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Nebraskans find that practical steps may minimize side effects from vaccine
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With many more Nebraskans now lining up for first and second shots of COVID-19 vaccines, chatter around who had what side effects — a fever or sore arm versus none at all — have become commonplace.

The full list of common, short-term effects includes soreness or swelling at the injection site, fatigue, joint and/or muscle pain, fever and/or chills, headache, nausea and swollen lymph nodes.

The good news: Those temporary responses mean your immune system is up and firing, preparing your body to combat coronavirus invaders. The better news: Just because you didn’t have much in the way of side effects doesn’t mean the vaccine didn’t work for you or that you didn’t have a strong immune response.

“Everybody is different,” said Dr. Rudolf Kotula, an infectious diseases physician with Methodist Health System. “There are some people who have side effects. Some people don’t know it was ever done.”

That said, there are some indications that younger people mount a more vigorous immune response than older people do. Women may have a stronger response than men, given they are generally thought to have stronger immune responses. Part of that may be due to the fact that some of the human immune response is encoded on the X chromosome, said Dr. Mark Rupp, chief of the University of Nebraska Medical Center’s infectious diseases division. Women have two X chromosomes and men have one.

With increased vaccine supplies, children 16 and older now have begun to get shots. The Pfizer vaccine has emergency authorization for people 16 and older and the Moderna shots have gotten the emergency OK for those 18 and older. (Johnson & Johnson’s vaccine also has been given emergency authorization for those 18 and older, but government health officials have called for a pause in the use of that vaccine after six women in the U.S. developed a rare clotting condition after they were vaccinated.)

Dr. Alice Sato, a pediatric infectious diseases physician with Children’s Hospital & Medical Center, said health officials don’t expect reactions among older teens to differ much from those in young adults.

Pfizer recently requested emergency approval from the FDA to begin using its vaccine in 12- to 15-year-olds. The company said its Phase 3 clinical trials showed its vaccine was safe and 100% effective in that age group.

Sato said additional studies will be needed in younger children to make sure the vaccines are safe for them and to determine proper dosing. Children’s and UNMC already have signed on to participate in trials of the Pfizer vaccine in pregnant women and children and in children ages 5 to 17.

The most important thing, Kotula said, is for people to get the shots. Recent data indicate that both the Pfizer and Moderna vaccines remain more than 90% effective six months out.

“Vaccinate with confidence,” he said. “That’s my message.”

Rupp said the nation needs to be pushing aggressively to get people vaccinated with the Pfizer and Moderna shots while waiting for federal officials to make a recommendation on the Johnson & Johnson shot.

White House officials said earlier this week that the U.S. has secured enough doses of the Pfizer and Moderna vaccines — which are based on different technology from the Johnson & Johnson shot — for 300 million Americans.

Kotula said it’s also important that people not skip the second dose because it boosts protection.

Why some people report more intense reactions to their second shot isn’t certain. And it may not be the same for everyone.

There is some thought that people’s bodies may respond more vigorously to a second dose because they already have antibodies ready and able to respond more quickly.

Any effects from the shots, however, should resolve within a day or two. If people experience unusual symptoms, said Dr. David Quimby, an infectious diseases physician with CHI Health, they should contact their health care provider.

While there’s not much scientifically proven guidance for minimizing common side effects from the vaccines or for maximizing your immune response, some practical advice is available. You’ve probably already heard it from your mother, and it applies to maintaining good health in general: get good rest, eat well and stay well-hydrated.

A few other practical steps people can take that may help minimize discomfort:

Take acetaminophen or ibuprofen

If you’re not otherwise medically prohibited, you can take these drugs in moderation to relieve discomfort.

Should you front-load them to head off a reaction or wait until you feel the effects?

Methodist’s Kotula said the federal Centers for Disease Control and Prevention recommend against taking pain and fever relievers before the shots. “There are no studies to support it, but that’s what they say,” he said.

Dr. David Quimby, an infectious diseases physician with CHI Health, said most of the information on the topic comes from studies in children. There’s some indication that kids who take ibuprofen before a single-dose vaccine might not get the same antibody response as if they took it later. With multi-dose vaccines, it’s less of a factor. Many vaccines that children receive, such as the measles, mumps and rubella shots, are administered in multiple doses.

With the COVID-19 vaccines, however, researchers don’t yet know whether taking the medications beforehand affects immune responses. Given that, Quimby said, it’s best to wait. “Why take something and take the chance that (it) might blunt your response?” he said.

Rupp agreed that he would recommend not starting off with the medications unless a person had a particularly vigorous response to the first shot.

Don’t like taking medication? Try applying a cool, wet cloth or compress to the injection site to alleviate pain and swelling. Sato, from Children’s, said a warm compress also may help.

Stay hydrated

While there’s no solid evidence for this, Quimby said, a lot of people run low on hydration, particularly if they drink caffeinated beverages that don’t hydrate well. Those who aren’t adequately hydrated are more prone to headaches and other effects, which can be similar to the shot’s side effects.

“It’s one of those things that’s not going to hurt,” he said, noting that the exception is a small group of people with certain heart or kidney conditions.

Kotula said people generally feel better when they’re properly hydrated. He equated proper hydration before the shots with eating a cracker when taking medication.

Move your arm, but avoid strenuous activity

Why does your arm hurt in the first place?

“At the tissue and cell level, there’s a whole lot of angry inflammation there,” Quimby said, “because your body’s saying this doesn’t belong.”

Some experts suggest moving your vaccinated arm may help reduce soreness. The idea is to increase blood flow to the arm and diffuse the vaccine away from the muscle. And while many people opt to get shots in their nondominant arm, some experts recommend getting them in your dominant arm because you naturally move it more.

But in general, it also may be a good idea to avoid strenuous activity for at least 24 hours afterward. “You don’t know how the vaccine is going to affect you,” Kotula said.

The vaccine, Rupp said, “clearly continues to be people’s best bet for avoiding COVID-19 and all of the really serious problems that go with it. So putting up with a few days of discomfort is a small price to pay for protecting yourself, your family and loved ones ... and the community.”

Now that you’re vaccinated, here's what you can and can’t do

Douglas County landfill workers accused of conspiracy to turn trash into cash
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Something smells at Douglas County’s landfill, and authorities say it isn’t just the scent of garbage and diesel fumes.

Five employees who worked in the weighhouse at the Pheasant Point Landfill and two business owners who dumped refuse there have been charged with conspiracy to commit theft in a scheme that could date back decades.

In the scheme, authorities allege, employees of the weighhouse would decrease the weight of a dump truck as it arrived at the landfill so the dump truck’s owner would have to pay the bare minimum for dumping tons of trash.

Membership had its privileges: Employees would signal who got the reduced dump fees by calling out: “He’s my guy.” Many of those would get a $20 or $26 flat fee instead of the hundreds of dollars they should have paid.

In return, the dump trucks’ owners would line the weighhouse employees’ pockets with cash, gift cards, even hams.

One employee allegedly stole enough to pay nearly $8,000 in cash for a 2015 Ford Fusion.

It is unclear how much money was stolen — the Douglas County Sheriff’s Office evaluated anywhere from three to six months of activity over the past year. An analyst estimated that the landfill’s contractor lost $350,000 over the past three years.

Revenue from the landfill is split among several entities: the county, the state, landowner Donald Graham and the trash contractor.

Some employees told sheriff’s investigators that grifting has been going on since 1995. The statute of limitations for felony theft is three years.

Douglas County Attorney Don Kleine said he expects more to come out of the investigation. He and detectives from the Douglas County Sheriff’s Office wanted to get the court cases moving to send a message.

“There’s still work being done to put together who all is involved and exactly how much money was being skimmed off,” Kleine said. “But we needed to get this going. The message needs to be sent that this is not something that can be tolerated in any way, shape or form.”

Some of the charged employees were working there up until last week. Others were retired. The employees charged with conspiracy to commit theft are: James E. Sudyka, 66; Mark Huntley, 68; Mark Helmberger, 53; Anahi Lara, 24; and Suzanne Swanson, 36.

Business owners who are accused in the theft conspiracy include Gary Cooper, 63, owner of Clean Up Containers, and Hector Flores, 42, owner of Hector Flores Roofing.

Attorneys for those charged either could not be reached Friday or declined to comment.

According to the sworn affidavit of Mike DeChellis, a Douglas County sheriff’s deputy and investigator in the case:

On Nov. 12, Kent Holmes, supervisor of Douglas County Environmental Services, called the Sheriff’s Office to report that employees were failing to properly weigh all vehicles entering and leaving, thus “substantially” lowering “the amount that was actually owed.” Holmes told the Sheriff’s Office he became aware of the matter when Waste Management sent three weighhouse employees home on suspicion of theft in October: Sudyka, Lara and Swanson.

Holmes told sheriff’s officials how the system is supposed to work: Vehicles get weighed as they come into the landfill near 216th Street and Nebraska Highway 36 — and those weights are recorded. They go and dump their contents in the designated area and then return to the exit lanes of the weighhouse to be weighed again.

Some employees worked out a system where they would manually adjust the computer that recorded the weights of incoming vehicles, decreasing them by tons. As the now-emptied vehicles exited, the system would record that they owed nothing, or only the bare minimum. In some cases, the trucks were allowed to drive by the scale without weighing.

An internal investigation by Waste Management analyzed activity at the weighhouse from June 5 to Aug. 20. The auditor spotted vehicles that were weighing in and out of the weigh station too quickly. He compared the receipts to video taken at the weighhouse. During those 12 weeks, for example, the auditor found that five employees lowered Cooper’s Cleanup Containers’ dump fees 336 times. Based on that pace, the Waste Management auditor estimated that the company lost $350,000 over three years.

Confronted by a sheriff’s deputy about his container company receiving a benefit, Cooper told sheriff’s deputies that he knew for a year or two that he was receiving a discount. Deputies said Cooper told them “he did not ask for this discount, but knew it was happening.” Sheriff’s deputies said the scheme saved Cooper $38,000 a year.

Another employee told investigators that she was “aware of Sudyka and other now retired employees taking money from the scale house illicitly since 1995.” They did so by creating false tickets and keeping the illegitimate cash separate from the legitimate payments, according to the Sheriff’s Office.

In 2019, an employee said, Lara let it be known that she needed money for a new car. Huntley took the cash reserve into the back room of the weighhouse and left it there. The employee said she watched Lara walk to the back room and return with a wad of cash in her hand. Soon after, Lara paid $7,750 in cash for a 2015 Ford Fusion.

In 2020, a manager became suspicious after cash amounts dropped significantly. His suspicion prompted an internal investigation.

Sudyka reportedly told investigators that “each employee had their customers they gave a discount to.”

“Staff would lower their fee to $20 and that was what the customer would pay,” the investigator’s affidavit said. “Sudyka admitted this was substantially less than the amount that was actually owed.”

Sudyka denied stealing any cash from the scale house “but later admitted that he stole $20 a week from transactions with customers.”

One contractor provided deputies with receipts from his trips to the landfill. In the traditional trips, where everything was done by the book, the contractor paid an average of $125 per load. In the cooked trips, the average weight was between $20 and $35 per load.

Helmberger told deputies that “discounts had been given to some individuals” since he began working at the landfill in 2007. He alleged that Sudyka “would frequently leave amounts of cash between $17 and $100 lying out” in the back room.

“Helmberger would then go into the back room and take that money, which he described as a ‘tip,’” the affidavit says.

DeChellis, the investigator, went on to write that he “has worked for Douglas County government for more than 13 years and … is not aware of any county government position in which it is customary, acceptable or legal to accept cash ‘tips’ as a reward for performing governmental duties.”

Maureen Boyle, a Douglas County Board member who is the chair of the board’s environmental services committee, said Friday that the allegations are “very disappointing as a taxpayer and as a commissioner.”

“Those who are accused, if it’s proven, they will be dealt with accordingly,” Boyle said.

Kleine said more likely will come out of the case. Another angle that could be investigated: whether the weighhouse employees increased the weight on private vehicles (such as pickups with their back ends full) to charge citizens $5 to $10 more per load.

“There’s all kinds of ways that you can cheat,” Kleine said. “It’s always possible that’s part of it. Who knows what else will come of this.”

In such a cash-heavy business, Kleine said, the county will have to increase its controls and its supervision to prevent future theft.

World-Herald Staff Writer Bob Glissmann contributed to this report.

Notable Nebraska crime news of 2021

Not the same 'Omaha' NCAA tournament feel, but businesses and teams are dealing with changes
  • Updated

Unbeknownst to the casual passerby, a full-fledged NCAA tournament is taking place in downtown Omaha.

It’s not drawing big crowds: That’s not allowed. Fans from around the country aren’t tailgating in parking lots.

But look closer, and you’ll see evidence.

A Starbucks coffee bar inside the Marriott Hotel across the street from the CHI Health Center is a good place to start. Manager P.J. Thomas says business has spiked since 48 teams from across the country descended on downtown hotels.

“We’re much busier than we’ve been the last four or five months,” Thomas said. “It’s definitely a huge jump.”

But walk around the streets outside the CHI Health Center arena and you’ll see just a few people, unless you happen to spy a team heading to a match.

That’s all according to plan. The teams are here, sans fans other than family and a few others. Mostly it’s volleyball and then back to the hotel.

And testing. Lots of testing.

A COVID test is part of the routine for players and coaches — it’s a given every day, according to Nebraska coach John Cook.

As one Huskers spokesperson put it: “They test, they eat, they practice, they play, they lift weights, they relax.”

There’s a team meeting room in the hotel where the Huskers gather and watch movies or other NCAA games. They enjoy an outing if weather allows and they don’t have a game that day.

The Nebraska players, for instance, visited Henry Doorly Zoo & Aquarium, an activity that’s on an NCAA-approved list of COVID-safe excursions. Pittsburgh coach Dan Fisher said after his team’s second-round win Thursday that his players planned to do the same.

Ohio State put together an event called Buckeye Olympics, where they played various games like pingpong to pass the time.

Some squads, like Purdue, aren’t spending all of their time together.

“It’s kind of weird,” said Caitlyn Newton, a senior outside hitter. “We all have our own hotel rooms. We spend a lot of time by ourselves.”

The postseason experience certainly hasn’t been ideal, given the limitations of the pandemic, Florida coach Mary Wise said. She got back to her hotel after Thursday’s match and didn’t know when her team would be allowed to practice next.

But Wise thinks players are making the most of their time in Omaha, and she’s grateful for the behind-the-scenes staffers who’re helping them do it.

“You come to Omaha you know you’re going to meet the nicest, kindest people,” Wise said. “And now we’ve got all these really nice and kind people trying to pull this off. I think it puts off an incredible vibe and Omaha should be very proud.”

For Omahans who are used to witnessing the hubbub of the College World Series and early rounds of the NCAA men’s basketball tournament, this is nothing like that.

Still, restaurants around the CHI Health Center seem to be benefiting somewhat.

About half of DJ’s Dugout, a sports bar, was occupied during a recent lunch hour, with many watching volleyball matches play out on the big screens.

“In a normal year, we would be full,’’ said Sean Glen, a manager. “The restaurant would be at capacity and lines out the door.”

He said he’s still grateful for the waves of business, as volleyball parents stop in for lunch or dinner before heading across the street to watch their daughters play.

Back at the Marriott Starbucks, Thomas said he had 240 tickets for food and drink Wednesday compared to about 40 or 50 the day before. He watched as his staff served a group of players from Wisconsin, who are among five Big Ten teams staying at the Capitol District Marriott, including Nebraska.

“Coffee is a game day necessity,” said Deahna Kraft, a defensive specialist and outside hitter for the Badgers.

At the Hilton, connected to the CHI Center by skywalk, players filled the chairs in the lobby on a recent day. General Manager Robert Sabin declined to say how many teams were staying there, but the hotel is making sure, with their CleanStay protocols, to safeguard all the teams as much as possible from the virus.

They opened their grab-and-go store near the entrance last week in anticipation of the tournament.

“Sales are better than we anticipated,” he said “It’s been very active in there.”

Adrian Leiser, a volunteer coach for Weber State, was getting ready to make a run to the grocery store for water and snacks.

He had nothing but good things to say about the takeout the team has ordered at places like the Blackstone Meatball, Lighthouse Pizza and Voodoo Taco.

“The local food has been awesome here,” he said.

Teams ordering takeout have been a boon for restaurants. Patrik Strate at the Blackstone Meatball was preparing a takeout dinner for 27, making sure to satisfy all the COVID-19 protocols. Classic beef marinara has been a favorite.

“It’s been a nice little boost of revenue,” Strate said. “Having something like a sporting event makes you feel more back to normal.”

Others teams are relying on the catering at their hotel.

Marriott General Manager Steve Hilton said staff has created zones for each of the teams there, with a dedicated room where they can eat meals and dedicated spaces where you’ll find 15 to 25 rooms blocked off for teams and their personnel. Cook, the Nebraska coach, approves.

“I have a really nice room. Great view of Omaha and the Missouri River, so I’m pretty happy.”

The Marriott typically provides two meals a day, depending on each team’s schedule.

“We’re extremely busy,” Hilton said. “We’re glad to be at that level of business.”

The Huskers have gotten takeout a few times, with NU sophomore Madi Kubik saying Clean Juice for breakfast Thursday is one of her favorites.

Former Texas State coach Karen Chisum, a tournament veteran, was enjoying lunch at DJ’s Dugout with several parents. The first days of the event have been quieter than what she’s been used to, she said.

The parents said they liked having the format in one place, giving them the same experience as the bigger teams although they rarely see the players out and about.

It’s also irritating not to get to see those same teams in action, Chisum said. Although she said the Bobcats were excited to be in Omaha, she wishes the NCAA would have spread the games around to other venues.

“Every coach will tell you this,” she said. “It’s like a club tournament. The kids should have a better experience than what they are having.”

Cook said teams walk in, throw their stuff down and play. Wisconsin coach Kelly Sheffield joked Thursday that the Badgers might have to get a campfire going next to their courtside tent, which is substituting as a game day locker room.

Purdue coach Dave Shondell said his players were allowed just 30 minutes to warm up Thursday on a convention center court they’d never seen before — then had to compete in a do-or-die second-round match.

“This has been unique,” Shondell said. “The NCAA’s doing a great job. No complaints at all about the NCAA. It’s just COVID, and all of the testing, and the back and forth from the hotel, to the gym, back to the hotel, to the gym.”

The challenge for teams, Shondell said, is to embrace the new set of circumstances. But perhaps things will normalize some as the tournament field shrinks and its matches move into the CHI Health Center arena next week.

For the city, this tournament is the kickoff to a busy summer, the Hilton’s Sabin said. There’s club volleyball and basketball tournaments ahead as well as the U.S. Swim Trials and the CWS.

It’s been a different event from those, Marriott’s Hilton said, but he says things will start to change in the next few days as more people are allowed into matches.

“It should grow,” he said. “We expect to see more traffic arriving on the weekend.”

Photos: Nebraska takes on Texas State in NCAA volleyball tournament