The IPV Vaccine

Polio inactivated vaccine

Polio is a disease in children that is caused by the poliovirus. Polio can cause paralysis of legs or can cause weakness of the entire body. This condition is entirely vaccine-preventable. 

Q. How does a person get this virus?

The poliovirus is a highly contagious virus and can spread through the feco-oral route. Most of the infected children (around 72%) remain asymptomatic. However, they can still shed virus and can cause disease transmission.

Q. How do I know I have developed polio?

Initially, the symptoms in a patient infected with the poliovirus are very nonspecific and similar to that of any other viral illness. Patients may develop features like sore throat, fever, vomiting, headache, joint pain, etc.

Sometimes, the virus can invade the brain and spinal cord and this event can cause paralysis of extremities or the diaphragm, causing difficulty in breathing and ultimately causing death in almost 10% of the cases.

Q. How is this condition treated?

Once the disease starts progressing there is no cure apart from symptomatic management. Therefore, prevention is the key.

Q. How do I prevent myself from developing Polio?

Since 1955, an injectable form of polio vaccine has been available in the health centers of the United States. The US government has been able to eradicate the disease itself by 1979. Owing to the success rate of the vaccine, CDC has recommended polio vaccine to be included in the list of routine vaccinations in a child.

This vaccine provides the body with the inactivated viral particles. The immune system recognizes these viral particles and starts forming antibodies to neutralize the viral particles so that whenever a fully functional virus enters the human body it is already prepared to fight off the virus and prevent the disease.

Q. When do the doctors inject the vaccine into my child?

Advisory Committee on Immunization Practices (ACIP) has recommended 0.5mL volume, 4doses to be given starting at 2months, 4months, 6-18months, and finally at 4years of age. There should be a gap of at least 6months between the 3rd and 4th dose. The vaccine is an inactivated polio vaccine (IPV) and can protect against all known strains (types 1, 2, and 3). 

If the child has to travel to the endemic region before completion of the vaccine series then CDC recommends that the child should take an accelerated schedule and the subsequent doses of the vaccine can be taken in the endemic regions itself or upon returning to the country.

Q. How should I protect myself as I am an adult?

Adults usually do not require vaccination like children because of the vaccination done during childhood. However, adults need vaccination if they have to travel to the endemic country or have to handle the suspected specimens in the laboratories, or if the adult is a healthcare worker actively involved in the treatment of a polio patient. 

Unlike the vaccination schedule in children, there are no routine recommendations available for adults. Adults have to consider accelerated vaccine series if they wish to travel to endemic regions. The first should be considered as soon as possible, and the second dose 1-2months later and the last dose 6-12months after the second dose.

Q. How effective is the vaccine?

The vaccine is highly effective and the oral polio vaccine (OPV) and inactivated polio vaccine (IPV) is equally effective. Two doses of IPV can provide 90% immunity to all three types of poliovirus and three doses can provide up to 99% of immunity.

Q, Are there any serious side effects?

Minor reactions to the vaccine may commonly occur. Pain, swelling, and redness may occur at the injection site. The serious side effects are rare, allergic reactions may occur in one case in 1million dose administration. That’s why the vaccine should not be given if the child has an allergy to the 1st dose or if the child has an allergy to medicines like neomycin or streptomycin. 

Oral polio vaccine should not be provided to immunocompromised individuals. Unlike the oral vaccine which contains live attenuated viral particles, the IPV does not carry the risk of paralysis post-administration. 

The oral polio vaccine has been discontinued in the United States since 2000 AD. 

References:

  1. O’Grady M, Bruner PJ. Polio Vaccine. StatPearls [Internet]. 2019 Oct 14.
  2. Polio Vaccination | What You Need to Know | CDC [Internet]. Cdc.gov. 2021 [cited 14 February 2021]. Available from: https://www.cdc.gov/vaccines/vpd/polio/public/index.html

SIRVA is about to do a disappearing act…not in reality, just in the Courts.

Shoulder Injuries as a result of Vaccine Administration (SIRVA) make up more than sixty percent (60%) of all reported vaccine injuries under the Vaccine Injury Compensation Program.

SIRVA can cause a myriad of injuries and symptoms, anything from a rotator cuff tear to shoulder inflammation. Some of these injuries cause a patient to use their arm/shoulder less….this can result in adhesive capsulitis (frozen shoulder) requiring physical therapy and/or surgery.

So why am I writing about SIRVA right now….? Because it will disappear from the vaccine injury program on February 22, 2021. Read more of the proposed changes in the Federal Register here.

The U.S. Department of Health and Human Services’ rationale is that the Vaccine Injury program is just that, meant to compensate people who have been injured by a vaccine, not the vaccination needle itself. They also point out that these cases are overwhelming the system in the United States Court of Federal Claims, taking away valuable resources and monies that could be used for other people injured by vaccines.

However much logic exists in the Government’s argument there are some counterpoints. Primarily…thousand of people are injured by SIRVA every year from vaccinations. These folks suffer pain, lose their jobs and have permanent disabilities. The injuries are real.

Further, where are they going to go for compensation? Forcing people to sue in other courts raises the burden on an injured person, costing them attorney’s fees and expenses. And sometimes, frankly quite often, simply because someone suffers SIRVA does not mean that someone is at fault. It’s a vaccination. A nurse or other medical provider does the best they can. While mistakes can and do happen, sometimes they are unavoidable or do not rise to the level of negligence (a violation of a duty of care).

So the conclusion? At a time when all of us are rightfully encouraged to receive our COVID vaccines, it is now becoming harder to recover vaccine compensation. Justice is not being served. We can do better. Let’s pause this change and try again….

How safe are the Covid Vaccines?

According to medical journal StatNews As of Jan. 19, there have been 15 confirmed cases of anaphylaxis after receipt of Moderna’s vaccine and 45 confirmed cases of anaphylaxis after receipt of the Pfizer vaccine, the CDC said in a statement to STAT. That works out to a rate of 2.1 cases per million doses of the Moderna vaccine and 6.2 cases per million doses of the Pfizer, according to the agency.

Anaphylaxis is a severe allergic reaction that can be life-threatening if not treated quickly.

Vaccine injuries are rare but real. There can be reactions to flu shots, Tetanus, HPV, Hepatitis A, Hepatitis B and others…

Anaphylaxis occurred quickly in the people affected, with the median time to the start of symptoms being 7.5 minutes. People who receive Covid-19 vaccines are supposed to be monitored for 15 minutes after the injection, with that period extended to 30 minutes for people with a history of severe allergies or anaphylaxis.

If you have been injured as a result of a vaccine, please contact Gold Law Firm, LLC. at info@goldlawfirm.net or via telephone 781-239-1000. Vaccine Injury Law is all we do.

Changes afoot to the Vaccine Injury Table?

On July 20, 2020. the Department of Health and Human Services proposed changes to the vaccine injury table In essence these changes, if adopted, would remove shoulder injuries incurred from vaccine administration, the actual need stick, from the vaccine injury compensation program.

The rationale is that the National Vaccine Injury Compensation Program was meant to compensate those injured from a vaccine…not a needle. It’s a controversial rule change that would deprive thousands of injured petitioner’s compensation. SIRVA is the most common vaccine injury, this includes rotator cuff injuries, tendonitis, shoulder inflammation. This can occur from a flu shot, Tdap, MMR, or even a COVID-19 vaccination.

If you have suffered from a shoulder injury as a result of a vaccination, please contact Gold Law Firm, LLC. today. Vaccine injury law is all we do. Period.

If you have been injured from a COVID-19 vaccination, please visit us here

Vaccine Injury Myths Debunked

U.S. public health officials and physicians have been combating misconceptions about vaccine safety for over twenty years. They’ve had mixed success. Despite the fact that numerous studies have found no evidence to support the notion that vaccines cause autism and other chronic illnesses, a growing number of parents are refusing to vaccinate their children.

Researchers now link falling immunization rates to recent resurgences of vaccine-preventable diseases. In 2010, California saw 9,120 cases of whooping cough, more than any year since the whooping cough vaccine was introduced in the 1940s. Ten infants too young to be vaccinated died of whooping cough during the outbreak. The CDC warns that events like these will become more frequent and harder to control if vaccination rates continue to fall.

Research, however, shows that most of our biggest fears about vaccinations are unfounded. These eight major vaccine myths that research has shown to be baseless:

Myth #1: Vaccines cause autism.

The widespread fear that vaccines increase risk of autism originated with a 1997 study published by Andrew Wakefield, a British surgeon. The article was published in The Lancet, a prestigious medical journal, suggesting that the measles, mumps, rubella (MMR) vaccine was increasing autism in British children.

The paper has since been completely discredited due to serious procedural errors, undisclosed financial conflicts of interest, and ethical violations. Andrew Wakefield lost his medical license and the paper was retracted from The Lancet.

Nonetheless, the hypothesis was taken seriously, and several other major studies were conducted. None of them found a link between any vaccine and the likelihood of developing autism.

Today, the true causes of autism remain a mystery, but to the discredit of the autism-vaccination link theory, several studies have now identified symptoms of autism in children well before they receive the MMR vaccine. And even more recent research provides evidence that autism develops in utero, well before a baby is born or receives vaccinations.

Myth #2: Infant immune systems can’t handle so many vaccines.

Infant immune systems are stronger than you might think. Based on the number of antibodies present in the blood, a baby would theoretically have the ability to respond to around 10,000 vaccines at one time. Even if all 14 scheduled vaccines were given at once, it would only use up slightly more than 0.1% of a baby’s immune capacity. And scientists believe this capacity is purely theoretical. The immune system could never truly be overwhelmed because the cells in the system are constantly being replenished. In reality, babies are exposed to countless bacteria and viruses every day, and immunizations are negligible in comparison.

Though there are more vaccinations than ever before, today’s vaccines are far more efficient. Small children are actually exposed to fewer immunologic components overall than children in past decades.

Myth #3: Natural immunity is better than vaccine-acquired immunity.

In some cases, natural immunity — meaning actually catching a disease and getting sick– results in a stronger immunity to the disease than a vaccination. However, the dangers of this approach far outweigh the relative benefits. If you wanted to gain immunity to measles, for example, by contracting the disease, you would face a 1 in 500 chance of death from your symptoms. In contrast, the number of people who have had severe allergic reactions from an MMR vaccine, is less than one-in-one million.

Myth #4: Vaccines contain unsafe toxins.

People have concerns over the use of formaldehyde, mercury or aluminum in vaccines. It’s true that these chemicals are toxic to the human body in certain levels, but only trace amounts of these chemicals are used in FDA approved vaccines. In fact, according to the FDA and the CDC, formaldehyde is produced at higher rates by our own metabolic systems and there is no scientific evidence that the low levels of this chemical, mercury or aluminum in vaccines can be harmful. See section III of this guide to review safety information about these chemicals and how they are used in vaccines.

Myth #5: Better hygiene and sanitation are actually responsible for decreased infections, not vaccines.

Vaccines don’t deserve all the credit for reducing or eliminating rates of infectious disease. Better sanitation, nutrition, and the development of antibiotics helped a lot too. But when these factors are isolated and rates of infectious disease are scrutinized, the role of vaccines cannot be denied.

One example is measles in the United States. When the first measles vaccine was introduced in 1963, rates of infection had been holding steady at around 400,000 cases a year. And while hygienic habits and sanitation didn’t change much over the following decade, the rate of measles infections dropped precipitously following the introduction of the vaccine, with only around 25,000 cases by 1970. Another example is Hib disease. According to CDC data, the incidence rate for this malady plummeted from 20,000 in 1990 to around 1,500 in 1993, following the introduction of the vaccine.

Myth #6: Vaccines aren’t worth the risk.

Despite parent concerns, children have been successfully vaccinated for decades. In fact, there has never been a single credible study linking vaccines to long term health conditions.

As for immediate danger from vaccines, in the form of allergic reactions or severe side effects, the incidence of death are so rare they can’t even truly be calculated. For example, only one death was reported to the CDC between 1990 and 1992 that was attributable to a vaccine. The overall incidence rate of severe allergic reaction to vaccines is usually placed around one case for every one or two million injections.

Myth #7: Vaccines can infect my child with the disease it’s trying to prevent.

Vaccines can cause mild symptoms resembling those of the disease they are protecting against. A common misconception is that these symptoms signal infection. In fact, in the small percentage (less than 1 in one million cases) where symptoms do occur, the vaccine recipients are experiencing a body’s immune response to the vaccine, not the disease itself. There is only one recorded instance in which a vaccine was shown to cause disease. This was the Oral Polio Vaccine (OPV) which is no longer used in the U.S. Since then, vaccines have been in safe use for decades and follow strict Food and Drug Administration (FDA) regulations.

Myth #8: We don’t need to vaccinate because infection rates are already so low in the United States.

Thanks to “herd immunity,” so long as a large majority of people are immunized in any population, even the unimmunized minority will be protected. With so many people resistant, an infectious disease will never get a chance to establish itself and spread. This is important because there will always be a portion of the population – infants, pregnant women, elderly, and those with weakened immune systems – that can’t receive vaccines.

But if too many people don’t vaccinate themselves or their children, they contribute to a collective danger, opening up opportunities for viruses and bacteria to establish themselves and spread.

Not to mention, as the Centers for Disease Control (CDC) warn, international travel is growing quickly, so even if a disease is not a threat in your country, it may be common elsewhere. If someone were to carry in a disease from abroad, an unvaccinated individual will be at far greater risk of getting sick if he or she is exposed.

Vaccines are one of the great pillars of modern medicine. Life used to be especially brutal for children before vaccines, with huge portions being felled by diseases like measles, smallpox, whooping cough, or rubella, to name just a few. Today these ailments can be completely prevented with a simple injection.

So as science continues to advance and tackle new challenges, people should not forget how many deaths and illnesses vaccines have prevented, and how they continue to protect us from potentially devastating forms of infectious disease.

In other words, get your vaccines. Keep your family safe. Ignorance kills.

Think the Flu Shot can give you the flu? Nope.

https://www.livescience.com/why-flu-shot-cant-give-you-flu.html

One of the common myths that leads people to avoid the flu shot is that they think the shot will give them the flu. But that is simply not true. The virus in the vaccine is not active, and an inactive virus cannot transmit disease. What is true is that you may feel the effects of your body mounting an immune response, but that does not mean you have the flu.

Why it Matters?

Facts matter and fear-mongering among anti-vax activists can have dangerous consequences as we have seen in the measles outbreaks over the last year. Some folks complain that they got the flu from the flu shot. They didn’t. The flu vaccine does not cause the flu. Full Stop.

Inactive virus

Influenza, or the flu, is a common but serious infectious respiratory disease that can result in hospitalization or even death. The CDC estimates that during a “good” flu season, approximately 8% of the U.S. population could get the flu. That is roughly 26 million people.

Each year the flu season is different, and the flu virus also affects people differently. One dangerous complication of the flu is pneumonia, which can result when your body is working hard to fight the flu. This is particularly dangerous in older adults, young children, and those whose immune systems aren’t working well, such as those receiving chemotherapy or transplant recipients.

Historically millions of Americans get the flu each year, hundreds of thousands are hospitalized and tens of thousands of people die from flu-related complications. During the 1918 flu pandemic, one-third of the world’s population, or about 500 million people, were infected with the flu. Since that time, vaccine science has dramatically changed the impact of infectious diseases.

The cornerstone of flu prevention is vaccination. The CDC recommends that everyone 6 months of age and older who does not have contraindications to the vaccine, receive the flu shot.

And just as the polio vaccine won’t give a child polio, the flu vaccine will not cause the flu. That’s because the flu vaccine is made with inactive strains of the flu virus, which are not capable of causing the flu.

That said, some people may feel sick after they receive the flu shot which can lead to thinking they got sick from the shot.

However, feeling under the weather after a flu shot is actually a positive. It can be a sign that your body’s immune response is working. What happens is this: When you receive the flu shot, your body recognizes the inactive flu virus as a foreign invader. This is not dangerous; it causes your immune system to develop antibodies to attack the flu virus when exposed in the future. This natural immune response may cause some people to develop a low-grade fever, headache or overall muscle aches. These side effects can be mistaken for the flu but in reality are likely the body’s normal response to vaccination.

And the good news is these natural symptoms are short-term side effects compared to the flu, which can last much longer and is more severe. It is estimated that less than 2% of people who get a flu shot will develop a fever.

Also, people often confuse being sick with a bad cold or stomach flu with having influenza. Influenza symptoms can include a fever, chills, sore throat, runny or stuffy nose, body aches, fatigue and headaches. Cold symptoms can be similar to the flu but are typically milder. The stomach flu, or gastroenteritis, can be caused by several different bacteria or viruses. Symptoms of gastroenteritis involve nausea, vomiting and diarrhea.

Pre-shot exposures and mismatches

Some people do get the flu after they have received a flu shot, but that is not from the shot. It can happen for a couple of reasons.

First, they could have been exposed to the flu before they had the shot. It can take up to two weeks after receiving the flu shot to develop full immunity. Therefore, if you do get the flu within this period, it is likely that you were exposed to the flu either prior to being vaccinated or before your full immunity developed.

Second, depending on the strain of the flu virus that you are exposed to, you could still get the flu even if you received the vaccine. Every year, the flu vaccine is created to best match the strain of the flu virus circulating. Therefore, the effectiveness of the flu vaccine depends on the similarity between the virus circulating in the community and the killed viruses used to make the vaccine.

If there is a close match between the two, then the effectiveness of the flu vaccine will be high. However, if there is not a close match, vaccine effectiveness could be reduced. Still, it is imperative to note that even when there is not a close match between the circulating virus and the virus used to make the vaccine, the vaccine will still lessen the severity of flu symptoms and also help prevent flu-related complications.

Bottom line: You cannot get influenza from getting the flu vaccine.

Gold Law Firm, LLC. is the National Vaccine Injury Law Firm. As vaccine injury attorneys we can say loudly and clearly…get vaccination. You owe to yourself, your family and your community.

Gold Law Firm, LLC. can be reached at info@goldlawfirm.net and via phone or text to 781-239-1000.

Facebook debuts new notifications to fight vaccine misinformation

Facebook is now rolling out a notification system aimed at combating anti-vaccine misinformation.

Whenever a user searches for vaccine-related information, Facebook will pop-up links to the CDC (Center for Disease Control), where accurate vaccination information can be found about the flu shot, MMR (Mumps, Measles, Rubella), Gardasil (HPV) and others.

Facebook debuts new notifications to fight vaccine misinformation
Facebook debuts new notifications to fight vaccine misinformation

It has been said that “Not all opinions are created equal.” Opinions based on facts, matter. Not fear, not innuendo, not manipulative mischaracterizations but facts.

Get the facts, talk to your doctor and get yourself and your children vaccinated.

Gold Law Firm, LLC. is a national vaccine injury law firm. Vaccine injury law is all we do.

Serving California, Florida, Massachusetts and your State too!

Flu Shots in Massachusetts’ Grocery Chain

Flu shots are now available in Stop and Shop, a Massachusetts supermarket chain.

Stop & Shop is encouraging customers to get their annual flu vaccination before flu activity traditionally picks up in the fall. The grocery chain’s 256 pharmacies have the vaccine in stock and pharmacists can vaccinate patients without an appointment. This season, Stop & Shop has a few types of flu vaccine available, including the quadrivalent vaccine and two flu vaccines specifically designed for people age 65 and older. 

“Stop & Shop is pleased to be able to offer flu vaccinations to our customers while they shop,” said Katie Thornell, Director, Pharmacy Operations, Stop & Shop. “We know that the flu vaccine is the most effective way to prevent the flu, so our pharmacy teams are poised and ready to provide vaccinations when it’s most convenient for our customers and their family members.”

The Centers for Disease Control and Prevention (CDC) recommend that everyone age six months and up receive the flu vaccination every flu season, ideally by the end of October. In particular, people who are at higher risk of developing complications from the flu, such as seniors, pregnant women, children, and people with compromised immune systems, should receive the vaccination.

It takes about two weeks for the antibodies that protect against the flu to develop, so customers are encouraged to get the flu vaccine sooner rather than later.

“Customers should get the flu vaccination before flu cases begin to appear and spread in their community,” added Thornell. “There’s no better time than now to get the flu shot.”

The flu vaccine is considered a preventative health service under most insurance plans and the cost is typically fully covered by insurance. For customers without insurance, the vaccine costs $42 for the quadrivalent and $80 for the senior versions. 

Stop & Shop pharmacies offer a wide array of immunizations, in addition to the flu vaccine. Pharmacists can provide immunizations against shingles, pneumonia, tetanus, hepatitis, meningitis, among others. Customers can speak with their local pharmacist to ensure they are up-to-date on all recommended immunizations. 

While Stop & Shop says that customers can speak to a pharmacist…they should speak to their physician first. Vaccines are safe and necessary but we should all be aware of what we need to be doing to be safe, not just for ourselves, but our families and communities.

Vaccine injuries are rare but real. Gold Law Firm LLC can help. Vaccine Injury Law is all we do.

HPV Vaccine…works to prevent cancer, not STD’s

https://www.expressnews.com/opinion/commentary/article/HPV-vaccine-is-to-prevent-cancer-not-STDs-14403103.php

A very important message about the need to take the HPV vaccine…it protects our kids in a very important way.

What if you could take a medicine that prevents cancer? Most of us already have. In 1982, the Federal Drug Administration approved the first medicine to prevent cancer, the hepatitis B vaccine.

Many people don’t realize that viruses can lead to cancer. Or that vaccines are a medicine that must be taken before being exposed to such a virus. Because children are vaccinated, rates of liver cancer have dropped fourfold in the United States.

In 2006, the FDA approved a second medicine to prevent cancer, the human papillomavirus vaccine. HPV infects almost 15 million Americans every year, many more than hepatitis B. Most of us will be infected with this virus at some point in our lives, and this year HPV will lead to cancer in more than 33,000 Americans. The best way to prevent this is to vaccinate our kids against HPV— so they don’t get cancer.

HPV is responsible for several cancers, most notably cervical cancer. Cervical cancer is one of the most common cancers in the world and the leading cause of cancer-related deaths in most countries. But there is hope. Twelve years ago, Australia and Scotland implemented national programs to provide the HPV vaccine at school for free, and now 80 percent of teenagers in these countries are fully vaccinated against HPV. According to a study published last year in The Lancet Public Health, Australia may very well eliminate cervical cancer from their country within my lifetime.

This month, the Texas Tribune compared Australia’s achievement with that of another high-income country, the United States. Less than 50 percent of teenagers in the U.S. are fully vaccinated against HPV, and Texas ranks near the bottom at 40 percent. Our vaccination rates are half of Australia and Scotland. If it takes them 10 years to eliminate cancer, it will take us 20. There is no excuse for placing our children at risk for cancer, and we need to do something about it now.

So, what can we do? First, as health care providers, we need to take responsibility for how we present the HPV vaccine to our patients. We’ve become complacent and afraid of the conversation, making it out to be bigger than it is. We don’t do this with other vaccines. The information about HPV and its link to cancer is clear. The vaccine is safe and saves lives. If medical professionals aren’t confident about recommending it, our patients won’t be confident about taking it.

Second, our legislators need to take responsibility for being educated on this topic. There is a lot of confusion and misinformation about the HPV vaccine. The vaccine exists to prevent cancer, not STDs. It’s given during early adolescence because the immune system is ramping up, and that’s the best age to provide the most protection.

Lost in political limbo, the HPV vaccine continues to be a platform by which legislators create division. The reality is that more than 97 percent of people will be sexually active during their lifetime, so the risk of HPV is universal. Therefore, regardless of age, gender or political party, the risk of cancer is universal.

The vaccine is very safe. When politicians argue for more research into the safety of the HPV vaccine, they are behind the times. The research has been done and it continues to show this vaccine to be safe.

Lastly, Texas can do better. Our vaccination rates against HPV are among the worst in the country. To fix this, we must make the vaccine more accessible. At a minimum, this means mandating coverage by all insurance companies and providing programs for uninsured patients. Some states have launched campaigns to provide public funding for HPV vaccine education and administration. Others have adopted mandatory vaccination for school entry with specific “opt out” criteria. Perhaps we should take the lead from Australia and Scotland, and provide vaccines at school. We know that when vaccines are easily available, they are taken.

It’s been nearly 15 years since the HPV vaccine was approved. Other countries are eliminating cancer by vaccinating their kids. Why aren’t we?

Dr. Dina Tom is a pediatric hospitalist with University Health System and an assistant professor with UT Health San Antonio. Born and raised in Boerne, she and her husband have two fully vaccinated school-age children.

Vaccines matter at the border

There are reports that detained migrants at the U.S. Southern Border are not receiving flu vaccines.

In small-spaces and densely-populated areas, immunity matters and health matters. Everyone should be getting vaccines. Three migrants have died from flu-related illnesses.

Here is a reminder to 1. speak to your medical professionals, get the facts, get vaccinated.

https://www.cbsnews.com/news/us-wont-give-flu-vaccines-to-migrants-in-border-detention-centers-near-mexico-border/