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  • The Special Election That Could Give Democrats Hope for November

    The Special Election That Could Give Democrats Hope for November

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    In late 2021, Tom Suozzi made an announcement that exasperated Democratic Party leaders: The third-term representative would give up a reelection bid for his highly competitive New York House district to mount a long-shot primary challenge against Governor Kathy Hochul.

    Suozzi got trounced, but the ripple effects of his ill-fated run extended far beyond his Long Island district. Democrats ended up losing their narrow majority in the House, in part because the seat Suozzi vacated went to a little-known Republican named George Santos. He’s not so little-known anymore. Nor is he in Congress, having been expelled in December after his colleagues discovered that his stated biography was a fiction and that his campaign was an alleged criminal enterprise.

    Steve Israel: How a perfectly normal New York suburb elected a con man

    In a special election next week, Suozzi will try to reclaim the seat he abandoned—and bring the Democrats one step closer to recapturing the House. He’s made amends with party leaders (including Hochul), but he’s not apologizing. “I don’t regret any of my decisions,” Suozzi told me recently. “When things don’t work out, that’s the way it is.”

    A pro-business moderate, Suozzi helped start the cross-party Problem Solvers Caucus in the House after Donald Trump won the presidency. He told me that his penchant for bipartisanship makes him “a very poor candidate” in a Democratic primary—he’s now lost two such gubernatorial campaigns by more than 50 points—but a much better one in a general election.

    Officials in both parties give Suozzi a slight edge; he has more money and is much better known than his GOP opponent, Mazi Pilip, a county legislator who spent her teenage years in Israel and served in the Israeli Defense Forces. But Suozzi is trying to run as an underdog, shunning a Democratic brand that he believes has been soiled on Long Island by voter frustration with the migrant crisis, the high cost of living, and turmoil overseas. He’s kept his distance from President Joe Biden, who, according to both Democratic and Republican strategists, is no more popular in the district than Trump. “If I run my campaign to say, ‘I’m Tom Suozzi. I’m the Democrat, and my opponent’s the Republican,’ I lose this race,” Suozzi said at a rally before members of the carpenters’ union on Saturday.

    The third congressional district borders the blue bastion of New York City and includes a sliver of Queens, but Republicans have clobbered Democrats across Long Island in recent years. Tuesday’s special election represents the Democrats’ first attempt to claw back some of that territory and test out messages that they hope can resonate in suburban swing districts across the country this fall.

    Like other Democrats, Suozzi is emphasizing his support for abortion rights, an issue that has helped the party limit GOP gains since the overturning of Roe v. Wade. But he’s also pitching himself as a bipartisan dealmaker—his campaign slogan is “Let’s fix this!” Suozzi is betting that voters are angered as much by congressional inaction on issues such as immigration and border security as they are by Biden or his policies. If he’s right, the GOP’s rejection this week of a bipartisan border deal that its leaders had initially demanded will play into his hands.

    Whether Suozzi’s campaign proves effective next week will offer clues about the swing districts that could determine control of Congress. A win could point the way for Democratic candidates to redirect attacks on Biden’s record and ease fears that the border impasse could be an insurmountable liability this fall. But his defeat in a district that ought to be winnable for Democrats would suggest that the party is in real trouble as the general election begins.

    Next week’s election will also serve as a test of whether Democrats can turn out voters for a candidate who, like Biden, doesn’t inspire much enthusiasm.

    Read: Is Biden toast?

    Suozzi, 61, is a familiar figure on Long Island; he became a mayor at 31 and then won two terms as a county executive overseeing a population of 1.3 million people in Nassau County. But he’s also suffered his share of defeats. Eliot Spitzer beat him by more than 60 points in the 2006 primary for governor. Suozzi then lost two campaigns for county executive before winning a House seat in 2016. “He felt that he was destined to be president of the United States,” former Representative Peter King, a Republican who served alongside Suozzi in the House and has known him for decades, told me. “Tom started off as the young superstar, and then suddenly you become old.”

    On Saturday, local labor organizers amassed several hundred members of the carpenters’ union in a banquet hall for the rally. Most of them had been bused from outside the district, and many of them weren’t exactly excited to be there. “We’re here under protest,” one union member grumbled as I searched for actual Suozzi supporters in the crowd. The murmuring laborers showed so little interest in the speakers who were touting Suozzi that the candidate at one point awkwardly grabbed the microphone and implored them to pay attention.

    Some of the attendees who did live in Nassau County weren’t thrilled about the Democrat, repeating attacks from GOP ads that have been airing nonstop in recent weeks. “Suozzi’s terrible on the border,” said Jackson Klyne, 44, who told me he didn’t plan to vote for either Suozzi or Pilip next week. A Biden voter in 2020, Klyne said that “it would probably be Trump” for him in November.

    Suozzi must also win over Democrats who are unhappy that he abandoned his congressional seat to challenge Hochul, leading to the election of Santos. “It was a dangerous choice,” Stephanie Visconti, a 47-year-old attorney from New Hyde Park, told me. “I thought it was self-serving.”

    Visconti volunteers with Engage Long Island, an affiliate of the progressive organizing group Indivisible that endorsed a primary challenger to Suozzi for Congress in 2020. But she fully backs him now; on Saturday, she and other members of the group were knocking on doors for his campaign. “He is the right candidate for right now,” she said, citing the need for Democrats to win back control of the House. “Looking at the global big picture, this for us is the first step toward making bigger and broader changes.”

    Biden carried the district in 2020, but Republicans have been ascendant on Long Island ever since. They swept the House races in the midterms and won big local races again last year. Santos defeated the Democratic nominee in the third district by seven points in 2022, and Suozzi isn’t sure he would have won had he been on the ballot. When I asked him what he’d say to people who argue that he bears some responsibility for Santos’s election, Suozzi replied, “‘Thank you for your endorsement, because you’re saying I’m the only person who could have won.’”

    Republican leaders are relying on Biden’s unpopularity and their party’s prodigious turnout machine to keep the seat. They picked Pilip as their candidate—the special election had no primary—in part because in the aftermath of October 7, they hoped that her connection to Israel would resonate in a district where about 20 percent of the electorate is Jewish. (Suozzi is also a longtime supporter of Israel. Within a week of Pilip’s selection, he traveled there to meet with the families of hostages held by Hamas.)

    With only a few exceptions, Pilip has kept a low profile for a political newcomer. She’s agreed to just one debate with Suozzi, three days before the election, and she hasn’t held many publicly promoted campaign events. (Her campaign did not make her available for an interview.) Nassau County Republicans scheduled their biggest rally of the election for a Saturday, when Pilip, who observes the Sabbath, would not be able to attend. She filmed a short video to be played in her absence. “The strategy is intentional,” Steve Israel, a Democrat who represented the third district in the House for 16 years, told me. “She is untested, and Republicans fear that she will say something that could effectively lose the election. They’d rather take their lumps for hiding her.”

    That approach could be risky given the district’s experience with Santos. “We’ve already had someone we didn’t know. We don’t want that again,” Judi Bosworth, a Democratic former town supervisor, said as she campaigned with Suozzi.

    Abortion has been a central issue in the race; Democratic ads have warned that a vote for Pilip could lead to a national ban. But in the closing weeks, the migrant crisis has come to the fore. GOP commercials blame Suozzi and Biden for the “invasion” at the southern border, and Suozzi has criticized Pilip for opposing the bipartisan border-security deal unveiled this week in the Senate. Although national issues are dominating the race, neither candidate wants to be associated with their party’s leaders in Washington. Pilip, until recently a registered Democrat, has declined to say whether she voted for Trump in 2020 and has yet to endorse his comeback bid. When House Minority Leader Hakeem Jeffries spoke at a rally for Suozzi on Saturday, the Democrat’s campaign did not invite the press. The day before, the Pilip campaign kept quiet about an appearance by Speaker Mike Johnson.

    The outcome next week could have an immediate impact in the narrowly divided House, where Republicans have only a three-vote majority. Earlier this week, Republicans fell just one vote short of impeaching Homeland Security Secretary Alejandro Mayorkas; a Suozzi victory would likely keep it on hold, at least for the time being. But Suozzi wants to make a deeper impression in a second stint in Congress. He has campaigned not as a dispassionate centrist but as an impatient negotiator anxious to get back to the bargaining table.

    He had wanted a bigger job altogether, but he assured me that he would not be bored by a return to the House. I asked him what message his victory would send. He rattled off a list of bipartisan deals he wants to strike—on the border, Ukraine, housing, climate change, and more. “If I win,” he said, “I can go to my colleagues in Washington and say, ‘Wake up. This is what the people want.’”

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    Russell Berman

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  • Should Your Flu and COVID Shots Go in Different Arms?

    Should Your Flu and COVID Shots Go in Different Arms?

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    At a press briefing earlier this month, Ashish Jha, the White House’s COVID czar, laid out some pretty lofty expectations for America’s immunity this fall. “Millions” of Americans, he said, would be flocking to pharmacies for the newest version of the COVID vaccine in September and October, at the same appointment where they’d get their yearly flu shot. “It’s actually a good idea,” he told the press. “I really believe this is why God gave us two arms.”

    That’s how I got immunized last week at my local CVS: COVID shot on the left, flu shot on the right. I spent the next day or so nursing not one but two achy upper arms. Reaching high shelves was hard; putting on deodorant was worse. And it did make me wonder what would have happened if I’d ignored Jha’s teleological advice and gotten both jabs in the same arm. Maybe my annoyance would have been lessened. Or perhaps the same-side shots would have made the soreness in my left arm way worse. When I posed this puzzle to immunologists, vaccinologists, and pharmacists, I got back a lot of hems and haws. For the millions of Americans who will be getting two-shot appointments by fall’s end, they told me, the choice really does come down to personal preference in the absence of clear data: You’ve just gotta pick a side. Or, you know, two.

    On the one hand (sorry), there are the vaccine double-downers. Sallie Permar, a pediatrician at Weill Cornell Medicine, and Stephanie Langel, an immunologist at Duke University, both said they’d probably get both shots in the same shoulder; so would Rishi Goel, an immunologist at the University of Pennsylvania. “Personally, I’d rather have one arm that’s slightly uncomfortable than both,” Goel told me.

    On the other hand, we’ve got Team Divide-and-Conquer. Several experts said they’d follow the White House protocol of splitting shots left and right. Ali Ellebedy, an immunologist at Washington University in St. Louis, told me he’d prefer to have two slightly sore arms to one totally dead one. Jacinda Abdul-Mutakabbir, a pharmacist at Loma Linda University, says she generally recommends that her patients get the vaccines on separate sides “for comfort.” Last year, she opted to get the flu shot and a COVID booster within a few inches of each other, and “I wanted to chop my arm off,” she told me. “Never again.”

    Read: America’s fall booster plan has a fatal paradox

    The deciding logic here should be pretty intuitive, Permar told me. Two shots on one side might be expected to double how sore that arm will get, though the experience of each vaccine recipient will depend on a bevy of factors, including the ingredients in the shots and that person’s infection and vaccination history, as well as their immune-system health. Also, for people like my husband—who’s prone to very heavy vaccine side effects—the choice may not matter at all. He was so knocked out by the fever and chills that came with his COVID-flu-shot combo, he couldn’t have cared less which arms got the shots.

    I dug around for studies examining the consequences of the one-versus-two-arm choice and found only one: a Canadian trial from 2003, which vaccinated a few hundred sixth-graders at two dozen middle schools against group C meningitis and hepatitis B at the same time. Roughly half the kids got both shots in the same arm; the others received one on each side. (Some kids in the latter group requested that their shots be administered by a pair of nurses who could plunge both syringes at the same time.) Among students in the same-arm group, 18 percent ended up with tenderness at the injection site that they rated “moderate or severe.” But those kids fared better than the ones in the two-arm group, 28 percent of whom experienced moderate or severe tenderness in at least one arm, and 8 percent of whom had it in both arms at the same time.

    But those results apply only to that group of kids in that setting, with those two specific vaccines; there’s no telling whether the same trends would be seen with flu shots and COVID shots when given to children or adults. Michela Locci, an immunologist at the University of Pennsylvania, told me she suspects that combining flu and COVID inoculations in the same arm could actually drive extra side effects: “The overall inflammation might be higher,” she said.

    Many pediatricians, who often have to administer four or five shots to a baby at once, are habitual splitters. “If there’s more than one vaccine syringe to give to a baby, generally, two legs are used,” Permar told me. (Kids usually upgrade to arm shots sometime in toddlerhood—it’s all about finding a muscle that’s big enough for the needle to hit its mark.) Doctors also have a nerdy reason to split shots between arms or legs. “If there’s a local reaction to the vaccine,” Permar said, “you can identify which vaccine it was if you separate them by space.” (For the record, I had a more painful reaction in my left arm, where I got the COVID shot. Others I’ve spoken with have reported the same disparity.)

    Read: Families are going rogue with rapid tests

    The CDC advocates for separating vaccination shots by at least one inch of space. Per the agency, if a COVID shot is being given at the same time as a vaccine “that might be more likely to cause a local injection site reaction,” the shots should be dosed into “different limbs, if possible.” Two types of flu shots cleared for use in people 65 years and older—the high-dose vaccine and the adjuvanted one—fall into that category. But the different-limb advice doesn’t seem to apply to other flu shots, including those cleared for use in younger adults and kids.

    However someone ends up taking simultaneous flu and COVID shots, the placement is unlikely to affect how much protection the vaccines provide. There could be an argument for letting “each side focus on its own thing,” says Gabriel Victora, an immunologist at Rockefeller University. “But it probably doesn’t make a whole lot of difference.” Children routinely get combo vaccines, such as DTaP and MMR, each of which combines multiple disease-fighting ingredients in a single syringe. The triple-threat formulas work just as well as injecting their individual parts. The immune system is used to multitasking: It spends all day being bombarded by microbes, so there’s good reason to believe that with vaccines, too, our body will see simultaneous shots “as independent events,” Goel told me.

    Which arm gets picked for which shot, though, will affect where the jab’s contents end up. After a vaccine is injected, its immunity-inducing ingredients meander to the nearest lymph node, such as the ones in the armpits. There, hordes of immune cells fight over the vaccine’s bits, and the fittest and fiercest among them are selected to leave the lymph node and fight. Here, again, doubling up on one arm shouldn’t be an issue, Goel said: The immune-cell boot camps in these lymph nodes have “a good amount of real estate.”

    It might even be a good idea to stick the same limb—and thereby, the same lymph node—every time you get another dose of a particular vaccine. After immune cells in a lymph node spot a particular bit of pathogen, some of them march off into battle, but others may hang around like reserve troops, mulling over what they’ve learned. A couple of recent studies, one of them in mice, hint that repeated delivery of the same ingredients to those veteran learners could give the body a slight edge—though the extent of that advantage “might be marginal,” Victora told me. Still, Langel, of Duke, told me jokingly that because she usually gets all of her vaccines in her “non-writing” arm, the lymph node beneath it could now be especially superpowered—a “nice bonus” for her defenses on the whole.

    That said, no one should stress too much about getting a shot in the “wrong” arm. “It’s not like you’re immune on the left side and not on the right side,” Goel told me. Immune cells travel throughout the body; there is no midline DMZ. Permar even points out that getting the newly formulated COVID vaccine, which includes new ingredients tailored to fight Omicron subvariants, on the opposite side from the previous rounds could help its ingredients reach a fresher slate of cells. “I think you could convince yourself either way,” she told me. Which, honestly, leaves me totally at peace with my choice. Apart from arm achiness, I had no other side effects—and in a way, I preferred the symmetry of the one-on-each-side injections.

    With all that said, it’s worth briefly acknowledging a third option: Splitting the flu and COVID vaccines into separate visits. I was, before my most recent COVID shot, some 10 months out from my previous dose. But it felt awfully early for my flu shot, which might be better timed for peak protection if taken later in the season. Still, the allure of getting it all over with was too tantalizing, especially because I happen to have a lot of travel up ahead. In the grand scheme of things, the bigger, more important choice was opting into the shots at all.

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    Katherine J. Wu

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