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been specifically and significantly connected to the HPV vaccination as an autoimmune reaction over
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and over again. POTS as an autoimmune disease triggered by vaccination has been established. Indeed,
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the connection between POTS and HPV vaccination in the peer-reviewed literature is undeniable.⁵
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Second, in Japan, the government recognized these symptoms of POTS following vaccination
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for HPV shortly after the vaccination was introduced. Unlike in the United States, Japan took action.
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The Japanese Ministry of Public Health withdrew recommendation for the HPV vaccination due to a
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significant number of adolescent girls developing these constellations of symptoms. The withdrawal of
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HPV vaccination recommendation in Japan occurred in 2014. Dr. Shu-ichi Ikeda, one of the medical
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practitioners in Japan who originally investigated the spike in POTS cases following the introduction of
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vaccination, published an article in 2019 discussing the fact that, once recommendation for HPV
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vaccination was withdrawn from the market in Japan, new cases of autonomic dysfunction all but
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⁴ For Plaintiff’s cited cases, please see Appendix B
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⁵ See Appendix B
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PLAINTIFF JENNIFER ROBI’S AMENDED OPPOSITION TO MERCK DEFENDANTS’ MOTION IN LIMINE NO. 25
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STRATEGIC OBJECTIVE 4: ADVOCATE PEOPLE-CENTRED HEALTH SYSTEMS THAT ARE ENABLED BY DIGITAL HEALTH
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Proposed Actions Short-term (1-2 years) Medium-term (2-4 years) Long-term (4-6 years)
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feedback for validating the performance of digital health tools and services. • Develop global minimum standards for electronic health records. • Develop global guidance on personalized medicine. • Develop an ethics framework for technologies for health, to support countries in strengthening public trust in digital health inside or outside the context of a public health emergency. • Promote ethics, governance and security in handling and processing data for research or for other data-sharing requirements for the public good. • Identify the core competencies of digital health literacy that might be included in education and training curricula of health professionals and allied workers. • Support Member States to identify and implement appropriate digital health interventions combined with appropriate health and data content across interoperating digital systems to address quality, coverage and equity goals within the health system. • Scan the landscape of projects and initiatives that use population health management and gender-equality approaches through digital health solutions to move health and well-being from reactive care models to active community- based models. health service with a focus on patient’s managed quality of service. • Synthesize international research results and disseminate evidence on the contribution of digital health interventions to performance of health systems and their impact on people- centred outcomes, including universal health coverage, with an essential package of interventions.
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Proposed actions by partners • Collaborate with the Secretariat in supporting countries in prioritizing an accessible tool for literacy in digital health technologies, digitization, digitalization and change management. • Collaborate with the Secretariat in developing a framework allowing individual feedback in validating the performance of digital health tools and services, with partners’ expertise. • Support the Secretariat in developing global minimum standards for electronic patient health records and their implementation. • Develop and promote the use of tools that support digitalizing processes at health service centres or relevant occasions with a focus on patients’ empowerment, standardized processes and managed quality of service.
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STRATEGIC OBJECTIVE 4: ADVOCATE PEOPLE-CENTRED HEALTH SYSTEMS THAT ARE ENABLED BY DIGITAL HEALTH
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Proposed Actions Short-term (1-2 years) Medium-term (2-4 years) Long-term (4-6 years)
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• Support the Secretariat in developing global guidance on personalized medicine and its implementation. • Support the Secretariat in developing ethics frameworks for technologies for health, and supporting countries in strengthening public trust in digital health including in the context of a public health emergency. • Support countries to adopt and effectively use person-centric digital technologies for the health workforce to facilitate evidence-based decision-making and strengthen health systems’ accountability. • Support countries to identify and implement appropriate digital health interventions, including in the context of a public health emergency combined with appropriate health data across interoperating digital health systems to achieve increased quality, coverage and accessibility of health care.
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4. Supplement the Health Care Workforce
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Practical Considerations
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Local level:
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Hire needed personnel through staffing agencies with existing contracts / relationships.
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When limitations exist, identify additional agencies able to provide the necessary personnel.
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Refer to and implement health care coalition (HCC) staff sharing plans.
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Consider using MRC or other volunteers, further discussed in the Engage Health Care Workforce Volunteers section.
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Consider contacting recently retired personnel who are still skilled and knowledgeable to return to supplement staffing needs.
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State Level:
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Exercise contractual agreements with state health departments or other agencies to address staffing shortages. During the pandemic, some states executed contracts with staffing firms and then allocated staff to hospitals based on the need to maintain a consistent level of care and avoid bidding wars between health care systems.
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Reassign staff under Section 319 of the Public Health Service (PHS) Act. This provision allows a state governor, tribal leader, or designee to request the temporary reassignment of state and local public health department or agency personnel funded in whole or in part through programs authorized under the PHS Act to immediately address a public health emergency.
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Determine available licensure waivers and flexibilities.
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Expand scope of practice.
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Determine capabilities of the National Guard.
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Identify service members who serve as health care providers in non-clinical positions who can be quickly trained to increase staffing.
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Some states have rapidly trained National Guard personnel to serve as health care assistants so they can support long-term care and other health care facilities.
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Ensure soldiers currently working in a clinical setting are not pulled from their communities for these types of assignments.
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Review additional planning considerations and examples of how soldiers were used to supplement the COVID-19 response.
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Request assistance through the Emergency Management Assistance Compact (EMAC).
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EMAC is a national disaster-relief compact that allows states to send personnel to assist with response and recovery efforts in other states.
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