The Vaccine Project Newsletter: The plot thickens

This edition of the Vaccine Project Newsletter is 3,159 words long and will take you nine minutes to read.

Source: Getty Images
Source: Getty Images

If COVID-19 had its own cable or livestreaming network, you could tune in to any number of storylines playing out at any given time on different channels.

Another World: After a year of tight restrictions, state economies and restaurant doors swing wide open, just as vaccination rates start to tumble.

The Haves and the Have Nots: The vaccinated and the unvaccinated. The unmasked and the masked. To wear or not to wear? Who can you trust? That is the question.

The Young and the Restless: Adolescents and young adults move to center stage in the vaccination rollout, carrying hopes of herd immunity on their shoulders. Kids under 12 will likely join them early next year.

Guiding Light: The Centers for Disease Control and Prevention struggles to be heard and understood. Sometimes, clarity gets lost in the sauce.

Dallas: Texas bans mask mandates by public schools and local government bodies. The Lone Star State is not alone in this.

Days of Our Lives: The white-collar world prepares to return to the office with more than a small measure of trepidation.

General Hospital: Health systems debate and, increasingly, adopt vaccine mandates for their employees. Legal battle lines form.

As the World Turns: The global scope of the pandemic becomes clear as news of the world streams into our living rooms. We ponder how best to help countries that are suffering the most.

All of these stories are playing out simultaneously in real life and real time, overlapping and interweaving like the plot lines of a novel by Tolstoy. Or maybe Stephen King.

No need for on-demand; this is 24/7 cinema verite. We’re not just extras in this drama. We have an important role to play.

This edition of the Vaccine Project Newsletter is 3,159 words long and will take you nine minutes to read.

The communications effort

The comms piece of the pandemic puzzle remains pivotal to its solution.

·  The CDC botched its announcement on mask wearing and mask shedding for the fully vaccinated, says PRWeek’s Steve Barrett. The agency created more confusion than clarification, ensuring that health issues will remain front and center on every PR person’s radar for the foreseeable future. The new reality for all brands, corporations and PR agencies is that “every communications strategy, activation, campaign and planning scenario has to be filtered through the lens of health, especially public health.”

·  The Department of Health and Human Services has published a new guide for nursing homes to help them build vaccine confidence and increase COVID-19 vaccination rates among certified nurse assistants, Alicia Lasek reports in McKnight’s Long-Term Care News. The 50-page guide notes that CNAs’ concerns are “varied, complex and not specific to any one demographic.” The full document, “Invest in Trust,” is available here.

·  The latest phase of the Ad Council and COVID Collaborative campaign focuses on young adults 18 to 29. Nearly a third of them are in wait-and-see mode, concerned about the perceived rush of vaccine development, lack of long-term data and possible impact of vaccination on fertility. Nearly half (45%) say they don’t have enough information to guide their decision. The Ad Council campaign is now jumping in with information delivered by a wide variety of social media partners, including Facebook, Instagram, Spotify, Reddit, Twitter and TikTok. Other media influencers are pitching in as well, from WWE and Enthusiast Gaming to Match Group (dating apps) and Fox’s Family Guy. The effort also includes campaigns within a campaign sending messages to young Black and Latino adults.

·  Cuebiq, a mobility intelligence and consumer insights company, is partnering with the Ad Council and COVID Collaborative to measure the impact of their messaging, Natasha Bach reports in PRWeek. Among other benchmarks, Cuebiq is calculating visit lift: Do people who are exposed to PSAs go to vaccine centers in higher numbers than those in a control group? Cuebiq is also collaborating with researchers at Johns Hopkins Bloomberg School of Public Health to determine which messages and delivery channels are most successful in overcoming vaccine hesitancy.

·  Nursing homes don’t have to become clinical experts, but they’ll need to make reasonable efforts to educate staff and residents about COVID-19 vaccines under a new federal rule, Kimberly Marselas reports in McKnight’s Long-Term Care News. The Center for Medicare and Medicaid Services suggests that nursing homes make use of educational resources available through the Food and Drug Administration, CDC and Immunization Action Coalition. The federal rule also requires nursing homes to report vaccination rates for residents and staff.

·  Patrick Gavigan, a pediatric infectious disease specialist at Penn State Health Children’s Hospital in Hershey, explains in an op-ed for Lancaster Newspapers why it’s important to vaccinate 12- to 15-year-olds. Gavigan offers succinct answers to each of the objections raised about the vaccines: that they’re too new, too fast, too risky, too political and “my kids are too young.”

·  More than 2.7 million vaccinated Ohioans have registered for the first of the state’s five $1 million lotteries, with the first drawing to be held this evening. In addition, 104,000 vaccinated youngsters ages 12 to 17 have signed up for a four-year college tuition giveaway. First doses of COVID-19 vaccine shot up, so to speak, by 33% among folks 16 and older in the first week after Governor Mike DeWine announced the Vax-a-Million program.

·  Ohio started something. Maryland Governor Larry Hogan announced a lottery for the vaccinated, with a drawing for a $40,000 prize every day from May 25 through July 3 and a final bonanza drawing on July 4 for $400,000. Total prize money in VaxCash is $2 million.

·  In New York, it’s Vax and Scratch. Everyone 18 and older who gets vaccinated Monday through Friday of this week at one of 10 vaccination mega-sites in the state will receive a free scratch-off lottery ticket. It’s the same ticket sold to the general population for $20. The grand prize is $5 million with other prizes ranging up to $50,000. All vaccination sites are open to walk-ins.

·  New York has also set up 11 pop-up vaccination sites in collaboration with the Metropolitan Transit Authority in New York City, Long Island and the mid-Hudson Valley. The program began as a pilot with eight sites that delivered 5,701 vaccinations from May 12 to May 16. All of the pop-up clinics are administering the J&J single-dose vaccine. Incentives to get vaccinated at the pop-ups include a seven-day MetroCard or a round-trip ticket on the Long Island Rail Road.

The Takeaway: The best payoff for getting vaccinated is preserving your health and the health of those you love.

Source: Getty Images

The rollout

After an initial burst of speed, we’ll need to find a second wind and a strong finishing kick.

·  At least eight states—Connecticut, Hawaii, Maine, Massachusetts, New Hampshire, New Jersey, Rhode Island and Vermont—have now given at least one dose of COVID-19 vaccine to 70% of their adult population, the national target set by the White House for July 4. And 25 of the 50 states, plus the District of Columbia, have fully vaccinated 50% of their adults.

·  A number of dating apps, including Tinder, Hinge and Bumble, are encouraging users to get vaccinated, with features including profile badges that show your vaccination status, access to premium content and other resources. Some apps will let daters filter their searches by vaccination status. Research from OKCupid suggests that people who are or plan to be vaccinated get 14% more matches. A surprise partner in all of this? The White House, swiping right.

·  United Airlines is offering Your Shot to Fly. New or existing members of the MileagePlus loyalty club can upload their vaccination records to United’s mobile app or website between now and June 22. You then have a chance to be one of 30 winners to receive roundtrip tickets for two, in any class of service, to anywhere in the world United flies. On July 1, United will also announce five randomly grand prizes of travel for a year for two, any class of service, anywhere this crow flies.

·  The University of Pennsylvania Health System, the largest private employer in Philadelphia, is requiring all employees to be vaccinated against COVID-19 by September 1. “We believe it is imperative… to take the lead in requiring vaccinations to protect our patients and to set an example for those who remain hesitant both within our institution and in the broader community,” officials said. Nearly 70% of the UPHS workforce of 47,000 is fully vaccinated.

·  RWJBarnabas Health, the largest academic health system in New Jersey and the state’s largest private employer, announced that COVID-19 vaccination is mandatory for all team members at supervisory level or above, “with the anticipation that it will eventually be required for all staff.” The system covers nine counties with a population of 5 million and has 11 acute-care hospitals and 35,000 employees. Supervisors and other leaders need to be fully vaccinated by June 30.

·  More than 400 colleges are implementing some version of a COVID-19 vaccination mandate for students or staff, according to the latest tally by the Chronicle of Higher Education. That’s about 10% of the nation’s institutions of higher learning. As it happens, the Chronicle’s map shows that more than 90% of the colleges with vaccination mandates are in states that voted blue in the 2020 presidential election.

·  Adults in the U.S. are more receptive to vaccine mandates than vaccine passports, an Axios poll reveals. More than 60% said they either strongly approve (38%) or somewhat approve (24%) of vaccine mandates set by federal, state or local governments; 24% strongly disapprove and 14% somewhat disapprove. When it comes to whether businesses should require vaccine passports of their patrons, 27.5% of adults say yes, 50.3% say no and 22.5% are not sure.

·  COVID-19 vaccination of nursing home residents has a coattail effect by helping to protect the unvaccinated, Danielle Brown notes in McKnight’s Long-Term Care News. Brown cites a study in The New England Journal of Medicine examining data at 280 facilities in 21 states. Along with the good news comes a caution from the investigators that cases continue to occur even in well-vaccinated long-term care settings, highlighting a “critical need for ongoing vaccination programs and surveillance testing in nursing homes to mitigate future outbreaks.”

·  Despite what you hear about military personnel resisting COVID-19 vaccination, sailors at the Great Lakes Naval Station north of Chicago tell a different story. Great Lakes, with the Navy’s only boot camp in the nation, reports that 75% of recruits who have been offered the vaccine have taken it. The Chicago Tribune also notes that 65% of the station’s 8,000 active-duty personnel, civilian staff and contractors (mostly Navy but some Army, Air Force and Marines) have received at least one dose.

·  Nationally, in the past month the number of active military personnel receiving at least one dose of COVID-19 vaccine jumped from 500,000 to 775,000, CNN reports, now reaching more than half of the 1.4 million total. The increase took place after the Pentagon opened eligibility to all on April 19. Individual military bases and installations are offering days off, increased freedom of movement and other privileges to the vaccinated.

·  For people who can’t come for their shots, shots are coming to them. The New York Times followed mobile clinics rolling from town to town and neighborhood to neighborhood in Washington state, Minnesota and Delaware, where a former mobile library has become the Magic Bus. The books are still on board.

·  One of the oldest mobile clinics in the nation (it was founded in 1980), the Health Wagon in the Appalachian mountains of southwest Virginia is now going door-to-door to homes and businesses, administering more than 2,500 COVID-19 vaccinations and posting videos to encourage neighbors in the community to roll up their sleeves. The staff boasts a 99% vaccination rate “thanks to employee culture and buy-in from leadership.”

The Takeaway: We’re not seeing long lines at vaccine mega-sites anymore, but a dedicated and diverse corps of worker bees are abuzz in the cities and villages.

Source: Getty Images

The challenges

Living in a half-vaccinated world is bound to have its gray areas and shadows.

·  In South Dakota, the vaccination effort has run up against a “rural wall” of reluctance, AP reports. The hope is that one-on-one conversations with local doctors and faith leaders will be both reassuring and persuasive. Alan Morgan, head of the National Rural Health Association, says that much of the messaging around vaccination has not been relevant to rural communities and that “politicians, government officials and movie stars” are not the right messengers.

·  Another wall: Only 8% of 18- to 24-year-olds in the U.S. have received at least one dose of COVID-19 vaccine. Comparatively low rates of vaccination also persist in ethnic and racial minorities, while case rates in those groups remain higher.

·  Vaccinated shoppers are happy with the CDC’s masks-off guidance. Store employees, not so much, Chris Daniels reports in PRWeek. The CDC’s advice can be superseded by “local business and workplace guidance,” which leaves retailers in the middle. They’ve swung both ways. Marc Perrone, president of United Food and Commercial Workers, said that frontline employees “have been forced to play mask police throughout the pandemic with many shoppers not following COVID safety standards. Now they are being asked to be the vaccination police.”

·  How well will the honor system work? A poll by Oklahoma State professor Matt Motta finds that 26% of those who are not vaccinated do not plan to wear a mask indoors. An Axios-Ipsos poll reports that 88% of us trust family or close friends to be honest about their vaccination status and 71% trust coworkers but don’t have much trust in other people dining indoors (25%), outdoors at a concert (25%) or at an airport (24%).

·  Utah and Iowa have enacted legislation that generally prohibits mask mandates in schools. The Utah measure allows mandates in certain situations, such as disease outbreaks. But as one legislator noted: “The whole point of a mask is to prevent an outbreak. Once you’ve already got it spread, it doesn’t really matter if you wear a mask.”

·  In a survey of 169 K-5 grade schools in Georgia with some degree of in-person instruction, the incidence of COVID-19 was 37% lower in schools that required mask use among teachers and staff members and 39% lower in schools that implemented strategies to improve classroom ventilation. The survey covered the period from November 16 to December 11, before vaccines were available. Total enrollment in the schools was 92,000 and 566 cases of COVID-19 were reported during the study period.

·  Parents are of two or three minds when it comes to having their children vaccinated against COVID-19, Civic Science tells us. While 54% have no hesitation at all, 12% are somewhat hesitant and 33% are very hesitant. Parents of 6- to 11-year-olds are slightly more hesitant than parents of younger or older children. More than half of parents surveyed say they would feel more comfortable having their child vaccinated at the pediatrician’s or family doctor’s office.

·  The CDC’s Advisory Committee on Immunization Practices is investigating a “relatively few” reported cases of inflammation of the heart muscle (myocarditis), primarily in adolescents and young adults who received an mRNA COVID-19 vaccine. Most cases appeared to be mild and occurred within four days after vaccination, more often after the second dose and more often in males. The American Heart Association/American Stroke Association was quick to say that the benefits of COVID-19 vaccination “enormously outweigh” the rare possible risk of heart-related complications, including myocarditis.

·  Eleven nursing home workers in Wisconsin who were laid off after declining COVID-19 vaccination have begun a legal challenge to a Rock County vaccine mandate, Danielle Brown reports in McKnight’s Long-Term Care News. Each worker could pursue $50,000 in damages, although the county is now considering dropping the mandate. If the case does proceed, McKnight’s James M. Berklan says it offers an opportunity to address some of the fundamental questions about mandates and their legality.

The Takeaway: Trying to stay one chess move ahead of COVID requires some practice. We’re getting some practice.

Source: Getty Images

The vaccine dashboard

In many ways, COVID-19 vaccine development is only getting started.

·  A second COVID-19 vaccine for 12- to 17-year-olds is on the way as Moderna prepares to submit data to regulators in early June. The Phase 2/3 trial, conducted in the U.S. among more than 3,700 adolescents, reported no cases of COVID-19 in participants who received two doses of vaccine. The vaccine also had 93% efficacy against a milder form of COVID based on a different case definition (one symptom, positive viral test).

·  In MM+M, Lecia Bushak explores what it will take to achieve global vaccine equity. The U.S. can help by donating extra vaccine doses and contributing to the expansion of manufacturing capacity in other countries, but the latter is a complex process both technically and politically. As Loren Becker, associate principal of vaccine policy and market access at healthcare consultancy Avalere, puts it, “We’re trying to build the plane at the same time we’re flying it.”

·  Pfizer and BioNTech are donating COVID-19 vaccine to help immunize Olympic and Paralympic athletes and their delegations in advance of the games scheduled for July and August in Japan. The first shipments will be delivered at the end of May with a goal of administering both doses before travel to Tokyo. Vaccination is not mandatory for athletes and their delegations, but International Olympic Committee President Thomas Bach is hoping they will “lead by example and accept the vaccine when and where possible.”

·  The Olympics themselves are facing a gathering hue and cry from the medical community that the games be cancelled or that a stepped-up risk management approach be implemented.

·  Storing the Pfizer/BioNTech COVID-19 vaccine for extended periods in doctors’ offices and other community locations just got easier, Brian Park reports in MPR. The FDA has approved storing thawed vials of the vaccine at regular refrigerated temperatures for up to 30 days rather than five days. That should make the vaccine more widely available at convenient locations. It’s a change in the fine print that can prove to be a game-changer.

·  Pfizer is testing a pneumococcal vaccine candidate in seniors that is given at the same time as a booster dose of COVID-19 vaccine. Some 600 trial participants age 65 and older have already had their shots, Alicia Lasek reports in McKnight’s Long-Term Care News.

The Takeaway: In many ways, the global vaccine discussion is just getting started as well.

…and some songs, featuring recipients of the 2021 Kennedy Center Honors

·  Battle Hymn of the Republic, Joan Baez

·  Prelude from Bach’s Partita No.3, Midori

·  Rosie, Dick Van Dyke, with 11-year-old Rosevelt

·  Amazing Grace, Garth Brooks

·  She Works Hard for the Money, Debbie Allen (with Gene Anthony Ray)

Many thanks for joining us, today and always. See you back here tomorrow for a Haymarket Media Coronavirus Briefing.

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