredericks started barnstorming with his own “Take Back Virginia Bus Tour.”
He says it is unaffiliated with any campaign, but the radio interviews he’s done along the way have tended to focus on Youngkin. At a stop in the suburban battleground of Chesterfield County earlier this week, Fredericks’s guest was state Sen Amanda Chase, R-Chesterfield, the self-described “Trump in heels” who told listeners she has been working closely with Youngkin’s campaign to foil what she said were plots by Democrats to steal Tuesday’s election. Youngkin’s team, which has deployed Chase as an official campaign surrogate, declined to comment on Chase’s claims or the bus tour.
On Friday, former Trump chief strategist Stephen Bannon is scheduled to join Fredericks when the bus stops at GOP headquarters in Loudoun County. Bannon’s appearance in that Northern Virginia swing territory comes with considerable risk of alienating swing voters, given that a U.S. House Committee investigating the Jan. 6 insurrection considers him a key witness. He has been defying the committee’s subpoena.
Two weeks ago, Bannon headlined the Richmond-area rally that Trump phoned into, where participants pledged allegiance to an American flag said to have flown in Washington ahead of the insurrection. Youngkin did not attend, saying he had a conflict, but he had publicly thanked Fredericks in advance for arranging the event and provided him with campaign signs to hand out. Youngkin later tried to distance himself from it, saying it was “weird and wrong” to make a pledge to that flag.
Fredericks said he is inviting Youngkin to join Trump on the call Monday night.
“If he wants to be governor of Virginia,” Fredericks said, “he will.”
WASHINGTON – Regulators on Friday authorized the Pfizer-BioNTech coronavirus vaccine for children 5 to 11 years old, a watershed moment celebrated by parents yearning for a return to normal life but viewed with ambivalence and outright skepticism by others worried about the potential risk of unknown side effects.
The Food and Drug Administration’s emergency action cleared the first pediatric coronavirus vaccine in the United States – a two-shot regimen administered three weeks apart. The dose, 10 micrograms, is one-third of that used for adolescents and adults. In a clinical trial of 5- to 11-year-olds, the vaccine was almost 91% effective at preventing covid-19, the disease caused by the virus. The vaccine’s safety was studied in about 3,100 children who received the shot and had no serious side effects, the agency said.
“Vaccinating younger children against COVID-19 will bring us closer to returning to a sense of normalcy,” FDA acting commissioner Janet Woodcock said in a statement. “Our comprehensive and rigorous evaluation of the data pertaining to the vaccine’s safety and effectiveness should help assure parents and guardians that this vaccine meets our high standards.”
The issue of safety was a main focus of regulators and their advisers partly because the vaccine has been linked to rare cases of cardiac side effects in another group – male adolescents and young men. The symptoms of the side effects – myocarditis and pericarditis, which are inflammation of the heart muscle and lining, respectively – tended to be mild and treatable, doctors say.
The FDA authorization is the latest step by the Biden administration to extend the reach of vaccines in hopes of taming a dangerous and vexing virus. The inoculation of adults, which began last December, recently entered a new phase, with booster shots for all three vaccines used in the United States available for many. About 28 million children are in the newly eligible group of 5- to 11-year-olds.
But the process of getting vaccines cleared for younger school-age children has been fraught, with members of the FDA’s outside advisory committee expressing some angst and disagreements during a vociferous public debate this week. In the end, the panel voted 17 to 0, with one abstention, to recommend the vaccine, agreeing with the FDA that the shot’s known and potential benefits outweighed the known and potential risks – the criteria for an emergency authorization.
The discussion about the shot is expected to resume Tuesday when the Advisory Committee on Immunization Practices, which advises the Centers for Disease Control and Prevention, is scheduled to meet to recommend how to use the vaccine. After CDC Director Rochelle Walensky signs off, probably on the same day, providers, including pediatricians and pharmacists, will be able to begin administering the vaccine.
The debate over the shot points up the complexities of making decisions involving vaccines, which are nearly always intended for healthy people. Covid poses special challenges because “while children are at lower risk of bad outcomes, they are not at no risk,” said Holly Fernandez Lynch, a bioethicist at the University of Pennsylvania.
About 1.9 million children 5 to 11 years old have been infected, and at least 146 have died, according to federal health officials. Those infected are vulnerable to “long-haul covid,” with lingering symptoms including fatigue, brain fog and respiratory problems, and a serious but rare condition called MIS-C, or multisystem inflammatory syndrome, which can cause inflammation of the heart, lungs, kidneys, brain and other organs.
In addition, Lynch said, there are other types of side effects that go beyond the strictly physical: “When children have exposures, they have to stay home from school and parents have to miss work.”
Parents’ uncertainty about the vaccine was captured in a new survey by the Kaiser Family Foundation that found only 27% of parents are planning to get their children vaccinated right away. A slightly larger group said they don’t intend to have their children vaccinated. About one-third said they will “wait and see.”
Trishan Arul, chief executive of a digital health company who lives in Cincinnati, said he plans to have his 7-year-old daughter vaccinated as soon as possible. But he is having second thoughts about his 10-year-old son.
“We may want to wait a little bit” until there is more information about the myocarditis risk for younger boys, he said. The complication did not show up in the trial, which was too small to detect such rare side effects. Arul said he might wait for a pediatric version of the Johnson & Johnson vaccine, which has not been linked to the cardiac ailment.
Pediatrician Elizabeth Meade at Swedish Medical Center in Seattle said she is convinced the vaccine is “highly safe and highly effective,” and is eager to have her 7-year-old daughter vaccinated so the family can resume normal activities. But she acknowledged the decision is difficult for many parents.
“It’s one thing to make a medical decision for ourselves and a different thing to make it for our kids,” she said.
Jennifer Su, a pediatric cardiologist at Children’s Hospital Los Angeles, said she tells worried parents that the chance of developing myocarditis or other side effects from the vaccine is much lower than harm from covid and that she strongly recommends the shot.
The safety issue was on full display this week when the FDA’s outside advisers reviewed the pediatric vaccine. Many members wanted all younger children to get the shot while others suggested it should be reserved for children at high risk of severe covid, and urged the CDC to narrow its use.
James Hildreth Sr., chief executive of Meharry Medical College, said he wanted to make sure that those who really need it, including children of color, could get the vaccine. “But to be honest, the best way to protect the health of some kids would be to do nothing at all because they’re going to be just fine,” he said.
Another member of the committee, Eric Rubin, editor in chief of the New England Journal of Medicine and an adjunct professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health, said in an interview this week he believes the vaccine will benefit children – but not as much as it has helped adults.
“So in that situation, we worry more about side effects” because the benefits are not as large, he said. “They are kids. The stakes are high.”
Ultimately, however, the panel endorsed the shot without a single “no” vote.
Federal officials and some experts said it was highly unlikely the CDC would recommend any limits involving which children could get the vaccine. Any parents who want a shot for their child should be able to get one, they said.
In a call with reporters Friday, Peter Marks, who oversees vaccines at the FDA, underscored the point, noting that at least one-third of children who are hospitalized with covid do not have identifiable risk factors, making it important to make the vaccine broadly available.
“Everyone 5 to 11 is still at risk of serious disease,” agreed Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia and a member of the FDA advisory committee. “I don’t think [the CDC] will layer it.”
Offit said there is always some uncertainty in trying to predict side effects that are so rare they show up only when vaccines are used in vast numbers of people.
“You go with the best data you have and hope you made the right decision,” he said. “A decision not to release the vaccine is also a decision, one to let children potentially get infected and potentially die.”
Peter Hotez, a vaccine expert at Baylor College of Medicine, said he was concerned that the FDA advisers, in debating the vaccine so vociferously, were “damning [the vaccine] with faint praise.”
“It’s great that people are seeing the sausage being made,” he said, but some of the skeptical comments “could chill the acceptance of some parents of the vaccine.”
But Paul Spearman, director of infectious diseases at Cincinnati Children’s Hospital Medical Center and a member of the FDA advisory committee, said the debate was “just part of the process . . . that is what we are supposed to do, dig in deeper.” Spearman did not take part in the meeting because he has worked on coronavirus vaccines, including Pfizer-BioNTech’s.
He said he was confident doctors would be able to persuade the wavering “wait-and-see” parents to get their children vaccinated. “This group needs to see that their trusted health-care providers are in favor of it and that kids are doing great after they get it,” he said.
The effectiveness data for the authorization came from an ongoing trial with about 4,700 children 5 to 11 years old who received the lower dose of the vaccine, the agency said. The FDA compared their immune responses to those of participants 16 to 25 years old who had received the adult dose in a previous study, and found the responses were comparable.
The trial was considered too small to detect rare complications, so the FDA produced an extensive analysis to try to determine the risk of cardiac side effects in children 5 to 11 years old. It compared the estimated number of covid-related illnesses, hospitalizations and deaths that would be prevented by the vaccine with the number of predicted myocarditis cases, hospitalizations and deaths caused by the vaccine.
Under most scenarios, the vaccine’s benefits outweigh its risks. The only exception was when the virus was circulating at very low levels. Even then, the agency said, the benefits might very well outweigh the risks because covid is so much more dangerous than vaccine-induced myocarditis.
The FDA officials, in the call with reporters, tried to assuage parental fears about the potential of long-term side effects, including on their children’s fertility.
“There is no evidence that there is an adverse effect on fertility” from the vaccine, Marks said. “And there is no reason why one would suspect” that mRNA vaccines such as those made by Pfizer-BioNTech and Moderna would harm fertility. He emphasized that the FDA and the CDC have several systems for monitoring vaccine safety for all age groups.
The FDA officials also said that although covid cases are declining, there could be a resurgence in cold weather and parents should not delay getting their children vaccinated.
As the release date for the pediatric vaccine approaches, anti-vaccine activity has exploded. FDA officials and members of the advisory committee report being deluged with emails and phone calls from people urging them to reject the vaccine and threatening lawsuits if they didn’t. “I’m getting ugly, virulent emails,” Rubin said.
On the other end of the spectrum, Piper Ryan, 46, is eager to get the vaccine for her 9-year-old son, Teague. He has been playing tennis and having outdoor play dates, but still is taking virtual classes at home. With the winter holidays approaching, they are both anxious for Teague to get his first dose.
Ryan, who lives in Great Falls, Va., said she wants to host Thanksgiving dinner with her extended family this year – it would be their first holiday gathering since the pandemic began. But Ryan said she would feel comfortable inviting out-of-state relatives only if her son had some protection against the virus.
“As soon as it is authorized, we’re absolutely going to get him vaccinated,” Ryan said.
The number of Covid-19 cases crossed 13.14 million across Southeast Asia, with 30,486 new cases reported on Friday (October 29), higher than Thursday’s tally at 30,327. New deaths are at 334, decreasing from Thursday’s number of 539. Total Covid-19 deaths in Asean are now at 277,698.
Cambodia’s Tourism Minister announced that the country recorded about 2.42 million domestic tourists, of whom more than 2.26 million were citizens and about 160,000 foreign nationals, in the first eight months of this year. This is a decrease of about 90%, respectively, compared to the same period last year.
The decline in the number of tourists has had a significant impact on the operation of the tourism business. As of August 31, a total of 3,915 businesses closed or suspended operations, affecting 53,534 people employed in the tourism sector.
Meanwhile, Malaysia will procure Pfizer-BioNTech vaccines for children in the country as the US Food and Drug Administration has recommended the vaccine for those between the ages of five to 12. Health minister added that they will also look at other options like Sinovac, whereas schools would be able to reopen safely as 82.4 per cent of the nation’s adolescents were partially vaccinated and 62 per cent fully vaccinated.
People carry relief assistance donated by World Food Programme (WFP) in Kandahar city, Afghanistan, Oct. 7, 2021. (Photo by Sanaullah Seiam/Xinhua)
Second-hand goods are for sale at a market in Kabul, capital of Afghanistan, on Oct. 13, 2021. (Photo by Saifurahman Safi/Xinhua)
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