Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

__

Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Apple drags on S&P, Nasdaq; Dell jumps after report

NEW YORK (Reuters) - The S&P 500 and Nasdaq ended lower on Monday as worries over demand for Apple products drove down its shares and investors braced for earnings disappointments.

Running counter to that was Dell Inc's stock which jumped 13 percent to about a five-month high at $12.29 after Bloomberg reported the No. 3 personal computer maker is in talks with private equity firms to go private. Dell's gains offset some tech-sector weakness.

Tech heavyweight Apple lost 3.6 percent to $501.75 and was the biggest weight on both the S&P 500 and Nasdaq 100 <.ndx> indexes after reports the company has cut orders for LCD screens and other parts for the iPhone 5 this quarter due to weak demand. The stock hit a session low of $498.51, the first dip below $500 since February 16.

"With Apple, it seems as if the sentiment has shifted from this being the one stock that everybody wanted to own to people beginning to look at it as a company (whose) business is slowing down somewhat," said Eric Kuby, chief investment officer of North Star Investment Management Corp in Chicago.

Adding to investor unease, fourth-quarter earnings kick into high gear this week. Analyst estimates for the quarter have fallen sharply since October. S&P 500 earnings growth is now seen up just 1.9 percent from a year ago, Thomson Reuters data showed.

The Dow Jones industrial average <.dji> was up 18.89 points, or 0.14 percent, at 13,507.32. The Standard & Poor's 500 Index <.spx> was down 1.37 points, or 0.09 percent, at 1,470.68. The Nasdaq Composite Index <.ixic> was down 8.13 points, or 0.26 percent, at 3,117.50.

Apple suppliers also lost ground, with Cirrus Logic off 9.4 percent at $28.62 and Qualcomm down 1 percent at $64.24.

The Dow fared better than the other two indexes, helped in part by Hewlett-Packard shares, which rose 4.9 percent to $16.95. The stock, up early in the session after JPMorgan upgraded its rating on the shares and raised its price target to $21 from $15, added to gains following the Dell report.

Tech has "become the arena for private equity or other capital-restructuring type of maneuvers because of the way their valuations and their balance sheets are," Kuby said.

Appliance and electronics retailer Hhgregg Inc slumped 5.7 percent to $7.44 after the company cut its same-store sales forecast for the full year.

Earnings reports are due this week from Goldman Sachs , Bank of America , Intel and General Electric , among other companies. Third-quarter reports ended with a gain of just 0.1 percent, the worst for an S&P 500 profit period in three years, according to Thomson Reuters data.

President Barack Obama warned Congress at a news conference on Monday that a refusal to raise the U.S. debt ceiling next month could mean a government shutdown and trigger economic chaos.

S&P futures had little reaction to comments after the bell by Federal Reserve Chairman Ben Bernanke, who urged lawmakers to lift the country's borrowing limit to avoid a debt default.

Volume was roughly 5.6 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.

Decliners were about even with advancers on the NYSE while decliners outpaced advancers on the Nasdaq by about 12 to 11.

(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry, Nick Zieminski and Andrew Hay)

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India Ink: Is Delhi So Different From Steubenville?

IN India, a 23-year-old student takes a bus home from a movie and is gang-raped and assaulted so viciously that she dies two weeks later.

In Liberia, in West Africa, an aid group called More Than Me rescues a 10-year-old orphan who has been trading oral sex for clean water to survive.

In Steubenville, Ohio, high school football players are accused of repeatedly raping an unconscious 16-year-old girl who was either drunk or rendered helpless by a date-rape drug and was apparently lugged like a sack of potatoes from party to party.

And in Washington, our members of Congress show their concern for sexual violence by failing to renew the Violence Against Women Act, a landmark law first passed in 1994 that has now expired.

Gender violence is one of the world’s most common human rights abuses. Women worldwide ages 15 through 44 are more likely to die or be maimed because of male violence than because of cancer, malaria, war and traffic accidents combined. The World Health Organization has found that domestic and sexual violence affects 30 to 60 percent of women in most countries.

In some places, rape is endemic: in South Africa, a survey found that 37 percent of men reported that they had raped a woman. In others, rape is institutionalized as sex trafficking. Everywhere, rape often puts the victim on trial: in one poll, 68 percent of Indian judges said that “provocative attire” amounts to “an invitation to rape.”

Americans watched the events after the Delhi gang rape with a whiff of condescension at the barbarity there, but domestic violence and sex trafficking remain a vast problem across the United States.

One obstacle is that violence against women tends to be invisible and thus not a priority. In Delhi, of 635 rape cases reported in the first 11 months of last year, only one ended in conviction. That creates an incentive for rapists to continue to rape, but in any case that reported number of rapes is delusional. They don’t include the systematized rape of sex trafficking. India has, by my reckoning, more women and girls trafficked into modern slavery than any country in the world. (China has more prostitutes, but they are more likely to sell sex by choice.)

On my last trip to India, I tagged along on a raid on a brothel in Kolkata, organized by the International Justice Mission. In my column at the time, I focused on a 15-year-old and a 10-year-old imprisoned in the brothel, and mentioned a 17-year-old only in passing because I didn’t know her story.

My assistant at The Times, Natalie Kitroeff, recently visited India and tracked down that young woman. It turns out that she had been trafficked as well — she was apparently drugged at a teahouse and woke up in the brothel. She said she was then forced to have sex with customers and beaten when she protested. She was never allowed outside and was never paid. What do you call what happened to those girls but slavery?

Yet prosecutors and the police often shrug — or worse. Dr. Shershah Syed, a former president of the Society of Obstetricians and Gynecologists of Pakistan, once told me: “When I treat a rape victim, I always advise her not to go to the police. Because if she does, the police might just rape her again.”

In the United States, the case in Steubenville has become controversial partly because of the brutishness that the young men have been accused of, but also because of concerns that the authorities protected the football team. Some people in both Delhi and Steubenville rushed to blame the victim, suggesting that she was at fault for taking a bus or going to a party. They need to think: What if that were me?

The United States could help change the way the world confronts these issues. On a remote crossing of the Nepal-India border, I once met an Indian police officer who said, a bit forlornly, that he was stationed there to look for terrorists and pirated movies. He wasn’t finding any, but India posted him there to show that it was serious about American concerns regarding terrorism and intellectual property. Meanwhile, that officer ignored the steady flow of teenage Nepali girls crossing in front of him on their way to Indian brothels, because modern slavery was not perceived as an American priority.

Secretary of State Hillary Clinton has done a superb job trying to put these issues on the global agenda, and I hope President Obama and Senator John Kerry will continue her efforts. But Congress has been pathetic. Not only did it fail to renew the Violence Against Women Act, but it has also stalled on the global version, the International Violence Against Women Act, which would name and shame foreign countries that tolerate gender violence.

Congress even failed to renew the landmark legislation against human trafficking, the Trafficking Victims Protection Act. The obstacles were different in each case, but involved political polarization and paralysis. Can members of Congress not muster a stand on modern slavery?

(Hmm. I now understand better the results of a new survey from Public Policy Polling showing that Congress, with 9 percent approval, is less popular than cockroaches, traffic jams, lice or Genghis Khan.)

Skeptics fret that sexual violence is ingrained into us, making the problem hopeless. But just look at modern American history, for the rising status of women has led to substantial drops in rates of reported rape and domestic violence. Few people realize it, but Justice Department statistics suggest that the incidence of rape has fallen by three-quarters over the last four decades.

Likewise, the rate at which American women are assaulted by their domestic partners has fallen by more than half in the last two decades. That reflects a revolution in attitudes. Steven Pinker, in his book “The Better Angels of Our Nature,” notes that only half of Americans polled in 1987 said that it was always wrong for a man to beat his wife with a belt or a stick; a decade later, 86 percent said it was always wrong.

But the progress worldwide is far too slow. Let’s hope that India makes such violence a national priority. And maybe the rest of the world, especially our backward Congress, will appreciate that the problem isn’t just India’s but also our own.

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Iowa man, sister reunite thanks to boy, Facebook

DAVENPORT, Iowa (AP) — An Iowa man and his sister have reunited 65 years after being separated in foster care thanks to a 7-year-old friend’s Facebook search.

Clifford Boyson of Davenport met his sibling, Betty Billadeau, in person Saturday. Billadeau drove up from her home in Florissant, Mo., with her daughter and granddaughter for the reunion at a hotel in Davenport.

Boyson, 66, and Billadeau, 70, both tried to find each other for years without success. They were placed in different foster homes in Chicago when they were children.

Then 7-year-old Eddie Hanzelin, who is the son of Boyson‘s landlord, got involved.

Eddie managed to find Billadeau by searching his mom’s Facebook account with Billadeau’s maiden name. He recognized the family resemblance when he saw her picture.

“Oh, my God,” Boyson said when he saw and hugged Billadeau.

“You do have a sister,” Billadeau said.

“You’re about the same height Mom was,” Boyson said.

Billadeau’s daughter, Sarah Billadeau, 42, and granddaughter, Megan Billadeau, 27, both wiped away tears and smiled during the reunion.

“He didn’t have any women in his life,” Sarah said. “We’re going to get that straightened out real fast.”

Boyson said he’s looking forward to visiting Billadeau near St. Louis and meeting more family.

“I’m hoping I can go and spend a week or two,” he said. “I want to meet the whole congregation. I never knew I had a big family.”

Eddie, who enjoys messing around with his family’s iPad, said he’s glad he was able to assist in making the reunion happen and that he learned about helping others at school.

“Clifford did not have any family, and family’s important,” the boy said.

Near the end of their tearful reunion Boyson and Billadeau presented Eddie with a $ 125 check in appreciation of his detective work.

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It's Halle Berry vs. Eva Longoria and the Thigh's the Limit

Stylewatch
Style News Now

01/13/2013 at 11:25 PM ET

Jason Merritt/Getty (2)

We could call it pulling an Angelina, but at this point, lots of stars have flashed lots of legs on lots of red carpets — and Halle Berry and Eva Longoria are two of the latest.

The stars tied for the “highest slit” award at the Golden Globes Sunday night, beating fellow risk-takers Lea Michele, Miranda Kerr and Katharine McPhee and giving all of us quite the eyeful. Berry gave the goods while posing in her Versace gown, while Longoria (in Emilio Pucci) made her big reveal as she walked toward the Beverly Hilton. So whose leg flashing did you like better? Vote in our poll below!

PHOTOS: FIND OUT WHICH STARS MADE THE BEST DRESSED LIST

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Flu more widespread in US; eases off in some areas

NEW YORK (AP) — Flu is now widespread in all but three states as the nation grapples with an earlier-than-normal season. But there was one bit of good news Friday: The number of hard-hit areas declined.

The flu season in the U.S. got under way a month early, in December, driven by a strain that tends to make people sicker. That led to worries that it might be a bad season, following one of the mildest flu seasons in recent memory.

The latest numbers do show that the flu surpassed an "epidemic" threshold last week. That is based on deaths from pneumonia and influenza in 122 U.S. cities. However, it's not unusual — the epidemic level varies at different times of the year, and it was breached earlier this flu season, in October and November.

And there's a hint that the flu season may already have peaked in some spots, like in the South. Still, officials there and elsewhere are bracing for more sickness

In Ohio, administrators at Miami University are anxious that a bug that hit employees will spread to students when they return to the Oxford campus next week.

"Everybody's been sick. It's miserable," said Ritter Hoy, a spokeswoman for the 17,000-student school.

Despite the early start, health officials say it's not too late to get a flu shot. The vaccine is considered a good — though not perfect — protection against getting really sick from the flu.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. The only states without widespread flu were California, Mississippi and Hawaii.

The number of hard-hit states fell to 24 from 29, where larger numbers of people were treated for flu-like illness. Now off that list: Florida, Arkansas and South Carolina in the South, the first region hit this flu season.

Recent flu reports included holiday weeks when some doctor's offices were closed, so it will probably take a couple more weeks to get a better picture, CDC officials said Friday. Experts say so far say the season looks moderate.

"Only time will tell how moderate or severe this flu season will be," CDC Director Dr. Thomas Frieden said Friday in a teleconference with reporters.

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people in an average year. Nationally, 20 children have died from the flu this season.

Flu vaccinations are recommended for everyone 6 months or older. Since the swine flu epidemic in 2009, vaccination rates have increased in the U.S., but more than half of Americans haven't gotten this year's vaccine.

Nearly 130 million doses of flu vaccine were distributed this year, and at least 112 million have been used. Vaccine is still available, but supplies may have run low in some locations, officials said.

To find a shot, "you may have to call a couple places," said Dr. Patricia Quinlisk, who tracks the flu in Iowa.

In midtown Manhattan, Hyrmete Sciuto got a flu shot Friday at a drugstore. She skipped it in recent years, but news reports about the flu this week worried her.

During her commute from Edgewater, N.J., by ferry and bus, "I have people coughing in my face," she said. "I didn't want to risk it this year."

The vaccine is no guarantee, though, that you won't get sick. On Friday, CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. That means the average vaccinated person is 62 percent less likely to get a case of flu that sends them to the doctor, compared to people who don't get the vaccine. That's in line with other years.

The vaccine is reformulated annually, and this year's is a good match to the viruses going around.

The flu's early arrival coincided with spikes in flu-like illnesses caused by other bugs, including a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." Those illnesses likely are part of the heavy traffic in hospital and clinic waiting rooms, CDC officials said.

Europeans also are suffering an early flu season, though a milder strain predominates there. China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo have also reported increasing flu.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Some shortages have been reported for children's liquid Tamiflu, a prescription medicine used to treat flu. But health officials say adult Tamiflu pills are available, and pharmacists can convert those to doses for children.

___

Associated Press writers Dan Sewell in Cincinnati, Catherine Lucey in Des Moines, and Malcolm Ritter in New York contributed to this report.

___

Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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Yen under pressure, Asian stocks subdued

SYDNEY (Reuters) - The yen plumbed a 2-1/2 year low against the dollar on Monday, grabbing the Asian spotlight amid subdued trading for the region's stock markets, with the focus on Japan's central bank as it faced unrelenting political pressure to deliver bold stimulus.

Prime Minister Shinzo Abe on Sunday said the Bank of Japan (BOJ) must set a 2 percent inflation target and make it a medium-term, not long-term, goal to show markets it was determined to pursue bold monetary easing to end nearly two decades of deflation.

His comments emboldened yen bears, who took a fresh swipe at the currency. That saw the U.S. dollar hit a high of 89.67 yen, a level not seen since mid-2010, while the euro came within a whisker of 120.00 yen, scaling a 20-month peak.

"The confirmation that there's going to be a push for a new (BOJ) governor, that new governor is going to have a mandate of 2 percent inflation, that plus the fiscal stimulus is a major negative for the yen," said Callum Henderson, global head of FX research for Standard Chartered Bank in Singapore.

In contrast, equity markets had little news to go on, and MSCI's broadest index of Asia-Pacific shares outside Japan was barely changed, remaining near a 17-month peak set on Friday. Tokyo markets were closed for a public holiday.

Having staged a 2-percent rally at the start of the year on growing optimism about the health of the global economy, stock markets appeared to be pausing for confirmation of a brighter global growth outlook.

Australian's benchmark S&P/ASX 200 index rose 0.3 percent, Hong Kong's Hang Seng index advanced 0.4 percent and South Korea's KOSPI gained 0.2 percent, reversing earlier losses.

"The KOSPI will continue to be rangebound before U.S. housing data and China's GDP data are released later this week," said Kim Joo-yong, an analyst at Bookook Securities.

Analysts at HSBC believe global developments this week will support demand for riskier assets, with U.S. and Chinese data likely to show further momentum in the world's two biggest economies.

"In addition, the Fed speaker calendar is dominated by doves in the early part of the week. These should provide reassurance that the Fed is in no rush to turn off the liquidity tap despite these early signs of encouragement on activity," they said in a client note.

Federal Reserve Chairman Ben Bernanke is due to speak at the University of Michigan on Monday and investors are eagerly waiting for clues on how long the Fed's latest bond purchase program will last.

Any signs that the Fed is in no hurry to end its quantitative easing program could see the U.S. dollar soften further against higher-yielding currencies such as the Australian dollar and those of faster-growing emerging economies.

The Aussie dollar rose 0.1 percent to $1.0549, within easy reach of a four-month high of $1.0599 set last week.

The euro was up 0.4 percent at a fresh nine-month high of $1.3404, continuing to outperform the greenback after European Central Bank chief Mario Draghi last week gave no indication the bank would ease monetary policy any further.

Commodity prices found some traction after last week's decline. U.S. crude rose 60 cents to $94.16 a barrel, recovering from Friday's 26-cent fall, while Brent crude gained 32 cents to $110.96 a barrel.

Copper edged up 0.4 percent to $8,075 a metric ton and gold was a shade firmer at $1,665 an ounce.

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Rovio has more monthly active users than Twitter

Rovio announced today it hit 263 million monthly active users in December 2012. This happened precisely three years after the first Angry Birds game debuted at the end of 2009. Incidentally, the somewhat better-known Twitter hit the 200 million monthly active user mark in December 2012. And since Twitter was launched in the summer of 2006, Rovio’s user growth has been notably brisker.

[More from BGR: Samsung cancels Windows RT plans in U.S.]

Rovio has recently been able to demonstrate it is a tad more than a flash in the pan. Angry Birds Star Wars has now remained the #1 paid iPhone app in America for 65 days. Angry Birds Space still clings to #6 slot nearly 300 days after its debut. And Bad Piggies is at #9 more than three months after the game was launched.

[More from BGR: LG reportedly halts Nexus 4 production to make way for new Nexus device]

Rovio thus holds three of the top 10 positions in the United States iPhone chart. Disney’s hottest title, the heavily promoted Where’s My Water has slumped to #24 after having a strong year in 2012. Three years in, Rovio has pulled off a remarkable fete: It’s been able to avoid boring consumers even as it saturation-bombs them with cutesy animals.

This article was originally published on BGR.com

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Miss New York Mallory Hytes Hagan Wins Miss America

01/12/2013 at 11:45 PM EST

Miss American 2013 Mallory Hytes Hagan

CraigSjodin/ABC

The crown is headed to the Big Apple!

Brooklyn, N.Y., native Mallory Hytes Hagan was crowned Miss America in Las Vegas on Saturday.

Miss New York, 23, beat out Miss South Carolina Ali Rogers, who placed second, and Miss Oklahoma Alicia Clifton, who finished third. Miss Wyoming Lexie Madden and Miss Iowa Mariah Cary rounded out the top five.

Miss Montana Alexis Wineman, who has autism, was one of 16 semifinalists.

Hagan tapped danced to James Brown's "Get Up Off That Thing" for her talent and answered a question about armed guards in schools from Good Morning America's Sam Champion, who was one of the celebrity judges for the pageant this year, in the Q&A portion of the competition.

"I don't think the proper way to fight violence is with violence," she said, donning a white evening gown.

Hagan, whose platform is child sexual abuse prevention, attended the Fashion Institute of Technology and hopes to obtain a degree in Cosmetics and Fragrance Marketing, according to her online bio.

She won a $50,000 scholarship as well as a sash and a crown.

Hagan's win was a bit of a surprise, considering Las Vegas oddsmakers didn't have her among the top 15 favorites to don the crown at the conclusion of the two-hour competition at Las Vegas's Planet Hollywood Resort and Casino.

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Q&A: Scramble for vaccine as flu season heats up

WASHINGTON (AP) — Missed flu-shot day at the office last fall? And all those "get vaccinated" ads? A scramble for shots is under way as late-comers seek protection from a miserable flu strain already spreading through much of the country.

Federal health officials said Friday that there is still some flu vaccine available and it's not too late to benefit from it. But people may have to call around to find a clinic with shots still on the shelf, or wait a few days for a new shipment.

"We're hearing of spot shortages," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Colorado offers an example. Kaiser Permanente, which has 535,000 members in the state, stopped giving flu shots this week. But it expected to resume vaccinations when new shipments arrive, expected this weekend.

Some questions and answers about flu vaccines:

Q: Are we running out of vaccine?

A: It's January — we shouldn't have a lot left. The traditional time to get vaccinated is in the fall, so that people are protected before influenza starts spreading.

Indeed, manufacturers already have shipped nearly 130 million doses to doctors' offices, drugstores and wholesalers, out of the 135 million doses they had planned to make for this year's flu season. At least 112 million have been used so far.

The nation's largest manufacturer, Sanofi Pasteur, said Friday that it still has supplies of two specialty vaccines, a high-dose shot for seniors, and an under-the-skin shot for certain adults, available for immediate shipment. But it also is working to eke out a limited supply of its traditional shots — some doses that it initially hadn't packaged into syringes, said spokesman Michael Szumera. They should be available late this month.

And MedImmune, the maker of the nasal spray vaccine FluMist, said it has 620,000 extra doses available.

Q: Can't they just make more?

A: No. Flu vaccine is complicated to brew, with supplies for each winter made months in advance and at the numbers expected to sell. Although health officials recommend a yearly flu vaccination for nearly everybody, last year 52 percent of children and just 39 percent of adults were immunized. Most years, leftover doses have to be thrown out.

Q: Should I still hunt for a vaccine?

A: It does take two weeks for full protection to kick in. Still, health officials say it's a good idea to be vaccinated even this late, especially for older people, young children and anyone with medical conditions such as heart or lung diseases that put them at high risk of dangerous flu complications. Flu season does tend to be worst in January and February, but it can run through March.

Q: I heard that a new flu strain is spreading. Does the vaccine really work?

A: Flu strains constantly evolve, the reason that people need an updated vaccine every year. But the CDC says this year's is a good match to the types that are circulating, including a new kind of the tough H3N2 strain. That family tends to be harsher than other flu types — and health officials warned last fall that it was coming, and meant this winter would likely be tougher than last year's flu season, the mildest on record.

Q: But don't some people get vaccinated and still get sick?

A: Flu vaccine never is 100 percent effective, and unfortunately it tends to protect younger people better than older ones. But the CDC released a study Friday showing that so far this year, the vaccine appears 62 percent effective, meaning it's working about as well as it has in past flu seasons.

While that may strike some people as low, Frieden said it's the best protection available. "It's a glass 62 percent full," he said. "It's well worth the effort."

Q: What else can I do?

A: Wash your hands often, and avoid touching your eyes, nose and mouth. Viruses can spread by hand, not just through the air. Also, cough in your elbow, not your hand. When you're sick, protect others by staying home.

And people who are in those high-risk groups should call a doctor if they develop symptoms, added CDC spokesman Tom Skinner. They might be prescribed antiviral medication, which works best if given within the first 48 hours of symptoms.

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AP Medical Writers Lindsey Tanner and Mike Stobbe contributed to this report.

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