High-tech shrink art may be the key to making tiny electronics, 3-D nanostructures or even holograms for hiding secret messages.

A new approach to making tiny structures relies on shrinking them down after building them, rather than making them small to begin with, researchers report in the Dec. 23 Science.

The key is spongelike hydrogel materials that expand or contract in response to surrounding chemicals (SN: 1/20/10). By inscribing patterns in hydrogels with a laser and then shrinking the gels down to about one-thirteenth their original size, the researchers created patterns with details as small as 25 billionths of a meter across.
At that level of precision, the researchers could create letters small enough to easily write this entire article along the circumference of a typical human hair.

Biological scientist Yongxin Zhao and colleagues deposited a variety of materials in the patterns to create nanoscopic images of Chinese zodiac animals. By shrinking the hydrogels after laser etching, several of the images ended up roughly the size of a red blood cell. They included a monkey made of silver, a gold-silver alloy pig, a titanium dioxide snake, an iron oxide dog and a rabbit made of luminescent nanoparticles.
Because the hydrogels can be repeatedly shrunk and expanded with chemical baths, the researchers were also able to create holograms in layers inside a chunk of hydrogel to encode secret information. Shrinking a hydrogel hologram makes it unreadable. “If you want to read it, you have to expand the sample,” says Zhao, of Carnegie Mellon University in Pittsburgh. “But you need to expand it to exactly the same extent” as the original. In effect, knowing how much to expand the hydrogel serves as a key to unlock the information hidden inside.

But the most exciting aspect of the research, Zhao says, is the wide range of materials that researchers can use on such minute scales. “We will be able to combine different types of materials together and make truly functional nanodevices.”

A 120-million-year-old fossil bird found in China could offer some new clues about how landbound dinosaurs evolved into today’s flying birds. The dove-sized Cratonavis zhui sported a dinosaur-like head atop a body similar to those of today’s birds, researchers report in the January Nature Ecology & Evolution.

The flattened specimen came from the Jiufotang Formation, an ancient body of rock in northeastern China that is a hotbed for preserved feathered dinosaurs and archaic birds. CT scans revealed that Cratonavis had a skull that was nearly identical (albeit smaller) as those of theropod dinosaurs like Tyrannosaurus rex, paleontologist Li Zhiheng of the Chinese Academy of Sciences in Beijing and colleagues report. This means that Cratonavis still hadn’t evolved the mobile upper jaw found in modern birds (SN: 5/2/18).
It’s among just a handful of specimens that belong to a recently identified group of intermediate birds known as the jinguofortisids, says Luis Chiappe, a paleontologist at the Natural History Museum of Los Angeles County who was not involved in the study. Its dino-bird mishmash “is not unexpected.” Most birds discovered from the Age of Dinosaurs exhibited more primitive, toothed heads than today’s birds, he says. But the new find “builds on our understanding of this primitive group of birds that are at the base of the tree of birds.”

Cratonavis also had an unusually elongated scapula and hallux, or backward-facing toe. Rarely seen in Cretaceous birds, enlarged shoulder blades might have compensated for the bird’s otherwise underwhelming flight mechanics, the researchers say. And that hefty big toe? It bucks the trend of shrinking metatarsals seen as birds continued to evolve. Cratonavis might have used this impressive digit to hunt like today’s birds of prey, Li’s team says.

Filling those shoes may have been too big of a job for Cratonavis, though. Given its size, Chiappe says, the dino-headed bird would have most likely been a petite hunter, taking down the likes of beetles, grasshoppers and the occasional lizard rather than terrorizing the skies.

Supercooled water is two of a kind, a new study shows.

Scientists have long suspected that water at subfreezing temperatures comes in two distinct varieties: a high-density liquid that appears at very high pressures and a low-density liquid at lower pressures. Now, ultrafast measurements have caught water morphing from one type of liquid to the other, confirming that hunch. The discovery, reported in the Nov. 20 Science, could help explain some of water’s quirks.

The experiment “adds more and more evidence to the idea that water really is two components … and that that is the reason that underlies why water is so weird,” says physicist Greg Kimmel of Pacific Northwest National Laboratory in Richland, Wash., who was not involved in the study.

When free from impurities, water can remain liquid below its typical freezing point of zero degrees Celsius, forming what’s called a supercooled liquid. But the dual nature of supercooled water was expected to appear in a temperature realm so difficult to study that it’s been dubbed “no-man’s-land.” Below around –40° C, water remains liquid for mere instants before it crystallizes into ice. Making the task even more daunting, the high-density phase appears only at very high pressures. Still, “people have dreamt about how to do an experiment,” says Anders Nilsson of Stockholm University.
Thanks to speedy experimental maneuvers, Nilsson and colleagues have infiltrated that no-man’s-land by monitoring water’s properties on a scale of nanoseconds. “This is one of the major accomplishments of this paper,” says computational chemist Gül Zerze of Princeton University. “I’m impressed with their work.”

The scientists started by creating a type of high-density ice. Then, a pulse from an infrared laser heated the ice, forming liquid water under high pressure. That water then expanded, and the pressure rapidly dropped. Meanwhile, the researchers used an X-ray laser to investigate how the structure of the water changed, based on how the X-rays scattered. As the pressure decreased, the water transitioned from a high-density to low-density fluid before crystallizing into ice.

Previous studies have used ultrafast techniques to find hints of water’s two-faced demeanor, but those have been done mainly at atmospheric pressure (SN: 9/28/20). In the new work, the water was observed at about 3,000 times atmospheric pressure and –68° C. “It’s the first time we have real experimental data at these pressures and temperatures,” says physicist Loni Kringle of Pacific Northwest National Laboratory, who was not involved with the experiment.

The result could indicate that supercooled water has a “critical point” — a certain pressure and temperature at which two distinct phases merge into one. In the future, Nilsson hopes to pinpoint that spot.

Such a critical point could explain why water is an oddball liquid. For most liquids, cooling makes them become denser and more difficult to compress. Water gets denser as it is cooled to 4° C, but becomes less dense as it is cooled further. Likewise, its compressibility increases as it’s cooled.

If supercooled water has a critical point, that could indicate that the water experienced in daily life is strange because, under typical pressures and temperatures, it is a supercritical liquid — a weird state that occurs beyond a critical point. Such a liquid would not be the high-density or low-density form, but would consist of some regions with a high-density arrangement of water molecules and other pockets of low density. The relative amounts of those two structures, which result from different arrangements of hydrogen bonds between the molecules, would change as the temperature changes, explaining why water behaves strangely as it is cooled.

So despite the fact that the experiment involved extreme pressures and temperatures, Nilsson says, “it influences water in our ordinary life.”

2022 was the year many people decided the coronavirus pandemic had ended.

President Joe Biden said as much in an interview with 60 Minutes in September. “The pandemic is over,” he said while strolling around the Detroit Auto Show. “We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over.”

His evidence? “No one’s wearing masks. Everybody seems to be in pretty good shape.”

But the week Biden’s remarks aired, about 360 people were still dying each day from COVID-19 in the United States. Globally, about 10,000 deaths were recorded every week. That’s “10,000 too many, when most of these deaths could be prevented,” the World Health Organization Director-General Tedros Adhanom Ghebreyesus said in a news briefing at the time. Then, of course, there are the millions who are still dealing with lingering symptoms long after an infection.
Those staggering numbers have stopped alarming people, maybe because those stats came on the heels of two years of mind-boggling death counts (SN Online: 5/18/22). Indifference to the mounting death toll may reflect pandemic fatigue that settled deep within the public psyche, leaving many feeling over and done with safety precautions.

“We didn’t warn people about fatigue,” says Theresa Chapple-McGruder, an epidemiologist in the Chicago area. “We didn’t warn people about the fact that pandemics can last long and that we still need people to be willing to care about yourselves, your neighbors, your community.”

Public health agencies around the world, including in Singapore and the United Kingdom, reinforced the idea that we could “return to normal” by learning to “live with COVID.” The U.S. Centers for Disease Control and Prevention’s guidelines raised the threshold for case counts that would trigger masking (SN Online: 3/3/22). The agency also shortened suggested isolation times for infected people to five days, even though most people still test positive for the virus and are potentially infectious to others for several days longer (SN Online: 8/19/22).

The shifting guidelines bred confusion and put the onus for deciding when to mask, test and stay home on individuals. In essence, the strategy shifted from public health — protecting your community — to individual health — protecting yourself.
Doing your part can be exhausting, says Eric Kennedy, a sociologist specializing in disaster management at York University in Toronto. “Public health is saying, ‘Hey, you have to make the right choices every single moment of your life.’ Of course, people are going to get tired with that.”

Doing the right thing — from getting vaccinated to wearing masks indoors — didn’t always feel like it paid off on a personal level. As good as the vaccines are at keeping people from becoming severely ill or dying of COVID-19, they were not as effective at protecting against infection. This year, many people who tried hard to make safe choices and had avoided COVID-19 got infected by wily omicron variants (SN Online: 4/22/22). People sometimes got reinfected — some more than once (SN: 7/16/22 & 7/30/22, p. 8).
Those infections may have contributed to a sense of futility. “Like, ‘I did my best. And even with all of that work, I still got it. So why should I try?’ ” says Kennedy, head of a Canadian project monitoring the sociological effects of the COVID-19 pandemic.

Getting vaccinated, masking and getting drugs or antibody treatments can reduce the severity of infection and may cut the chances of infecting others. “We should have been talking about this as a community health issue and not a personal health issue,” Chapple-McGruder says. “We also don’t talk about the fact that our uptake [of these tools] is nowhere near what we need” to avoid the hundreds of daily deaths.

A lack of data about how widely the coronavirus is still circulating makes it difficult to say whether the pandemic is ending. In the United States, the influx of home tests was “a blessing and a curse,” says Beth Blauer, data lead for the Johns Hopkins University Coronavirus Resource Center. The tests gave an instant readout that told people whether they were infected and should isolate. But because those results were rarely reported to public health officials, true numbers of cases became difficult to gauge, creating a big data gap (SN Online: 5/27/22).
The flow of COVID-19 data from many state and local agencies also slowed to a trickle. In October, even the CDC began reporting cases and deaths weekly instead of daily. Altogether, undercounting of the coronavirus’s reach became worse than ever.

“We’re being told, ‘it’s up to you now to decide what to do,’ ” Blauer says, “but the data is not in place to be able to inform real-time decision making.”

With COVID-19 fatigue so widespread, businesses, governments and other institutions have to find ways to step up and do their part, Kennedy says. For instance, requiring better ventilation and filtration in public buildings could clean up indoor air and reduce the chance of spreading many respiratory infections, along with COVID-19. That’s a behind-the-scenes intervention that individuals don’t have to waste mental energy worrying about, he says.

The bottom line: People may have stopped worrying about COVID-19, but the virus isn’t done with us yet. “We have spent two-and-a-half years in a long, dark tunnel, and we are just beginning to glimpse the light at the end of that tunnel. But it is still a long way off,” WHO’s Tedros said. “The tunnel is still dark, with many obstacles that could trip us up if we don’t take care.” If the virus makes a resurgence, will we see it coming and will we have the energy to combat it again?

A group at the National Bureau of Standards at B­oulder, Colo., now reports an extremely accurate [speed of light] measurement using the wavelength and frequency of a helium-neon laser.… The result gives the speed of light as 299,792.4562 kilometers per second.

Update
That 1972 experiment measured the two-way speed of light, or the average speed of photons that traveled from their source to a reflective surface and back. The result, which still holds up, helped scientists redefine the standard length of the meter (SN: 10/22/83, p. 263). But they weren’t done putting light through its paces. In the late 1990s and early 2000s, photons set a record for slowest measured speed of light at 17 meters per second and froze in their tracks for one-thousandth of a second (SN: 1/27/01, p. 52). For all that success, one major hurdle remains: directly testing the one-way speed of light. The measurement, which many scientists say is impossible to make, could resolve the long-standing question of whether the speed of light is uniform in all directions.

Some immune defenses of the brain may have their roots in the gut.

A new study in mice finds that immune cells are first trained in the gut to recognize and launch attacks on pathogens, and then migrate to the brain’s surface to protect it, researchers report online November 4 in Nature. These cells were also found in surgically removed parts of human brains.

Every minute, around 750 milliliters of blood flow through the brain, giving bacteria, viruses or other blood-borne pathogens an opportunity to infect the organ. For the most part, the invaders are kept out by three membrane layers, called the meninges, which wrap around the brain and spinal cord and act as a physical barrier. If a pathogen does manage to breach that barrier, the researchers say, the immune cells trained in the gut are ready to attack by producing a battalion of antibodies.

The most common route for a pathogen to end up in the bloodstream is from the gut. “So, it makes perfect sense for these [immune cells] to be educated, trained and selected to recognize things that are present in the gut,” says Menna Clatworthy, an immunologist at the University of Cambridge.

Clatworthy’s team found antibody-producing plasma cells in the leathery meninges, which lie between the brain and skull, in both mice and humans. These immune cells produced a class of antibodies called immunoglobulin A, or IgA.

These cells and antibodies are mainly found in the inner lining of the gut and lungs, so the scientists wondered if the cells on the brain had any link to the gut. It turned out that there was: Germ-free mice, which had no microbes in their guts, didn’t have any plasma cells in their meninges either. However, when bacteria from the poop of other mice and humans were transplanted into the mice’s intestines, their gut microbiomes were restored, and the plasma cells then appeared in the meninges.

“This was a powerful demonstration of how important the gut could be at determining what is found in the meninges,” Clatworthy says.

Researchers captured microscope images of an attack in the meninges of mice that was led by plasma cells that had likely been trained in the guts. When the team implanted a pathogenic fungus, commonly found in the intestine, into the mice’s bloodstream, the fungus attempted to enter the brain through the walls of blood vessels in the meninges. However, plasma cells in the membranes formed a mesh made of IgA antibodies around the pathogen, blocking its entry. The plasma cells are found along the blood vessels, Clatworthy says, where they can quickly launch an attack on pathogens.

“To my knowledge, this is the first time anyone has shown the presence of plasma cells in the meninges. The study has rewritten the paradigm of what we know about these plasma cells and how they play a critical role in keeping our brain healthy,” says Matthew Hepworth, an immunologist at the University of Manchester in England who was not involved with the study. More research is needed to classify how many of the plasma cells in the meninges come from the gut, he says.

The finding adds to growing evidence that gut microbes can play a role in brain diseases. A previous study, for instance, suggested that in mice, boosting a specific gut bacterium could help fight amyotrophic lateral sclerosis, or ALS, a fatal neurological disease that results in paralysis (SN: 7/22/19). And while the new study found the plasma cells in the brains of healthy mice, previous research has found other gut-trained cells in the brains of mice with multiple sclerosis, an autoimmune disease of the brain and the spinal cord.

For now, the researchers want to understand what cues plasma cells follow in the guts to know it is time for them to embark on a journey to the brain.

When some bacteria manage to escape being killed by a virus, the microbes end up hamstringing themselves. And that could be useful in the fight to treat infections.

The bacterium Shigella flexneri — one cause of the infectious disease shigellosis — can spread within cells that line the gut by propelling itself through the cells’ barriers. That causes tissue damage that can lead to symptoms like bloody diarrhea. But when S. flexneri in lab dishes evolved to elude a type of bacteria-killing virus, the bacteria couldn’t spread cell to cell anymore, making it less virulent, researchers report November 17 in Applied and Environmental Microbiology.

The research is a hopeful sign for what’s known as phage therapy (SN: 11/20/02). With antibiotic-resistant microbes on the rise, some researchers see viruses that infect and kill only bacteria, known as bacteriophages or just phages, as a potential option to treat antibiotic-resistant infections (SN: 11/13/19). With phage therapy, infected people are given doses of a particular phage, which kill off the problematic bacteria. The problem, though, is that over time those bacteria can evolve to be resistant against the phage, too.

“We’re kind of expecting phage therapy to fail, in a sense,” says Paul Turner, an evolutionary biologist and virologist at Yale University. “Bacteria are very good at evolving resistance to phages.”
But that doesn’t mean the bacteria emerge unscathed. Some phages attack and enter bacteria by latching onto bacterial proteins crucial for a microbe’s function. If phage therapy treatments relied on such a virus, that could push the bacteria to evolve in such a way that not only helps them escape the virus but also impairs their abilities and makes them less deadly. People infected with these altered bacteria might have less severe symptoms or may not show symptoms at all.

Previous studies with the bacteria Pseudomonas aeruginosa, for instance, have found that phage and bacteria can engage in evolutionary battles that drive the bacteria to be more sensitive to antibiotics. The new study hints that researchers could leverage the arms race between S. flexneri and the newly identified phage, which was dubbed A1-1 after being found in Mexican wastewater, to treat shigellosis.

S. flexneri in contaminated water is a huge problem in parts of the world where clean water isn’t always available, such as sub-Saharan Africa and southern Asia, says Kaitlyn Kortright, a microbiologist also at Yale University. Every year, approximately 1.3 million people die from shigellosis, which is caused by four Shigella species. More than half of those deaths are in children younger than 5 years old. What’s more, antibiotics to treat shigellosis can be expensive and hard to access in those places. And S. flexneri is becoming resistant to many antibiotics. Phage therapy could be a cheaper, more accessible option to treat the infection.

The blow to S. flexneri’s cellular spread comes because to enter cells, A1-1 targets a protein called OmpA, which is crucial for the bacteria to rupture host cell membranes. The researchers found two types of mutations that made S. flexneri resistant to A1-1. Some bacteria had mutations in the gene that produces OmpA, damaging the protein’s ability to help the microbes spread from cell to cell. Others had changes to a structural component of bacterial cells called lipopolysaccharide.

The mutations in lipopolysaccharide were surprising, Kortright says, because the relationship between that structural component and OmpA isn’t fully worked out. One possibility is that those mutations distort OmpA’s structure in a way that the phage no longer recognizes it and can’t enter bacterial cells.

One lingering question is whether S. flexneri evolves in the same way outside a lab dish, says Saima Aslam, an infectious diseases physician at the University of California, San Diego who was not involved in the work. Still, the findings show that it’s “not always a bad thing” when bacteria become phage-resistant, she says.

The twilight time between fully awake and sound asleep may be packed with creative potential.

People who recently drifted off into a light sleep later had problem-solving power, scientists report December 8 in Science Advances. The results help demystify the fleeting early moments of sleep and may even point out ways to boost creativity.

Prolific inventor and catnapper Thomas Edison was rumored to chase those twilight moments. He was said to fall asleep in a chair holding two steel ball bearings over metal pans. As he drifted off, the balls would fall. The ensuing clatter would wake him, and he could rescue his inventive ideas before they were lost to the depths of sleep.

Delphine Oudiette, a cognitive neuroscientist at the Paris Brain Institute, and colleagues took inspiration from Edison’s method of cultivating creativity. She and her colleagues brought 103 healthy people to their lab to solve a tricky number problem. The volunteers were asked to convert a string of numbers into a shorter sequence, following two simple rules. What the volunteers weren’t told was that there was an easy trick: The second number in the sequence would always be the correct final number, too. Once discovered, this cheat code dramatically cut the solving time.
After doing 60 of these trials on a computer, the volunteers earned a 20-minute break in a quiet, dark room. Reclined and holding an equivalent of Edison’s “alarm clock” (a light drinking bottle in one dangling hand), participants were asked to close their eyes and rest or sleep if they desired. All the while, electrodes monitored their brain waves.

About half of the participants stayed awake. Twenty-four fell asleep and stayed in the shallow, fleeting stage of sleep called N1. Fourteen people progressed to a deeper stage of sleep called N2.

After their rest, participants returned to their number problem. The researchers saw a stark difference between the groups: People who had fallen into a shallow, early sleep were 2.7 times as likely to spot the hidden trick as people who didn’t fall asleep, and 5.8 times as likely to spot it as people who had reached the deeper N2 stage.

Such drastic differences in these types of experiments are rare, Oudiette says. “We were quite astonished by the extent of the results.” The researchers also identified a “creative cocktail of brain waves,” as Oudiette puts it, that seemed to accompany this twilight stage — a mixture of alpha brain waves that usually mark relaxation mingled with the delta waves of deeper sleep.

The study doesn’t show that the time spent in N1 actually triggered the later realization, cautions John Kounios, a cognitive neuroscientist at Drexel University in Philadelphia who cowrote the 2015 book The Eureka Factor: Aha Moments, Creative Insight, and the Brain. “It could have been possible that grappling with the problem and initiating an incubation process caused both N1 and the subsequent insight,” he says, making N1 a “by-product of the processes that caused insight rather than the cause.”

More work is needed to untangle the connection between N1 and creativity, Oudiette says. But the results raise a tantalizing possibility, one that harkens to Edison’s self-optimizations: People might be able to learn to reach that twilight stage of sleep, or to produce the cocktail of brain waves associated with creativity on demand.

It seems Edison was onto something about the creative powers of nodding off. But don’t put too much stock in his habits. He is also said to have considered sleep “a criminal waste of time.”

2021 was the year the COVID-19 vaccines had to prove their mettle. We started the year full of hope: With vaccines in hand in record-breaking time and their rollout ramping up, we’d get shots in arms, curb this pandemic and get life back to normal. That was too optimistic.

Roughly 200 million people in the United States — and billions globally — have now been fully vaccinated. Three vaccines — one from Pfizer and its partner BioNTech, and the other two from Moderna and Johnson & Johnson — are available in the United States. Pfizer’s is even available for children as young as 5. About two dozen other vaccines have also been deployed in other parts of the world. In some higher-income countries, the United States included, people have already queued up for booster shots.

But 2021 has also been the year of learning the limits of the vaccines’ superpowers. With the vaccines pitted against aggressive coronavirus variants, inequitable distribution, some people’s hesitancy and the natural course of waning effectiveness, there’s still a lot of work to do to bring this pandemic to an end. As if to hammer home that point, the detection of the omicron variant in late November brought new uncertainty to the pandemic’s trajectory. Here are some of the top lessons we’ve learned in the first year of the COVID-19 vaccine. — Macon Morehouse
The shots work, even against emerging variants
Many COVID-19 vaccines proved effective over the last year, particularly at preventing severe disease and death (SN: 10/9/21 & 10/23/21, p. 4). That’s true even with the emergence of more transmissible coronavirus variants.

In January, in the midst of a bleak winter surge that saw average daily cases in the United States peaking at nearly 250,000, the vaccination rollout here began in earnest. Soon after, case numbers began a steep decline.

Over the summer, though, more reports of coronavirus infections in vaccinated people began to pop up. Protection against infection becomes less robust in the months following vaccination in people who received Pfizer’s or Moderna’s mRNA vaccines, multiple studies have shown (SN Online: 9/21/21). Yet the shots’ original target — preventing hospitalization — has held steady, with an efficacy of about 80 percent to 95 percent.
A single dose of Johnson & Johnson’s vaccine is less effective at preventing symptoms or keeping people out of the hospital than the mRNA jabs. The company claims there’s not yet evidence that the protection wanes. But even if that protection is not waning, some real-world data hint that the shot may not be as effective as clinical trials suggested (SN Online: 10/19/21).

Evidence of waning or lower protection ultimately pushed the United States and some other countries to green-light COVID-19 booster shots for adults (SN: 12/4/21, p. 6).

Much of the worry over waning immunity came amid the spread of highly contagious variants, including alpha, first identified in the United Kingdom in September 2020, and delta, first detected in India in October 2020 (SN Online: 7/30/21). Today, delta is the predominant variant globally.

The good news is that vaccinated people aren’t unarmed against these mutated foes. The immune system launches a multipronged attack against invaders, so the response can handle small molecular tweaks to viruses, says Nina Luning Prak, an immunologist at the University of Pennsylvania. Dealing with variants “is what the immune system does.”
Vaccine-prompted antibodies still attack alpha and delta, though slightly less well than they tackle the original virus that emerged in Wuhan, China, two years ago. Antibodies also still recognize more immune-evasive variants such as beta, first identified in South Africa in May 2020, and gamma, identified in Brazil in November 2020. Although protection against infection dips against many of these variants, vaccinated people remain much less likely to be hospitalized compared with unvaccinated people.
Experts will continue to track how well the vaccines are doing, especially as new variants, like omicron, emerge. In late November, the World Health Organization designated the omicron variant as the latest variant of concern after researchers in South Africa and Botswana warned that it carries several worrisome mutations. Preliminary studies suggest that, so far, omicron is spreading fast in places including South Africa and the United Kingdom, and can reinfect people who have already recovered from an infection. The variant might be at least as transmissible as delta, though that’s still far from certain, according to a December 9 report from researchers with Public Health England, a U.K. health agency. How omicron may affect vaccine effectiveness is also unclear. Pfizer’s two-dose shot, for instance, may be about 30 percent effective at preventing symptoms from omicron infections while a booster could bring effectiveness back up to more than 70 percent, according to estimates from Public Health England. But those estimates are based on low case numbers and could change as omicron spreads.

“This is the first time in history that we’re basically monitoring virus mutations in real time,” says Müge Çevik, an infectious diseases physician and virologist at the University of St. Andrews in Scotland. “This is what the viruses do. It’s just that we’re seeing it because we’re looking for it.”

But it’s unlikely that any new variant will take us back to square one, Çevik says. Because of the immune system’s varied defenses, it will be difficult for a coronavirus variant to become completely resistant to vaccine-induced protection. The vaccines are giving our immune systems the tools to fight back. — Erin Garcia de Jesús

The shots are safe, with few serious side effects
With billions of doses distributed around the world, the shots have proved not only effective, but also remarkably safe, with few serious side effects.

“We have so much safety data on these vaccines,” says Kawsar Talaat, an infectious diseases physician at the Johns Hopkins Bloomberg School of Public Health. “I don’t know of any vaccines that have been scrutinized to the same extent.”

Commonly reported side effects include pain, redness or swelling at the spot of the shot, muscle aches, fatigue, fever, chills or a headache. These symptoms usually last only a day or two.
More rare and serious side effects have been noted. But none are unique to these shots; other vaccines — plus infectious diseases, including COVID-19 — also cause these complications.

One example is inflammation of the heart muscle, known as myocarditis, or of the sac around the heart, pericarditis. Current estimates are a bit squishy since existing studies have different populations and other variables (SN Online: 10/19/21). Two large studies in Israel estimated that the risk of myocarditis after an mRNA vaccine is about 4 of every 100,000 males and 0.23 to 0.46 of every 100,000 females, researchers reported in October in the New England Journal of Medicine. Yet members of Kaiser Permanente Southern California who had gotten mRNA vaccines developed myocarditis at a much lower rate: 5.8 cases for every 1 million second doses given, researchers reported, also in October, in JAMA Internal Medicine.

What all the studies have in common is that young males in their teens and 20s are at highest risk of developing the side effect, and that risk is highest after the second vaccine dose (SN Online: 6/23/21). But it’s still fairly rare, topping out at about 15 cases for every 100,000 vaccinated males ages 16 to 19, according to the larger of the two Israeli studies. Males in that age group are also at the highest risk of getting myocarditis and pericarditis from any cause, including from COVID-19.
Components of the mRNA vaccines may also cause allergic reactions, including potentially life-threatening anaphylaxis. The U.S. Centers for Disease Control and Prevention calculated that anaphylaxis happens at a rate of about 0.025 to 0.047 cases for every 10,000 vaccine doses given.

But a study of almost 65,000 health care system employees in Massachusetts suggests the rate may be as high as 2.47 per 10,000 vaccinations, researchers reported in March in JAMA. Still, that rate is low, and people with previous histories of anaphylaxis have gotten the shots without problem. Even people who developed anaphylaxis after a first shot were able to get fully vaccinated if the second dose was broken down into smaller doses (SN Online: 6/1/21).

The only side effect of the COVID-19 vaccines not seen with other vaccines is a rare combination of blood clots accompanied by low numbers of blood-clotting platelets. Called thrombosis with thrombocytopenia syndrome, or TTS, it’s most common among women younger than 50 who got the Johnson & Johnson vaccine or a similar vaccine made by AstraZeneca that’s used around the world (SN Online: 4/23/21).
About 5 to 6 TTS cases were reported for every 1 million doses of the J&J vaccine, the company reported to the U.S. Food and Drug Administration. The clots may result from antibodies triggering a person’s platelets to form clots (SN Online: 4/16/21). Such antibodies also cause blood clots in COVID-19 patients, and the risk of developing strokes or clots from the disease is much higher than with the vaccine, Talaat says. In one study, 42.8 of every 1 million COVID-19 patients developed one type of blood clot in the brain, and 392.3 per 1 million developed a type of abdominal blood clot, researchers reported in EClinicalMedicine in September.

“Your chances of getting any of these side effects, except for the sore arm, from an illness with COVID are much higher” than from the vaccines, Talaat says. — Tina Hesman Saey

Getting everyone vaccinated is … complicated
The quest to vaccinate as many people as quickly as possible this year faced two main challenges: getting the vaccine to people and convincing them to take it. Strategies employed so far — incentives, mandates and making shots accessible — have had varying levels of success.

“It’s an incredibly ambitious goal to try to get the large majority of the country and the globe vaccinated in a very short time period with a brand-new vaccine,” says psychologist Gretchen Chapman of Carnegie Mellon University in Pittsburgh, who researches vaccine acceptance. Usually “it takes a number of years before you get that kind of coverage.”
Globally, that’s sure to be the case due to a lack of access to vaccines, particularly in middle- and lower-income countries. The World Health Organization set a goal to have 40 percent of people in all countries vaccinated by year’s end. But dozens of countries, mostly in Africa and parts of Asia, are likely to fall far short of that goal.

In contrast, the United States and other wealthy countries got their hands on more than enough doses. Here, the push to vaccinate started out with a scramble to reserve scarce appointments for a free shot at limited vaccination sites. But by late spring, eligible people could pop into their pharmacy or grocery store. Some workplaces offered vaccines on-site. For underserved communities that may have a harder time accessing such vaccines, more targeted approaches where shots are delivered by trusted sources at community events proved they could boost vaccination numbers (SN Online: 6/18/21).

Simply making the shot easy to get has driven much of the progress made so far, Chapman says. But getting people who are less enthusiastic has proved more challenging. Many governments and companies have tried to prod people, initially with incentives, later with mandates.
Free doughnuts, direct cash payments and entry into million-dollar lottery jackpots were among the many perks rolled out. Before the pandemic, such incentives had been shown to prompt some people to get vaccines, says Harsha Thirumurthy, a behavioral economist at the University of Pennsylvania. This time, those incentives made little difference nationwide, Thirumurthy and his colleagues reported in September in a preliminary study posted to SSRN, a social sciences preprint website. “It’s possible they moved the needle 1 or 2 percentage points, but we’ve ruled out that they had a large effect,” he says. Some studies of incentives offered by individual states have found a marginal benefit.

“People who are worried about side effects or safety are going to be more difficult to reach,” says Melanie Kornides, an epidemiologist at the University of Pennsylvania. And with vaccination status tangled up in personal identity, “you’re just not going to influence lots of people with a mass communication campaign right now; it’s really about individual conversations,” she says, preferably with someone trusted.
“Or,” she adds, “they’re going to respond to mandates.” Historically, sticks such as being fired from a job or barred from school are the most effective way of boosting vaccination rates, Kornides says. For example, hospitals that require flu shots for workers tend to have higher vaccination rates than those that don’t. For decades, mandates in schools have helped push vaccination rates up for diseases like measles and chickenpox, she says.

As COVID-19 mandates went into effect in the fall, news headlines often focused on protests and refusals. Yet early anecdotal evidence suggests some mandates have helped. For instance, after New York City public schools announced a vaccine requirement in late August for its roughly 150,000 employees, nearly 96 percent had received at least one shot by early November. Still, about 8,000 employees opted not to get vaccinated and were placed on unpaid leave, the New York Times reported.

Many people remain vehemently opposed to the vaccines, in part because of rampant misinformation that can spread quickly online. Whether more mandates, from the government or private companies, and targeted outreach will convince them remains to be seen. — Jonathan Lambert

Vaccines can’t single-handedly end the pandemic
One year in, it’s clear that vaccination is one of the best tools we have to control COVID-19. But it’s also clear vaccines alone can’t end the pandemic.

While the jabs do a pretty good job preventing infections, that protection wanes over time (SN Online: 3/30/21). Still, the vaccines have “worked spectacularly well” at protecting most people from severe disease, says Luning Prak, the University of Pennsylvania immunologist. And as more people around the world get vaccinated, fewer people will die, even if they do fall ill with COVID-19.

“We have to make a distinction between the superficial infections you can get — [like a] runny nose — versus the lower respiratory tract stuff that can kill you,” such as inflammation in the lungs that causes low oxygen levels, Luning Prak says. Preventing severe disease is the fundamental target that most vaccines, including the flu shot, hit, she notes. Stopping infection entirely “was never a realistic goal.”
Because vaccines aren’t an impenetrable barrier against the virus, we’ll still need to rely on other tactics to help control spread amid the pandemic. “Vaccines are not the sole tool in our toolbox,” says Saad Omer, an epidemiologist at Yale University. “They should be used with other things,” such as masks to help block exposure and COVID-19 tests to help people know when they should stay home.

For now, it’s crucial to have such layered protection, Omer says. “But in the long run, I think vaccines provide a way to get back to at least a new normal.” With vaccines, people can gather at school, concerts or weddings with less fear of a large outbreak.

Eventually the pandemic will end, though when is still anyone’s guess. But the end certainly won’t mean that COVID-19 has disappeared.

Many experts agree that the coronavirus will most likely remain with us for the foreseeable future, sparking outbreaks in places where there are pockets of susceptible people. Susceptibility can come in many forms: Young children who have never encountered the virus before and can’t yet get vaccinated, people who choose not to get the vaccine and people whose immunity has waned after an infection or vaccination. Or the virus may evolve in ways that help it evade the immune system.

The pandemic’s end may still feel out of reach, with the high hopes from the beginning of 2021 a distant memory. Still, hints of normalcy have returned: Kids are back in school, restaurants and stores are open and people are traveling more.

Vaccines have proved to be an invaluable tool to reduce the death and destruction that the coronavirus can leave in its wake. — Erin Garcia de Jesús

The Denver Nuggets will be without their superstar and the league's reigning MVP Nikola Jokic when they take on the Bulls at home.

This is the first game that Jokic will miss this season due to an injury, with the only other game he didn't suit up for so far was due to a suspension, following his altercation with the Miami Heat's Markieff Morris.
Through 14 games, he's averaging career-highs of 26.4 points and 13.6 rebounds while also dishing out 6.4 assists on career-high shooting efficiencies of 59.3 percent from the field and 41.0 percent from beyond the arc.
What's next for Jokic? Here's everything we know about his injury.

What is Nikola Jokic's injury?
Hours before the game against the Bulls, the Nuggets declared Jokic out with a right wrist sprain.
It's an injury that the Serbian big man reportedly suffered midway through the team's previous game, a home loss against the Philadelphia 76ers. Although he played until the end, he was seen favouring it in the second half.

How long is Nikola Jokic out?
It's currently unknown if Jokic will miss more than one game. In addition, the Nuggets will be without other key young stars in Jamal Murray (ACL) and Michael Porter Jr. (back).

The Serbian has been one of the most reliable players in his career, having missed just 20 games through his six previous seasons.

Nuggets upcoming schedule
The Nuggets enter this Bulls game with a 9-6 record, good for sixth in the West prior to Friday's games.

After this Bulls game, Denver will kick-off a road-heavy schedule as they play nine of their next 10 games away from home.

Date Opponent Time (ET)
Nov. 21 at Suns 8:00 p.m.
Nov. 23 at Trail Blazers 10:00 p.m
Nov. 26 vs. Bucks 9:00 p.m
Nov. 29 at Heat 7:30 p.m
Dec. 1 at Magic 7:00 p.m
Currently, the Nuggets rank third in defensive rating (103.8) and 20th in offensive rating (106.2).