The Vaccine Project Newsletter: Turning a corner on Sesame Street

This week's edition of the Haymarket Media Vaccine Project Newsletter is 2,170 words and will take seven minutes to read.

Source: Getty Images

This week’s edition of the Haymarket Media Vaccine Project Newsletter is 2,170 words and will take seven minutes to read.

If you are keeping score, and indeed we are:

  • More than 223 million people ages 12 and older have received at least one dose of COVID-19 vaccine (78.9% of that population).
  • 194 million people 12 and older are fully vaccinated (68.4% of that population, and 70% of all adults).
  • 98.4% of seniors 65+ have received at least one dose of vaccine and 85.7% are fully vaccinated.
  • More than 25 million people have received a COVID-19 booster shot — 14% of the adult population and 31.6% of seniors.

The vaccine-eligible population, of course, now includes 28 million children ages 5 to 11, who are rolling up their sleeves to get a Pfizer/BioNTech shot at one-third the dose given to everyone 12 and older.

Big Bird got a COVID-19 vaccine shot and some political voices squawked. And tweeted. Many feathers ruffled.

The federal government’s broad-based efforts to mandate COVID-19 vaccination, newly released and immediately facing a coordinated legal challenge, may find its way to the steps of the U.S. Supreme Court.

Meanwhile, with or without individual mandates by local governments and businesses, the campaign to win hearts, minds and arms continues in communities across the land. It’s hard to believe that the vaccination scenario, with all its plots and subplots, has unfolded in less than a year’s time.

The children’s hour

  • Among 200 pediatricians surveyed by InCrowd, 88% plan to recommend the COVID-19 vaccine for all 5- to 11-year-olds in their practice and 79% intend to administer it as soon as possible. In addition, 30% plan to perform extra outreach to families of color.
  • InCrowd conducted the research right after the Food and Drug Administration’s decision to authorize the vaccine for emergency use. The pediatricians surveyed acknowledge that they have some work to do in addressing parental hesitancy: They expect that just 51% of the kids in their practice will accept the shot. Half of the doctors polled support school vaccination mandates.
  • One thing to be ready for is the onslaught of misinformation on kids’ vaccines. NBC News offers a thoughtful analysis of a phenomenon that began long before the COVID pandemic.
  • Chicago public schools will be closed on Friday in the hopes that students will use the time off to get vaccinated. City employees will be released from work two hours early, for the same reason.
  • Across the country, schools are taking a lead role in promoting and orchestrating the children’s vaccination campaign, the AP reports.
  • In an interview with Nikki Kean of The Clinical Advisor, pediatric nurse practitioner Mary Koslap-Petraco, DNP, discusses her strategies for getting children immunized against both flu and COVID-19 by the end of December. “My job is to tell [parents] how many thousands and thousands of doses we’ve given to adolescents already and that the vaccines have a very good safety profile,” she says.
  • Dr. Leana Wen, professor of health policy and management at George Washington University, offers three ways to overcome parental vaccine hesitancy. (1) Focus first on getting shots to the “ready, willing and eager” and then enlist them as ambassadors. (2) Don’t blame hesitancy when the actual barrier is access. (3) Boldly declare that widespread vaccination will replace widespread masking.

The mandate mambo

  • November 22 is the date by which 4 million federal workers are supposed to be fully vaccinated against COVID-19. If they aren’t, they’ll receive counseling and will have five days to start the vaccination process. Down the road, suspension and termination are possible.
  • Eleven federal workers have filed a class action suit claiming that they have infection-acquired natural immunity and should be exempt from the mandate, Kathleen Steele Gaivin reports in McKnight’s Senior Living.
  • The Occupational Safety and Health Administration has issued its long-awaited rule for businesses with 100 or more employees, setting forth what employers must do to ensure their workers are either vaccinated or regularly tested and masked. In issuing the rule, OSHA noted that “the nation’s unvaccinated workers face grave danger from workplace exposure to coronavirus, and immediate action is necessary to protect them.” Employer policies must be in place by December 6 and full implementation must occur by January 4.
  • A number of states have already filed suit to block the mandate, charging federal overreach. At this writing, a federal appeals court in New Orleans has put a mid-autumn freeze on the executive actions, saying the matter raises “grave constitutional issues.” The White House acknowledges that the merits will be “well litigated” in numerous courtrooms before the scheduled implementation date.
  • At the same time, the Centers for Medicare and Medicaid Services has issued its own rule governing 17 million workers in 76,000 nursing homes, hospitals and other facilities that receive Medicare and Medicaid funding. This mandate has no option for testing; it’s vaccinate, obtain a medical or religious exemption, or seek employment elsewhere. All staff covered by the mandate must be fully vaccinated by January 4.

Yet another mandate, for federal contractors, also has a January 4 deadline, postponed from an earlier date of December 8.

Source: Getty Images

Long-term life

Our Haymarket colleagues at McKnight’s, with a family of publications covering long-term care, senior living, and home care, are busily taking the pulse of the industry, which has faced stiff challenges vaccinating its workforce.

  • Mark Parkinson, president and CEO of the American Health Care Association, worries that “a hard deadline with no resources for providers or glide path for unvaccinated workers is likely to push too many out the door.” He feels that the loss of even a small percentage of workers would have a “disastrous impact on vulnerable seniors who need around-the-clock care,” Danielle Brown reports in McKnight’s Long-Term Care News.
  • Other leaders are less worried. Rick Matros, President, CEO and chair of Sabra Health Care REIT, notes that several senior living companies have seen no more than “low to mid-single-digit attrition” after implementing a vaccination mandate. Lois A. Bowers offers further insights in McKnight’s Senior Living.
  • Kimberly Bonvissuto, also writing in McKnight’s Senior Living, notes that the healthcare mandate does not apply to assisted living facilities and group homes that are not regulated by CMS. However, most of those facilities would be covered by the less stringent OSHA vaccinate-or-test standards.
  • Noncompliance with the CMS mandate could result in payment denials or termination from Medicare-Medicaid, Diane Eastabrook notes in McKnight’s Home Care.
  • As for the official thinking behind these strategies, an instructive read is the White House background press call on OSHA and CMS Rules for Vaccination in the Workplace.

Veterans Day is November 11

  • More than 16,000 COVID-19 deaths have occurred within the Veterans Affairs medical system. This does not include deaths in state-run veterans’ homes.
  • Federal investigators are looking into 194 COVID-19 deaths that took place at two state-run veterans homes in New Jersey.
  • The Washington Post Magazine explores why COVID-19 deaths were so high at some veterans’ homes. The story focuses on a facility in Charlotte Hall, Maryland, where 66 residents and one staff member died.
  • This Veterans Day marks the 100th anniversary of the Tomb of the Unknown Soldier in Arlington National Cemetery. The Tomb now holds the remains of three unidentified casualties of war. The cemetery conducts 27 to 30 funerals each weekday and six to eight on Saturdays. More than 400,000 veterans and their eligible dependents lie in rest at Arlington.
  • The Ad Council is partnering with the Department of Veterans Affairs to help prevent suicides by veterans. PSAs encourage vets to “Don’t Wait. Reach Out” and direct them to a website with resources. TBWA\Chiat\Day NY developed the PSA strategy pro bono.
  • Members of the military who refuse vaccination, do not obtain an exemption and are discharged may forfeit their eligibility for certain veterans benefits, Military Times reports.
Source: Getty Images

The pills

  • British health authorities last week became the first in the world to approve the Merck/Ridgeback antiviral pill molnupiravir. The drug treats mild to moderate COVID-19 in adults who have at least one risk factor for severe disease. Merck and Ridgeback have also submitted data to the FDA and the European Medicines Agency. The FDA’s Antimicrobial Drugs Advisory Committee will discuss molnupiravir on November 30.
  • Pfizer has a pill too, named Paxlovid. As Brian Park reports in MPR, iInterim results from a Phase 2/3 trial show that the antiviral reduced the risk of COVID-19 hospitalization or death from any cause by 89% in adults who were infected and at high risk for progression to severe disease.
  • Both the Merck and Pfizer pills are designed to treat early COVID-19 infections before they require hospitalization and become life-threatening. However, clinical trials are also looking into their use for post-exposure prophylaxis – that is, preventing COVID-19 in people who are not infected but have been exposed or are likely to be exposed to the virus at home or where they live or work. 
  • Merck expects to produce 10 million doses of molnupiravir in 2021 and 20 million in 2022 and has already agreed to supply 1.7 million doses to the U.S. government. The company has also entered into a licensing agreement with the Medicines Patent Pool, a public health organization backed by the United Nations, to increase access to the pill in low- and middle-income countries.

The vaccine dashboard

  • This makes sense: People who have had their COVID-19 shot are more likely to get their flu shot as well. In polling by CivicScience, 75% of the COVID-19 vaccinated said they have received or plan to receive their flu shot, while 80% of the COVID-19 unvaccinated do not plan to get their flu shot or are unsure.
  • The First Wave,” a National Geographic documentary about the first four months of the pandemic in New York City, opens in theaters November 19.
  • The NBA is already advising all players, coaches and referees to get their boosters. Those who don’t will be subject to game-day testing starting December 1.

Is the U.S. doing enough to ensure global vaccine equity? About half of us say yes, 29% say no, and the rest aren’t sure, according to a Kaiser Family Foundation survey. In MM+M, Lecia Bushak explores the need for better understanding and clearer messaging on our role.

Source: Getty Images

The rest

  • Green Bay Packers quarterback Aaron Rodgers is no longer a spokesperson for Prevea Health, an organization based in Green Bay with more than 80 healthcare facilities in Wisconsin. The unvaccinated Rodgers sat out Sunday’s 13-7 loss to the Kansas City Chiefs after testing positive for COVID-19. He’s taken a public relations hit by initially claiming he was “immunized” and then trying to explain why.
  • State Farm, with which Rodgers has an endorsement deal, essentially punted on the matter, quietly cutting back on the number of ads featuring the QB but saying “we encourage vaccinations but respect everyone’s right to make a choice.”
  • Puerto Rico has achieved a COVID-19 vaccination rate higher than any state, with 89.7% of adults and 71.5% of the total population fully vaccinated, STAT reports. There’s no one secret but a combination of factors: coordination of effort by trusted National Guard leadership, selected vaccination mandates, easy access to vaccines (at beaches and bars) and a refreshing lack of political divisiveness.
  • A study among more than 780,000 veterans reports that the effectiveness of the Pfizer/BioNTech, Moderna and J&J vaccines in preventing SARS-CoV-2 infection declined between February 1 and October 1, while protection against death remained strong. The authors say the results demonstrate “an urgent need to reinstate multiple layers of protection, such as masking and physical distancing—even among vaccinated persons—while also bolstering current efforts to increase vaccination.”

Parting shot

Have we turned a corner on COVID-19, or at least the latest surge? We can show you headlines from December 2020 to May 2021 through October 2021 asserting as much.

Some suggest that we will see a return to normal in January, with the Delta variant finally in our rearview mirror. Others warn that surges will continue, especially in areas with pockets of unvaccinated people

Infectious disease expert Dr. Michael Osterholm cautions, “If you are not vaccinated, you can’t run out the clock on this virus. It will find you and you will know a COVID-19-related outcome.” In an interview with Minnesota Public Radio, he described the 60-plus million unvaccinated Americans as providing “more than enough human wood for this coronavirus forest fire to burn.”

The latest surges and spikes across Europe, arriving just when the U.S. has opened its borders to vaccinated foreign travelers, are a reminder that the road ahead has many a winding turn. 

… and some songs for Veterans Day

Arlington, Trace Adkins

Freedom Song, The United States Air Force Band

Some Gave All, Voices of Service and Billy Ray Cyrus

Coming Home, The Soldiers

Travelin’ Soldier, The Chicks

Battle Hymn of the Republic, Joan Baez

A Soldier’s Memoir (PTSD Song), Joe Bachman

Thank you, veterans, for your service and thank you all for joining us here today. Stay well. Back next Wednesday.

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