Third vaccine doses on deck for immunocompromised Americans — Covid cases swamp children’s hospitals — Dem tensions rise over spending package plan

From: POLITICO Pulse - Thursday Aug 12,2021 02:03 pm
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Quick Fix

— The FDA is expected to authorize additional Covid-19 vaccine doses for adults with compromised immune systems.

— Children's hospitals are filling up with Covid-19 patients, sparking fears they could soon be overwhelmed as the Delta variant spreads through reopened schools.

— A rebellion is brewing among centrist House Democrats over plans to delay passage of the bipartisan infrastructure package.

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Driving the Day

THIRD DOSES ON DECK FOR IMMUNOCOMPROMISED — The Biden administration is poised to authorize third vaccine doses today for people with weakened immune systems , in an effort to bolster their Covid-19 protection amid a Delta-fueled resurgence.

The FDA’s planned move will come in the form of amended emergency use authorizations for Pfizer’s and Moderna’s vaccines, according to a person familiar with the decision. That would put roughly 7 million immunocompromised people in line for third shots — a population likely to include solid-organ transplant recipients, people with cancer and those with HIV.

The authorizations have been a long time coming. Administration officials and medical experts telegraphed for weeks that the immunocompromised would need additional protection, after studies suggested the initial two-dose regimen was not as effective as in healthy adults. And some doctors have even begun recommending additional doses on their own, despite the lack of a federal signoff.

But the new policy won’t apply to J&J recipients. That’s primarily because officials believe very few people with weakened immune systems got the J&J vaccine, especially after the CDC recommended that the group specifically seek out Pfizer or Moderna shots.

Biden officials have sought to separate these extra vaccines from the broader concept of boosters, arguing the data shows only the most vulnerable need another shot right now. Even as some in the administration believe additional shots for a wider population are inevitable, there’s no consensus yet on when and whether healthy Americans will need boosters.

What to expect: The FDA is likely to amend the authorizations at some point today, allowing a CDC advisory panel to vote Friday on recommending that the immunocompromised seek out the third shots. Assuming the panel approves, the CDC could make its formal recommendation by Saturday.

 

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COVID CASES SWAMP CHILDREN’S HOSPITALSChildren’s hospitals across several hard-hit states are buckling under a steep rise in Covid-19 cases among kids — a situation that health experts fear will only worsen as schools reopen, POLITICO’s Dan Goldberg and Alice Miranda Ollstein report.

Nearly 1,600 children are already hospitalized by the disease, according to the CDC’s most recent count. That’s a new seven-day record and a 27 percent jump from the prior week that comes as children’s hospitals also contend with unusually high levels of the respiratory virus respiratory syncytial virus.

In Tennessee, the state’s health commissioner is warning that its children’s hospitals will be full by the end of the week. Louisiana reached that point more than a week ago. And Arkansas’ only children’s hospital has just two ICU beds remaining.

“We have kids in the emergency department on gurneys,” said Mark Wietecha, CEO of the Children’s Hospital Association.

But the escalating crisis is having little political impact, even in the southeastern states where Delta is surging. Most GOP governors and state officials insist they’ll stick by policies enacted earlier this year banning vaccine mandates, mask requirements and other public health tools for fighting the pandemic.

“There’s no need to require masks in schools at this time,” South Carolina Gov. Henry McMaster said, accusing the media and scientists of “exaggerating, engaging in hyperbole and unnecessarily alarming people” about the threat to kids.

DEM TENSIONS RISE OVER SPENDING PACKAGE PLAN — Speaker Nancy Pelosi has made herself clear: There’ll be no infrastructure vote without a $3.5 trillion spending package waiting in the wings.

But that rigid position isn’t sitting well with some moderates in her caucus , who are already bristling over the delay of a bipartisan bill that Democrats see as key to keeping control of the House, POLITICO’s Sarah Ferris and Heather Caygle report.

At least six centrist Democrats say they’re willing to block the party’s budget blueprint and stall work on the reconciliation effort — though none are yet willing to commit to that publicly. Their concerns heightened this week after swing-district Rep. Ron Kind (D-Wis.) announced his retirement, plunging Democrats’ majority further in jeopardy.

Yet Pelosi is showing no sign of backing down. That’s in part because bringing up the infrastructure bill early would trigger mass opposition from the House’s progressive wing, who are putting their faith in leadership to ensure a reconciliation bill stuffed with their priorities gets through as well. On a call Wednesday, Pelosi characterized the two-pronged strategy as “the consensus of the caucus.”

Nevertheless, Democratic leaders are eager to speed work on both fronts. House committees have a Sept. 15 deadline to hammer out their parts of the $3.5 trillion package, with some believing the chamber could pass both bills by the end of the month.

To watch today: President Joe Biden is slated to make a drug-pricing speech later this morning, as congressional Democrats begin to hammer out the policy specifics of their reconciliation package.

Biden has endorsed a range of drug-pricing policies that could generate major savings as part of an eventual bill. But the central provision that he's supported — permitting Medicare to negotiate the cost of medicines — has yet to win consensus within the party.

 

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Drug Pricing

FIRST IN PULSE: HEALTH ADVOCATES CALL FOR MAJOR DRUG-PRICE CRACKDOWN — Dozens of consumer advocacy groups want the Biden administration to take drastic action on pharmaceutical prices, arguing it should be willing to break drug patents to keep costs low.

In a letter to HHS Secretary Xavier Becerra, the organizations contend the government has the power to use so-called march-in rights to create generic competition — and that Biden shouldn’t be afraid to use it.

“Any plan developed by the Department of Health and Human Services to combat excessive drug prices that does not call for the use of competitive licensing remedies would be incomplete,” the groups, including Public Citizen, Indivisible and Doctors for America, wrote. “High drug prices are rooted in monopoly power.”

In the States

CALIF. REQUIRES VACCINATIONS FOR TEACHERSCalifornia will require all teachers and school employees to be vaccinated or submit to weekly Covid-19 testing, making it one of the first states to issue such a directive, POLITICO’s Mackenzie Mays reports.

The policy would force school workers to show proof of vaccination, and comes after three of the state’s larger districts decided to implement similar requirements on their own. California’s two major teachers unions and the American Federation of Teachers have all backed the plan, which would also apply to education workers in private schools.

It’s the latest effort by Gov. Gavin Newsom to tamp down Covid-19’s resurgence, while also trying to save his job. The Democrat faces a recall election in less than five weeks, and has insisted that schools will remain open throughout the year.

Students must also wear masks while attending class — one of several public health precautions that’s prompted criticism from his Republican challengers.

 

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What We're Reading

Sen. Rand Paul (R-Ky.) only just disclosed that his wife bought stock last February in a pharmaceutical company that makes a Covid-19 treatment, violating disclosure requirements, The Washington Post’s Isaac Stanley-Becker reports.

For the Commonwealth Fund, Georgetown professor Katie Keith details how insurers could use the Affordable Care Act to help narrow racial and ethnic health disparities.

Anti-vaccine nurses are relying on social media platforms like Instagram and Facebook to amplify misinformation — and using their status as health workers to lend credibility to otherwise discredited arguments, NBC News’ Brandy Zadrozny and Ben Collins report.

A message from HCA Healthcare:

At HCA Healthcare, investing in the communities where we work and live is a priority. We are proud to contribute to community infrastructure and economic development through the $4.1 billion federal, state and local taxes we incurred in 2020. In addition, HCA Healthcare returned or repaid early approximately $6 billion in CARES Act funds because it was the right thing to do.

We invest in other ways, as well. We employ over 275,000 colleagues across 20 states, and made $2.8 billion in capital investments last year. We also provide significant financial benefits to patients throughout our communities; in 2020, we provided an estimated $3.4 billion in the delivery of charity care, uninsured discounts and other uncompensated care.

We are committed to the health and well-being of all of our patients and communities. Learn more about how HCA Healthcare shows up to create healthier tomorrows.

 
 

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