Tag: Vaccines

GOP Presidential Hopefuls Use Trump’s Covid Record to Court Vaccine Skeptics

Former President Donald Trump often seems proud to advertise his administration’s record on speedily developing covid-19 vaccines.

On the campaign trail to win another term in the White House, though, he also has knocked the use of those very vaccines. In October, for example, he unleashed a barrage of social media attacks on Ron DeSantis’ pandemic record by reposting claims that the Florida governor — who is running against him in the Republican presidential primaries — was too active in vaccinating Sunshine State residents.

In a further twist, Trump simultaneously circulated an MSNBC article suggesting DeSantis wasn’t vaccinating his constituents enough.

Trump’s tap dance — touting Operation Warp Speed’s success at developing vaccines while criticizing vaccine use — is emblematic of how pandemic politics are intensifying broader vaccine politics. Republican presidential candidates currently trailing the former president in polls are contorting their messaging to court the party’s vaccine-skeptical voters. No one embraces, without qualification, the utility of a public health measure that has saved millions of lives.

Like Trump, even the more establishment candidates can’t seem to avoid embracing the anti-vaccine leanings of the party’s base. Take Nikki Haley, who formerly served as governor of South Carolina and ambassador to the United Nations and has been rising in the polls. In the waning days of the Trump administration, she was pro-vaccine. But by the end of November 2021, in an interview with the Christian Broadcasting Network, she repeated dubious anti-vaccine claims: for instance, that the vaccine could undermine a woman’s fertility. (Studies consistently show no effect.)

The GOP has gained the allegiance of “a minority of people who feel very strongly about the safety of vaccines,” Robert Blendon, a Harvard professor of public health, told KFF Health News. Presidential candidates are trying to use this sensibility as “a cultural issue” to signal distrust in scientists, other experts, and government authority in general, he said.

The resulting dynamic carries the risk of reaching beyond the current election cycle to affect public health policy in years to come, leading to lower rates among schoolchildren and seniors of vaccinations that protect them from measles, shingles, and HPV. Even as candidates try to weaponize this rhetoric, they’ve had little luck in changing the former president’s front-runner status.

A recent KFF survey of adults about their plans to get vaccinated against the flu, respiratory syncytial virus, known as RSV, and covid found that partisanship remains a key predictor of how people view vaccines. Confidence in the safety of the updated covid vaccines split sharply along party lines, with more than 8 in 10 Democrats saying they trust the new shots, compared with 1 in 3 Republicans.

But unease about covid or the vaccines is not Republican primary voters’ top issue — Blendon said concerns around the border, crime, and inflation are — and it’s not clear vaccine-focused attacks hurt Trump.

“I didn’t like his response to covid,” says an Iowa business owner featured in a critical ad from a well-funded political action committee that questioned Trump’s handling of the pandemic. “I thought he probably got led a little bit by the bureaucrats,” he says, hitting Trump on his bragging about the development of the vaccine and contrasting Trump unfavorably with certain governors the man in the ad thought performed better against covid. (Images of DeSantis, otherwise unnamed, flash by.)

The result? The ad “produced a backlash” and, when audience-tested with focus groups, improved the former president’s support, according to a memo summarizing the political action committee’s attempts to dent the front-runner.

Candidates nonetheless are trying to make hay, acknowledged Joe Grogan, who led the Domestic Policy Council during the Trump administration. But “I think people have a lot of other targets for ire about the pandemic.”

“Trump is not at the top of the list for Republican primary voters,” Grogan said. “He’s not on Page 2. Or 3, or 4. It begins with the media, the public health bureaucracy, or Big Tech companies.”

Voters have strong, yet divided and sometimes inconsistent, opinions. Some, like Joshua Sharff, 48, of Chesapeake, Virginia, are opposed to the covid vaccines and to candidates who support the shots as safe and effective. Sharff describes himself as a conservative voter who intends to support the Republican nominee for president. Though he’s vaccinated, he said, “If you’re a governor or a president and you tell me that I have to take a vaccine that has not been tried, that has not been tested, and ignores the science, that’s a problem for me. You’re taking away my freedoms as an American citizen.”

These positions have led Sharff away from Trump — and toward DeSantis, who has promoted anti-vaccine and anti-public health positions in his quest for the nomination.

Trump “pushed the vaccine very hard and recently came out, when he began to get pushback on it, that it was somebody else’s fault,” Sharff said. “That’s not true.”

Other Republican voters said the vaccine is not key to their vote.

“It will not sway my vote one way or another,” said Kimberly Hunt, 59, of Melville, Tennessee.

In chasing these voters, some candidates are distancing themselves from initial, pro-vaccine positions to embrace outspoken views against the shot. Vivek Ramaswamy, a biotech entrepreneur, started out as a vaccine cheerleader. But then he flipped, coming out against vaccine mandates and saying this summer that he regretted getting vaccinated. (His wife, a doctor, said she had no regrets.)

The most vocal of all is DeSantis.

Appearing on the right-leaning “PBD Podcast” on Oct. 30, DeSantis attacked Trump and “the corrupt medical swamp in D.C.” for overselling a vaccine that, despite the initial federal guidance, could not prevent infection or transmission of covid. The Centers for Disease Control and Prevention recommends the vaccine for anyone 6 months and older to protect against serious illness.

Though he initially encouraged people to get vaccinated in early 2021, DeSantis pivoted months later, banning vaccine passports for businesses and government entities, and later approving legislation prohibiting vaccine mandates in the state. That fall, he also appointed a new Florida surgeon general, physician Joseph Ladapo, whose guidance on covid vaccines contradicts CDC recommendations. DeSantis formed a Public Health Integrity Committee to assess, and generally dispute, federal health recommendations.

When the CDC released new vaccine guidance in September, Florida responded with its own advisory casting doubt on the safety of the boosters.

This anti-vaccine positioning hasn’t helped DeSantis. He has been losing support nationally and is generally polling third behind Haley and Trump in New Hampshire, a key early primary state. He headlined a “medical freedom” town hall in Manchester on Nov. 1 with Ladapo as a special guest.

Among the candidates remaining, DeSantis may be the most famous convert to the politics of anti-vaccination, but, with this subject, Haley has more experience.

In the 2021 CBN interview, she said “mandates are not what America does.” But the forceful declaration is merely the end of an ambivalent record, and, for critics, demonstrates her willingness to get in sync with the demands of the GOP base. As a state legislator, she supported 2007 legislation that included a mandate for HPV vaccines before voting against it; and later, as governor, she vetoed an effort to promote those vaccinations.

Bakari Sellers — now a commentator on CNN, but at the time a lawmaker who spearheaded that bill — told KFF Health News, “That’s the biggest Nikki Haley issue that there is: She kind of has her finger in the air.”

The issue of vaccines may affect the general election: Even as Trump defends his vaccine record, it’s nevertheless clear he has support from the anti-vaccine crowd. An analysis by Politico, for example, found overlap among donors to independent presidential candidate Robert F. Kennedy Jr., who is staunchly opposed to vaccines, and Trump.

The willingness among politicians to assail what’s traditionally looked on as a foundational achievement of public health is likely to lead to turbulence for doctors themselves. Allison Ferris, a primary care physician and an associate professor at Florida Atlantic University, said people should be listening to their doctors and not to presidential candidates about whether to take the new covid vaccines. But that message is hard to deliver in the current climate.

“It is a tricky position to be in,” said Ferris, who co-authored recently released guidance advising doctors to counsel patients that frequent covid vaccination will likely become a necessity.

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What Would a DeSantis Presidency Look Like for Health Care?

On the presidential campaign trail, Republican Ron DeSantis touts himself as a champion of medical freedom, outlawing vaccine mandates and protecting doctors who refuse to provide certain medical treatments on moral grounds.

His record as Florida’s governor suggests a presidency that would prioritize individual freedom over public health, but his push for such freedoms ends when it comes to abortion and treatment for gender dysphoria. In Florida, he has pushed restrictions on those medical services.

Critics contend those were the wrong priorities in a state where 7.4% of children had no medical insurance as of 2022. Since then more than 250,000 Florida children have lost the health insurance they had through Medicaid.

The DeSantis campaign did not return multiple requests for comment on the governor’s health policy campaign plans.

As he sets his sights on the White House, here’s a recap of his health care record:

Public Health

At campaign stops, DeSantis talks often of his handling of the covid-19 pandemic even as the issue has largely disappeared from the public’s radar.

DeSantis initially followed federal health guidance and ordered a statewide lockdown in April 2020. But the governor quickly changed course, beginning a phased reopening of Florida just one month later. Around then, Florida’s then-surgeon general, Scott Rivkees, was hustled out of a news conference and hardly seen for months after he said residents might have to socially distance themselves from others and wear masks until vaccines became available.

Florida was one of four states that reopened schools in August 2020, and DeSantis banned cities and counties from enforcing mask mandates. He later suspended local pandemic restrictions and outlawed vaccine passports.

DeSantis did initially champion covid-19 vaccines, especially for Florida’s older adults. That changed in 2021, when DeSantis appointed Joseph Ladapo as his next surgeon general. A Harvard-trained doctor, Ladapo had gained prominence as a skeptic of the scientific consensus on how to treat and prevent the spread of the virus.

Subsequently, Florida was the only state not to preorder covid-19 vaccine doses for children under 5 when those became available in 2022. At news conferences, DeSantis publicized covid-19 treatments such as monoclonal antibodies but didn’t urge residents to get vaccinated.

Later, DeSantis’ health department recommended against vaccines for young men and against people under 65 getting updated vaccines, guidance that contradicted that of the U.S. Centers for Disease Control and Prevention.

DeSantis as president would likely downplay the importance of the CDC, which is an advisory body, and instead might require states to invest more in public health infrastructure, said Jay Wolfson, a public health professor at the University of South Florida.

The pandemic exposed that Florida’s public health system had been underfunded and largely ignored by successive administrations, including DeSantis’, Wolfson said. Having led Florida through hurricanes Ian and Idalia, DeSantis may want a similar response to public health emergencies like covid-19, where states take the lead and the federal government’s role is to support them, he said.

Abortion

DeSantis has said he supports a “culture of life.” As governor, he’s signed the most anti-abortion modern-day legislation Florida has seen. But he has faced pushback from the anti-abortion crowd for his initial reluctance to endorse a federal ban and from other anti-abortion Republicans for signing a ban on most abortions after six weeks of pregnancy, which some have said is too extreme.

That bill, which DeSantis signed this year, has exceptions for rape, incest, and human trafficking up to 15 weeks into the pregnancy if the woman seeking an abortion has documentation proving her circumstances.

That bill has not taken effect, because of a pending court challenge over Florida’s current 15-week abortion ban, which DeSantis signed in 2022. That law does not have any exceptions for victims of rape or incest but does have exceptions for the health of the mother.

Opponents of Florida’s abortion restrictions say the threat of a felony arrest for violating the law makes it difficult for a doctor to provide an abortion they think is necessary.

After months of declining to directly answer whether he would support a nationwide abortion ban, DeSantis said during the second GOP presidential primary debate that he would sign a 15-week federal abortion ban.

The issue remains a difficult one for Republicans. A recent successful ballot measure in Ohio suggests that preserving abortion rights remains an effective issue for Democrats to drive turnout.

With Florida’s ban held up in legal challenges, the state continues to be one of the biggest providers of abortions in the Southeast. About 65,000 abortions have been recorded by the Florida Agency for Health Care Administration so far this year. Almost 6,000 were for out-of-state residents.

Medicaid

Even as states long opposed to Medicaid expansion such as South Dakota and North Carolina have recently reversed course, Florida remains in a group of 10 holdout states that refuse to expand the program as part of the Affordable Care Act.

The act provides extra federal funding to states that increase eligibility. In Florida’s case, doing so would help an estimated 514,000 residents gain health coverage, according to an October analysis by the Urban Institute.

Florida has had one of the highest child uninsured rates for many years, higher than poorer states such as neighboring Alabama, another state that has refused to expand Medicaid, said Joan Alker, executive director at the Georgetown University Center for Children and Families.

Almost 823,000 Floridians have lost Medicaid coverage since April, when states could remove recipients for the first time since the pandemic began. That includes at least 250,000 children. It’s unknown how many of those children are now covered through their parents’ insurance. But despite the state’s reassurance that kids who lose coverage would be referred to child health insurance programs like KidCare, Democratic state and federal lawmakers point to enrollment in the state program rising by only 25,000 children.

Florida is also the only state that has not taken advantage of federal waivers that would enable the state to keep more people on Medicaid while it transitions back to normal Medicaid operation.

Wolfson said Florida’s position reflects DeSantis’ belief that the program has become “an expensive and overextended giveaway” that discourages people from working hard to better their lives.

“We’re not going to be like California and have massive numbers of people on government programs without work requirements,” DeSantis said during the second Republican debate when asked why Florida’s uninsured rate — 11.2% in 2022, according to U.S Census Bureau estimates — was higher than the national average, which was 8%.

DeSantis has, however, approved bills that expanded Medicaid coverage based on needs, an approach that may be more illustrative of his handling of the health insurance program should he end up in the White House.

In 2021, DeSantis signed a bill to extend postpartum Medicaid coverage to up to 12 months. This year, he approved legislation for Medicaid to cover glucose monitors and for family members who are 18 or older to be able to be trained and paid under Medicaid as home health aides for medically fragile child relatives.

DeSantis also signed a bill to make more lower-income families eligible for KidCare, a set of child health insurance programs.

Gender Dysphoria Care

Like other GOP-led states, Florida has restricted the rights of transgender minors to access treatments such as puberty blockers and hormone therapy.

Florida health officials in 2022 approved rules prohibiting minors from accessing treatment for gender dysphoria. They then in 2023 prohibited minors from accessing that treatment even in clinical trials.

This past legislative session, Florida lawmakers passed a bill codifying that rule, which DeSantis signed into law. The decision runs counter to recommendations from major medical organizations. The legislation also requires that, for adults, gender dysphoria care, which the state calls “sex-reassignment prescriptions or procedures,” can be administered only by a physician.

In 2022, DeSantis’ administration published a report that created the foundation for a rule that prohibited Medicaid from covering gender dysphoria treatments for both minors and adults. To create the report, the Florida health agency veered from its standard protocol and brought in consultants who had known views that ran counter to major medical organizations’ guidance.

A judge has since struck that Medicaid ban down, but lawyers are arguing in court that DeSantis’ administration has been willfully defying the order and has continued to implement the Medicaid ban.

Medical Freedom

Earlier this year, DeSantis declared Florida the “medical freedom” state as he signed into law protections for medical providers who turn away patients on “conscience” grounds.

The law provides similar protections for insurance companies.

Opponents of the legislation worry it will allow doctors to discriminate against LGBTQ+ people or other groups. The legislation does not allow someone to opt out of providing care because of “race, color, religion, sex, or national origin.”

Federal laws protect health care workers from having to provide abortions if doing so goes against their personal beliefs. Florida’s new law is much broader, allowing a medical professional to deny nearly any procedure if it goes against their conscience.

This article was produced in partnership with the Tampa Bay Times.

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Nikki Haley (And Her Opponents) Struggle With a Vaccine Message

Former South Carolina governor Nikki Haley portrays herself as a voice of reason in the Republican Party. “Let’s find consensus,” she said about abortion during the first GOP primary debate. “Let’s treat this like a respectful issue.”

It’s talk like that — and strong polling in a hypothetical matchup against President Biden — that has helped position Haley to potentially overtake Florida Gov. Ron DeSantis as the GOP’s “plan B” presidential candidate.

But an examination of her record on vaccination shows how she’s also tuned her positions to the views of the Republican base. 

Many of the GOP presidential candidates have struggled to fine-tune their message on vaccination, my colleague Daniel Chang and I have reported, as their voters grow increasingly skeptical of shots that most doctors will tell you are vital for public health. Former president Donald Trump, for example, has tried to simultaneously claim credit for his “Operation Warp Speed” program to accelerate development of coronavirus vaccines and also bash DeSantis for promoting vaccination to Floridians.

Forty percent of Republicans believe that parents should be able to opt out of required childhood vaccines — about double the rate in 2019, according to a September survey from KFF. Support for vaccination among Democrats has remained stable, by comparison, with 84 percent saying they should be required for public school students.

It’s an especially tricky subject for Haley as she tries to hold herself out as the sensible GOP candidate. Her basic message: Covid vaccines are good but shouldn’t be required. 

During the height of the pandemic, Haley praised the Trump administration’s efforts to expedite vaccine development — and even touted Microsoft co-founder Bill Gates’s donations for vaccine manufacturing plants.

But she’s since declared her opposition to vaccine mandates, saying in a November 2021 interview with the Christian Broadcasting Network: “Mandates are not what America does.” And she’s encouraged some anti-vaccine themes. 

“Did I get it, did my family get it? Yes,” she said in the CBN interview. “But if you ask a woman who wants to get pregnant, and she’s worried about it, or you ask a parent whose child might be compromised, and they’re worried about it, that’s a personal family decision.”

The idea that the coronavirus vaccine may interfere with fertility is a common fear stoked by anti-vaccine activists. The Centers for Disease Control and Prevention says on its website that there is “no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems.”

Early in her political career as a state legislator, Haley co-sponsored a bill mandating vaccinations for HPV — a common sexually transmitted virus, some variants of which can cause cervical and other cancers as well as genital warts.

The benefits of HPV vaccination are hard to dispute. One 2020 study tracking nearly 1.7 million Swedish girls and women over 11 years found a nearly 90 percent reduction of risk for cervical cancer for those who began vaccination before age 17, compared with the unvaccinated. HPV vaccination can also help protect boys against some cancers.

But Haley, and the rest of the South Carolina legislature, faced a lobbying blitz by evangelicals, who feared that the vaccine would encourage children to have sex. Support for the bill cratered; Haley kept her name on as co-sponsor but later voted against the legislation. As governor, Haley vetoed a bill that would have encouraged — not mandated — HPV shots.

Haley’s primary positioning on vaccines is less extreme than that of some of her rivals; biotech entrepreneur Vivek Ramaswamy, for example, has said he regrets getting the covid shot. 

But her long history on vaccination issues looks today like a premonition. Megan Weis, a faculty member at the University of South Carolina’s Arnold School of Public Health, said of the state’s struggle over the HPV vaccine: “In retrospect, that was the beginning of some of the vaccine misinformation movement.”

This article is not available for syndication due to republishing restrictions. If you have questions about the availability of this or other content for republication, please contact NewsWeb@kff.org.

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Is Novavax, the Latecomer Covid Vaccine, Worth the Wait?

Erin Kissane, a co-founder of the COVID Tracking Project, rolled up her sleeve for the Novavax covid-19 vaccine in mid-October soon after it was finally recommended in the United States. Like many people with autoimmune diseases, she wants to protect herself from a potentially devastating covid infection.

Kissane’s autoimmune arthritis seems to make her susceptible to unusual vaccine side effects. After getting an mRNA booster last year, her joints ached so painfully that her doctor prescribed steroids to dampen the inflammation. She still considers the mRNA vaccines “miraculous,” knowing covid could be far worse than temporary aches.

Nonetheless, when the pain subsided, she pored through studies on Novavax’s shot, a vaccine that is based on proteins rather than mRNA and has been used since early 2022 in other countries. Data from the United Kingdom found that people more frequently reported temporary reactions — like low fevers, fatigue, and pain — as their immune system ramped up in the days following booster vaccination with Moderna’s mRNA vaccine versus the one by Pfizer. And those boosted with Novavax’s had fewer complaints than either of those. That finding was corroborated in an analysis of international data published last year.

Such studies have driven people with long covid and chronic fatigue syndrome (also known as myalgic encephalomyelitis, or ME/CFS) to seek out Novavax, too, since the FDA and the Centers for Disease Control and Prevention greenlighted Novavax’s vaccine — updated to protect against recent omicron coronavirus variants — about three weeks after recommending updated mRNA vaccines in September.

Waiting paid off for Kissane, whose arm was briefly sore. “It was a dramatically different experience for me,” she said. “I hope that plays out for others.”

Another group who waited on Novavax are biologists who geek out over its technology. When asked why he opted for Novavax, Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai, replied on X, formerly known as Twitter: “Because I am [a] vaccine nerd, I like insect cell produced vaccines.”

Whereas mRNA vaccines direct the body to produce spike proteins from the coronavirus SARS-CoV-2, which then train a person’s immune system to recognize and fight the virus, Novavax simply injects the proteins. These proteins are grown within moth cells in a laboratory, while other protein-based shots use cells from mammals. And Novavax has said that a special ingredient derived from the bark of Chilean soapbark trees enhances the vaccine’s power.

Research suggests that the Novavax vaccine is about as safe and effective as the mRNA shots. Its main disadvantage is arriving late to the scene. Vaccine uptake has plummeted since the first shots became widely available in 2021. Nearly 70% of people got the primary vaccines, compared with fewer than 20% opting for the mRNA covid boosters released last year. Numbers have dwindled further: As of Oct. 17, only 5% of people in the United States had gotten the latest covid vaccines, according to the Department of Health and Human Services.

Daniel Park, an epidemiologist at George Washington University, said low rates might improve if people who felt lousy after their last mRNA shots gave Novavax a try. It protects against severe illness, but researchers struggle to specify just how effective this and other vaccines are, at this point, because studies have gotten tricky to conduct: New coronavirus variants continuously emerge, and people have fluctuating levels of immunity from previous vaccines and infections.

Still, a recent study in Italy suggests that Novavax is comparable to mRNA vaccines. It remained more than 50% effective at preventing symptomatic covid four months after vaccination. Some data suggests that mixing and matching different types of vaccines confers stronger protection — although other studies have found no benefit.

Given all this, Park held out for the Novavax vaccine on account of its potentially milder side effects. “Between a demanding full-time job and two young kids at home, I wanted to stay operational,” he said. His arm was sore, but he didn’t have the 24-hour malaise accompanying his last mRNA shot.

Most people don’t strike a fever after mRNA shots. Even when they do, it is brief and therefore far less detrimental than many cases of covid. In fact, most reactions are so minor that they’re hard to interpret. During clinical trials on mRNA vaccines, for example, up to a third of people in the placebo group reported fatigue and headaches after injection.

People with ME/CFS and long covid — a potentially debilitating condition that persists months after a covid infection — have responded to covid vaccinations in a wide variety of ways. Most participants with long covid in an 83-person Canadian study said their levels of fatigue, concentration, and shortness of breath improved following vaccination. Inflammatory proteins that have been linked to long covid dropped as well.

However, larger studies have yet to corroborate the hopeful finding. Jennifer Curtin, a doctor who co-founded a telehealth clinic focused on long covid and ME/CFS, called RTHM, said vaccines seem to temporarily aggravate some patients’ conditions. To learn how Novavax compares, she posted polls on X in late October asking if people with long covid or ME/CFS felt that their symptoms worsened, improved, or stayed the same after Novavax. Most replied: unchanged.

“It’s not scientific, but we need to figure it out since these folks don’t want to get covid,” Curtin said. “My patients are all wondering about what vaccine to get right now.”

Adding to the uncertainty, the rollout of Novavax and mRNA vaccines has been bumpy as pharmacies struggle to predict demand and insurance companies figure out how to reimburse providers for the shots. Unlike previous vaccine offerings, these options are no longer fully covered by the federal government. A testament to this season’s struggle to get vaccinated is that at least one do-gooder has created an online tool to find open appointments for Novavax.

Buoyed by anecdotes of relief from others with long covid, Hayley Brown, a researcher at the Center for Economic and Policy Research who has the condition, opted for Novavax recently. Unfortunately, her symptoms have flared. She said a temporary discomfort will still be preferable to risking another infection. “As someone with long covid, the idea of getting covid again is terrifying.”

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Por un tecnicismo, niños necesitados podrían no tener acceso a vacunas contra el VRS

Tras casi cinco décadas de intentos, la industria farmacéutica está a punto de suministrar vacunas eficaces contra el virus respiratorio sincitial (VRS), que ha llevado al hospital a 90,000 niños en lo que va del invierno. 

Sin embargo, solo una de las vacunas está diseñada para administrarse a bebés, y un error en la redacción de la ley puede imposibilitar que los niños de bajos ingresos tengan el mismo acceso a la vacuna que los que tienen un buen seguro.

Desde 1994, la vacunación sistemática es un derecho de la infancia en el marco del programa Vacunas para los Niños, a través del cual el gobierno federal compra millones de vacunas y las suministra gratuitamente a través de pediatras y clínicas a los niños sin seguro, con seguro insuficiente o con Medicaid, que son más de la mitad de todos los menores estadounidenses.

La ley de 1993 por la que se creó el programa no incluye específicamente las inyecciones de anticuerpos, que se utilizaban raramente y solo como terapia de emergencia al momento en que se redactó el proyecto de ley.

Pero la primera inmunización que probablemente esté disponible para los bebés, llamada nirsevimab –se aprobó en Europa en diciembre y se prevé que la Administración de Drogas y Alimentos (FDA) la apruebe este verano–, no es una vacuna sino un anticuerpo monoclonal, que neutraliza los virus del VRS en el torrente sanguíneo.

La doctora Kelly Moore, presidenta del grupo de defensa Immunize.org, dijo que no hay duda que el Comité Asesor sobre Prácticas de Inmunización (ACIP) de Los Centros para el Control y la Prevención de Enfermedades (CDC) recomendará administrar el anticuerpo a los bebés. Ahora los CDC están analizando si nirsevimab sería elegible para el programa Vacunas para los Niños, dijo a KHN Kristen Nordlund, vocera de la agencia. 

No hacerlo “condenaría a miles y miles de niños a hospitalizaciones y enfermedades graves por razones semánticas, a pesar de la existencia de una inmunización que funciona igual que una vacuna estacional”, afirmó.

Funcionarios de Sanofi, que está produciendo la inyección de nirsevimab junto con AstraZeneca, se negaron a indicar un precio, pero dijeron que el rango sería similar al de un curso de vacuna pediátrica. Los CDC pagan alrededor de $650 por la vacuna de rutina más costosa, las cuatro inyecciones contra la infección neumocócica. En otras palabras, la aprobación de la FDA convertiría al nirsevimab en un fármaco de gran éxito con un valor de miles de millones anuales si se administra a una gran parte de los aproximadamente 3,7 millones de niños que nacen en el país cada año.

Pfizer y GSK están fabricando vacunas tradicionales contra el VRS y esperan la aprobación de la FDA a finales de este año. La inyección de Pfizer inicialmente se administraría a las mujeres embarazadas, para proteger a sus bebés de la enfermedad, mientras que la de GSK sería para los adultos mayores.

Las vacunas para lactantes se encuentran en fase de desarrollo, pero expertos aún están un poco nerviosos al respecto. En 1966 fracasó estrepitosamente el ensayo de una vacuna contra este virus en el que murieron dos bebés, y los inmunólogos no se ponen totalmente de acuerdo sobre la causa del desastre, según el doctor Barney Graham, científico jubilado de VRS y covid.

Después que los aislamientos y las máscaras por covid ralentizaran su transmisión durante dos años, el VRS estalló este año en todo Estados Unidos, inundando las unidades de cuidados intensivos pediátricos.

Sanofi y AstraZeneca, los fabricantes de nirvisemab, esperan que la FDA lo apruebe, que los CDC lo recomienden y que se aplique en todo el país antes del otoño para prevenir nuevas epidemias del VRS.

Su producto está diseñado para administrarse antes de la primera temporada invernal del VRS de cada bebé. En los ensayos clínicos los anticuerpos ofrecieron una protección de hasta cinco meses; la mayoría de los menores no necesitarían una segunda dosis porque el virus no es un peligro mortal para los niños sanos de más de un año, dijo Jon Heinrichs, miembro principal de la división de vacunas de Sanofi.

Si no se acepta el tratamiento con anticuerpos para el programa Vacunas para Niños, habrá un acceso limitado a la vacuna para los que no tienen seguro médico y para los beneficiarios de Medicaid, la mayoría de los cuales son negros e hispanos (que pueden ser de cualquier raza), indicó Moore. Las farmacéuticas tendrían que negociar con el programa Medicaid de cada estado para incluirlo en sus formularios.

Excluir la vacuna del programa Vacunas para Niños “sólo empeoraría las disparidades sanitarias existentes”, dijo el doctor Sean O’Leary, profesor de pediatría de la Universidad de Colorado y presidente del comité de enfermedades infecciosas de la Academia Americana de Pediatría.

El VRS afecta a bebés de todas las clases sociales, pero tiende a perjudicar más a los hogares pobres y hacinados, dijo Graham. “Los antecedentes familiares de asma o alergia lo empeoran, y si son muy prematuros”, dijo.

Aunque entre el 2% y el 3% de los lactantes son hospitalizados cada año por el virus respiratorio sincitial, hay una alta supervivencia. Pero hasta 10,000 adultos mayores mueren cada año a causa de estas infecciones. Esto cambiará con el fin de pagos de bolsillo para todas las vacunas bajo Medicare, incluida la del VRS, bajo la Ley de Reducción de la Inflación de 2022.

Jennifer Reich, socióloga de la Universidad de Colorado que estudia las actitudes en materia de vacunación, afirmó que es probable que el alto grado de indecisión sobre las vacunas reduzca su aceptación, independientemente de quién las pague.

Los nuevos tipos de vacunas, como los anticuerpos de Sanofi/AstraZeneca, suelen asustar a los padres, y es probable que la vacuna de Pfizer para las mujeres embarazadas también provoque temor.

Los responsables de salud pública “no parecen saber cómo superar la desinformación” de que las vacunas merman la fertilidad o perjudican de algún otro modo a las personas, dijo Reich.

Por otra parte, la epidemia del VRS de este año será significativa para muchas madres, dijo Heidi Larson, líder del Vaccine Confidence Project y profesora de antropología en la Escuela de Higiene y Medicina Tropical de Londres.

“Tener a un hijo hospitalizado por el VRS da miedo”, afirmó.

Aunque desafortunado, “el elevado número de niños que murieron o ingresaron en la UCI en la última temporada con VRS es, en cierto modo, útil”, dijo la doctora Laura Riley, catedrática de obstetricia y ginecología de Weill Cornell Medicine en Nueva York.         

Los especialistas de su campo no han empezado realmente a hablar de cómo informar a las mujeres sobre la vacuna, dijo Riley, presidenta del grupo de inmunización del Colegio Americano de Obstetras y Ginecólogos.

“Todo el mundo ha estado esperando a ver si se aprobaba”, señaló. “La educación tiene que empezar pronto, pero es difícil educar antes de lanzar la vacuna”.

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KHN’s ‘What the Health?’: Health Spending? Only Congress Knows

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Congress has a tentative framework for government spending through this fiscal year. Now, lawmakers must fill in the blanks, including on key health care provisions, and get it passed. The Biden administration will send more free covid-19 home tests to Americans after initial fears the program was running out of money.

And there’s plenty of news coming in from the states, where this week a Texas judge tossed out a lawsuit based on the state’s so-called vigilante abortion law, and the governor of Florida is asking for a grand jury investigation into harm caused by covid vaccines.

This week’s panelists are Mary Agnes Carey of KHN, Rachel Cohrs of Stat, Alice Miranda Ollstein of Politico, and Rebecca Adams of KHN.

Among the takeaways from this week’s episode:

  • Congressional appropriators have settled on an omnibus framework that would set government spending through next fall and hope to pass it by the end of next week. But lawmakers still have details to iron out. While health measures like extended flexibilities for telehealth are likely to get approved — and others, like more money for pandemic response, are not — the outcome is less clear for some key provisions. Will lawmakers relax or even nix Medicare pay cuts for doctors scheduled for next year?
  • Pharmacy chains CVS and Walgreens announced a major settlement this week in lawsuits alleging they mishandled opioid prescriptions. Most of the settlement money awarded in ongoing opioid epidemic litigation is earmarked to pay for opioid-related treatment, and families of victims are also asking for compensation for the harm opioids have caused. Meanwhile, federal lawmakers have shown little urgency to respond to the country’s epidemic of opioid-related overdoses.
  • Abortion fights continued to play out in the states this week, including in Iowa, where a judge blocked an effort to ban most abortions in the state. In Texas, a judge dealt a blow to the state’s so-called vigilante law, ruling that an individual who is not directly affected by an abortion may not sue for violations of the state’s ban. Watch for the legal challenges to continue, especially as some state legislatures return to session in January for the first time since the Supreme Court overturned Roe v. Wade.
  • In pandemic news, the Biden administration plans to reopen its program allowing Americans to request free covid home tests through the U.S. Postal Service. And the House of Representatives select committee investigating the pandemic wrapped up its work this week, with Democrats and Republicans coming to different conclusions and issuing recommendations unlikely to come to pass — a reflection of partisan tensions and a loss of public interest in the pandemic.
  • And Gov. Ron DeSantis of Florida, a Republican who is considered a possible 2024 presidential candidate, has called for a grand jury to examine alleged “crimes and wrongdoing” related to the covid vaccines.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Mary Agnes Carey: Scientific American’s “Kindness Can Have Unexpectedly Positive Consequences,” by Amit Kumar

Rachel Cohrs: The Washington Post’s “From Heart Disease to IUDs: How Doctors Dismiss Women’s Pain,” by Lindsey Bever

Alice Miranda Ollstein: Stat’s “Watch: With Little More Than a Typewriter, an Idaho Man Overturns the Entire State’s Policy on Hepatitis C Treatment in Prison,” by Nicholas Florko

Rebecca Adams: KHN’s “Mass Shootings Reopen the Debate Over Whether Crime Scene Photos Prompt Change or Trauma,” by Lauren Sausser

Also mentioned in this week’s podcast:

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KHN’s ‘What the Health?’: Voters Will Get Their Say on Multiple Health Issues

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Voters in several states will be asked to vote on ballot questions related to abortion, but it’s not the only health issue that will be decided on Election Day. Other ballot proposals will ask voters whether they want to curb interest on medical debt (Arizona), expand Medicaid (South Dakota), or make health care a right under the state constitution (Oregon).

Meanwhile, plaintiffs in a suit charging that the Affordable Care Act’s requirement to provide preventive medication against HIV are expanding their scope. Now they want the judge to rule that all preventive benefits under the health law are unconstitutional.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Jessie Hellmann of CQ Roll Call, and Victoria Knight of Axios.

Among the takeaways from this week’s episode:

  • The South Dakota ballot measure is the latest effort by health care advocates in conservative states to get a Medicaid expansion despite resistance from state officials. South Dakota’s governor and state legislature have refused to make the move. In recent years, voters in several of those states, including Idaho, Missouri, and Utah, have pushed the expansion forward over officials’ objections through voter initiatives.
  • Arizona’s unique ballot measure would limit interest rates on medical debt, among other things. It’s a bit of an under-the-radar issue, but if Arizona passes the measure, it could spur other states to try similar initiatives.
  • A handful of states will also be voting on abortion issues. In Kentucky, the legislature has put forward a constitutional amendment that says abortion rights aren’t protected by the state constitution and that government funding for abortions is not required. Voters in another red state, Kansas, surprised political pundits last summer when they overwhelmingly voted to maintain the right to abortion access, so the Kentucky results will be watched closely. If voters disapprove of the measure, it would be the first Southern state where voters have turned against the tide of legislation seeking to restrict abortion.
  • On the other hand, two reliably blue states — California and Vermont — are asking voters to enshrine a right to abortion in the states’ constitutions. Debate on the ballot measures, however, has raised the question of whether fetal viability should be a standard for when an abortion can’t be performed. Neither the groups supporting wide access for abortion rights nor those opposing abortion have said they are comfortable making a decision on abortion by using a viability standard.
  • In Washington, D.C., news, the Department of Defense’s announcement that it would pay travel expenses and provide leave for servicemembers seeking abortions out of state is likely to rile Republicans on Capitol Hill. It could also make the final negotiations tense over a defense spending bill that needs to be settled before the end of the year. The tone of those talks will likely depend on the election results next month.
  • The suit in federal court in Texas challenging the ACA’s preventive care mandates continues to grow. Judge Reed O’Connor has already ruled that the plaintiffs’ religious views should exempt them from having to provide some preventive care, including certain HIV drugs. It may yet take months to realize the implications of the case, but the plaintiffs have asked the judge to strike down all the preventive care provisions and to make the ruling applicable across the country. If that happens, the case will undoubtedly be appealed.
  • Studies out this week show that the covid-19 pandemic had a nasty aftereffect for children: Test scores have dropped around the country. And an analysis by The Washington Post found that the covid death rate among white Americans is now higher than among Black residents. These data points add to concerns this fall as public health officials face difficulty encouraging people to get the latest covid booster, let alone their flu shot.

Also this week, Rovner interviews Sandra Alvarez, writer, director, and co-producer of the documentary “InHospitable,” which looks at the growing market power of nonprofit hospitals and how well they serve their patients and their communities.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: The Washington Post’s “An Autistic Teen Needed Mental Health Help. He Spent Weeks in an ER Instead,” by William Wan

Alice Miranda Ollstein: CBS News’ “U.S. Offers Flu Shots to Migrants in Border Custody, Reversing Long-Standing Policy,” by Camilo Montoya-Galvez

Victoria Knight: Stat’s “Inside Michelle McMurry-Heath’s Departure From BIO: Firings, Internal Clashes, and a Pivotal Job Review,” by Rachel Cohrs

Jessie Hellmann: KHN’s “Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds,” by Fred Clasen-Kelly

Also mentioned in this week’s episode:

The Washington Post’s “Whites Now More Likely to Die From Covid Than Blacks: Why the Pandemic Shifted,” by Akilah Johnson and Dan Keating

Bloomberg Law’s “Law Firm Calls Out Ex-EEOC Counsel’s Note on Abortion Travel,” by Rebecca Rainey and J. Edward Moreno

To hear all our podcasts, click here.

And subscribe to KHN’s What the Health? on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

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With Polio’s Return, Here’s What Back-to-Schoolers Need to Know

Before polio vaccines became available in the 1950s, people wary of the disabling disease were afraid to allow their children outside, let alone go to school. As polio appears again decades after it was considered eliminated in the U.S., Americans unfamiliar with the dreaded disease need a primer on protecting themselves and their young children — many of whom are emerging from the trauma of the covid-19 pandemic.

What is poliomyelitis?

Polio is short for “poliomyelitis,” a neurological disease caused by a poliovirus infection. Of the three types of wild poliovirus — serotypes 1, 2, and 3 — serotype 1 is the most virulent and the most likely to cause paralysis.

Most people infected with poliovirus don’t get sick and won’t have symptoms. About a quarter of those infected might experience mild symptoms like fatigue, fever, headache, neck stiffness, sore throat, nausea, vomiting, and abdominal pain. So, as with covid-19, people who don’t have symptoms can unknowingly spread it as they interact with others. But in up to 1 in 200 people with a poliovirus infection, the virus may attack the spinal cord and brain. When it infects the spinal cord, people may develop muscle weakness or paralysis, including of the legs, arm, or chest wall. Poliovirus may also infect the brain, leading to difficulty breathing or swallowing.

People can develop post-polio syndrome decades after infection. Symptoms may include muscle pain, weakness, and wasting.

People with poliomyelitis may remain wheelchair-bound or unable to breathe without the help of a ventilator for the rest of their lives.

How does polio spread?

The virus that causes polio spreads through the “oral-fecal route,” which means it enters the body through the mouth by way of the hands, water, food, or other items contaminated with poliovirus-containing feces. Rarely, poliovirus may spread through saliva and upper respiratory droplets. The virus then infects the throat and gastrointestinal tract, spreads to the blood, and invades the nervous system.

How do doctors diagnose polio?

Poliomyelitis is diagnosed through a combination of patient interviews, physical examinations, lab testing, and scans of the spinal cord or brain. Health care providers may send feces, throat swabs, spinal fluid, and other specimens for lab testing. But because polio has been vanishingly rare in the United States for decades, doctors may not consider the diagnosis for patients with symptoms. And tests for suspected polio must be sent to the Centers for Disease Control and Prevention, since even academic centers no longer perform the tests.

How can poliovirus transmission be prevented?

The CDC recommends that all children be vaccinated against polio at ages 2 months, 4 months, 6 to 18 months, and 4 to 6 years, for a total of four doses. All 50 states and the District of Columbia require that children attending day care or public school be immunized against polio, but some states allow medical, religious, or personal exemptions. The Vaccines for Children program provides polio vaccine free of charge for children who are eligible for Medicaid, uninsured, or underinsured, or who are American Indian or Alaska Native. Most people born in the United States after 1955 likely have been vaccinated for polio. But in some areas the vaccination rates are dangerously low, such as New York’s Rockland County, where it is 60%, and Yates County, where it is 54%, because so many families there claim religious exemptions.

There are two types of polio vaccine: killed, inactivated polio vaccine (IPV) and weakened, live, oral polio vaccine (OPV). IPV is an injectable vaccine. OPV may be given by drops in the mouth or on a sugar cube, so it’s easier to administer. Both vaccines are highly effective against paralytic poliomyelitis, but OPV appears to be more effective in preventing infection and transmission.

Both the wild poliovirus and the live, weakened OPV viruses can cause infection. Because IPV is a killed virus vaccine, it cannot infect or replicate, give rise to vaccine-derived poliovirus, or cause paralytic poliomyelitis disease. The weakened, OPV viruses can mutate and regain their ability to cause paralysis — what’s called vaccine-derived poliomyelitis.

Since 2000, only IPV has been given in the United States. Two doses of IPV are at least 90% effective and three doses of IPV are at least 99% effective in preventing paralytic poliomyelitis disease. The United States stopped using OPV due to a 1-in-2,000 risk of paralysis among unvaccinated persons receiving OPV. Some countries still use OPV.

Vaccination against polio began in 1955 in the United States. Cases of paralytic poliomyelitis disease plummeted from over 15,000 a year in the early 1950s to under 100 in the 1960s and then down to fewer than 10 in the 1970s. Today, poliovirus is most likely to spread where hygiene and sanitation are poor and vaccination rates are low.

Why is polio spreading again?

The World Health Organization declared North and South America polio-free as of 1994, but in June 2022, a young adult living in Rockland County, New York, was diagnosed with serotype 2 vaccine-derived poliovirus. The patient complained of fever, neck stiffness, and leg weakness. The patient had not traveled recently outside the country and was presumably infected in the United States. The CDC has since started to monitor wastewater for poliovirus. Poliovirus genetically linked to the Rockland County case has been detected in wastewater samples from Rockland, Orange, and Sullivan counties, demonstrating community spread as far back as May 2022. Unrelated vaccine-derived poliovirus has also been detected in New York City wastewater.

How do I know if I’ve been vaccinated against polio?

There is no national database of immunization records, but all 50 states and the District of Columbia have immunization information systems with records going as far back as the 1990s. Your state or territorial health department may also have records of your vaccinations. People immunized in Arizona, the District of Columbia, Louisiana, Maryland, Mississippi, North Dakota, and Washington can access their immunization records using the MyIR Mobile app, and those who got vaccines in Idaho, Minnesota, New Jersey, and Utah can do so using the Docket app.

You may also ask your parents, your childhood pediatrician, your current doctor or pharmacist, or the K-12 schools, colleges, or universities you attended if they have records of your vaccinations. Some employers, like health care systems, may also keep records of your vaccinations in their occupational health office.

There is no test to determine if you’re immune to polio.

Do I need a polio vaccine booster if I was fully vaccinated against polio as a child?

All children and unvaccinated adults should complete the CDC-recommended four-dose series of polio vaccinations. You do not need an IPV booster if you received OPV.

Adults who are immunocompromised, traveling to a country where poliovirus is circulating, or at increased risk for exposure to poliovirus on the job, such as some lab workers and health care workers, may get a one-time IPV booster.

How is polio treated?

People with mild poliovirus infection don’t require treatment. Symptoms usually go away on their own within a couple of days.

There is no cure for paralytic poliomyelitis. Treatment focuses on physical and occupational therapy to help patients adapt and regain function.

Why hasn’t poliovirus been eradicated?

Smallpox is the only human virus to have been declared eradicated to date. A disease may be eradicated if it infects only humans, if viral infection induces long-term immunity to reinfection, and if an effective vaccine or other preventive exists. The more infectious a virus, the more difficult it is to eradicate. Viruses that spread asymptomatically are also more difficult to eradicate.

In 1988, the World Health Assembly resolved to eradicate polio by 2000. Violent conflict, the spread of conspiracy theories, vaccine skepticism, inadequate funding and political will, and poor-quality vaccination efforts slowed progress toward eradication, but before the covid pandemic, the world had gotten very close to eradicating polio. During the pandemic, childhood immunizations, including polio vaccinations, dipped in the U.S. and around the world.

To eradicate polio, the world must eradicate all wild polioviruses and vaccine-derived polioviruses. Wild poliovirus serotypes 2 and 3 have been eradicated. Wild poliovirus serotype 1, the most virulent form, remains endemic only in Pakistan and Afghanistan, but vaccine-derived polioviruses continue to circulate in some countries in Africa and other parts of the world. A staged approach involving the use of OPV, then a combination of OPV and IPV, and then IPV alone would likely be needed to finally eradicate polio from the planet.

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KHN’s ‘What the Health?’: Graham’s Bill Recenters Abortion Debate

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Sen. Lindsey Graham (R-S.C.) put abortion back on Republicans’ agenda this week with a legislative proposal calling for a national ban on most abortions after 15 weeks of pregnancy. For many in his party, it was an unwelcome intrusion that could add to public unease with the party’s efforts to limit access to abortion as they look toward the midterm elections.

The World Health Organization suggested this week that the end of the covid-19 pandemic is within sight, but that doesn’t mean there’s an end to second-guessing about how public health officials reacted or their plans going forward.

This week’s panelists are Mary Agnes Carey of KHN, Rachel Cohrs of Stat, Sandhya Raman of CQ Roll Call, and Margot Sanger-Katz of The New York Times.

Among the takeaways from this week’s episode:

  • Graham appeared to be trying to build consensus among conservatives with his bill. Republicans have been startled how the Supreme Court’s decision this summer ending a constitutional right to abortion has energized voters opposed to the move. In some red states, confusion has arisen over how strict a ban lawmakers can support. Graham’s bill would allow states to enact abortion laws that are more restrictive but would cap efforts by more progressive states to keep abortion legal later in pregnancy. He had the backing of several influential anti-abortion groups.
  • That didn’t seem to matter to many Capitol Hill Republicans. Senate Minority Leader Mitch McConnell was dismissive of the proposal, saying the issue needs to be dealt with on a state level, and refused to commit to bringing up the bill if Republicans capture the Senate in the fall elections. Conservatives have long argued that abortion access should be a state decision.
  • Graham’s announcement was inconvenient for Capitol Hill Republicans. Much of the political debate on abortion access had been focused on state races, but his bill allows Democrats to make it an issue in congressional races, too.
  • Groups that oppose abortion say that Graham’s effort is a good first step toward setting policy for the country, especially since states may continue to be more restrictive.
  • In the past, the 15-week gestational ban has been fairly well supported by the public, according to opinion polling. But new surveys suggest Americans’ views may be shifting as they witness the consequences of the Supreme Court decision and tragic stories appear about pregnancies in which fetal anomalies are discovered late or a mother’s health is impaired in late pregnancy.
  • On the covid-19 front, World Health Organization Director-General Tedros Adhanom Ghebreyesus told reporters Wednesday that the covid pandemic is not over but was upbeat about the fight against the virus. “The end is in sight,” he said.
  • His comments came as a group of world health experts, the Lancet Covid-19 Commission, blamed the WHO, the U.S. government, and others for insufficient coordination in fighting the disease. And a report by Politico and the German newspaper Welt looks at four non-governmental health organizations that had an influence on pandemic efforts.
  • Despite Adhanom Ghebreyesus’ comments, public health officials in the U.S. are pushing hard for Americans to get another covid booster this fall. And the situation points out that public health officials may not have a good handle on how to transition from treating covid as an emergency to an ongoing health threat.
  • The outlook is also muddled because the Biden administration has asked for more money from Congress to continue to fund vaccination and testing efforts, but congressional Republicans appear unlikely to support that effort. They believe it is time for the government to move out of that effort and allow the regular health industry to take over.
  • The latest statistics from the Census Bureau show a near-record low in the number of people who are uninsured. But most experts are concerned because once the covid emergency ends, states will again be allowed to recalibrate their Medicaid rolls and many people who have been covered by the federal-state health program during the pandemic could be pushed off government coverage.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Mary Agnes Carey: KHN’s “As State Institutions Close, Families of Longtime Residents Face Agonizing Choices” by Tony Leys

Rachel Cohrs: Politico’s “A New Approach to Domestic Violence” by Joanne Kenen

Sandhya Raman: The Philadelphia Inquirer’s “Philly’s Kids Are Grieving Alone From the Far-Reaching Trauma of Gun Violence, Advocates Say” by Abraham Gutman

Margot Sanger-Katz: The New York Times’ “Despite Their Influence and Extensive Access to Information, Members of Congress Can Buy and Sell Stocks With Few Restrictions”  and “These 97 Members of Congress Reported Trades in Companies Influenced by Their Committees” by Kate Kelly, Adam Playford, and Alicia Parlapiano

Also discussed on this week’s podcast:

Politico and Welt’s “How Bill Gates and Partners Used Their Clout to Control the Global Covid Response — With Little Oversight” by Erin Banco, Ashleigh Furlong, and Lennart Pfahler

The Census Bureau’s “Income, Poverty, and Health Insurance Coverage in the United States: 2021“

To hear all our podcasts, click here.

And subscribe to KHN’s What the Health? on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

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KHN’s ‘What the Health?’: Judge Takes Aim at the Affordable Care Act’s Preventive Care Benefits

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The same federal judge in Texas who tried — unsuccessfully — to strike down the entire Affordable Care Act in 2018 has ruled that portions of the health law’s preventive care benefit package are unconstitutional. But it will be a long time, with many more court actions, before it becomes clear whether the decision will change how the law works.

Meanwhile, the U.S. Department of Veterans Affairs, after several weeks of deliberations, has decided to make abortions available to patients and some dependents in some circumstances. And in Michigan, a closely watched ballot measure on abortion scheduled for this fall may not get a vote after all because of a printing problem.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico.

Among the takeaways from this week’s episode:

  • A decision announced this week by a federal judge in Texas could have a major impact on a popular provision of the Affordable Care Act that gives consumers no-cost access to a host of preventive care tests and treatments. Judge Reed O’Connor said the group that determines which services are eligible for that coverage does not have proper authorization from Congress.
  • O’Connor also ruled that employers with deep religious beliefs should not have to provide HIV prevention medications to workers if the employers believe those drugs encourage improper sexual behavior. The judge has not yet announced how he will suggest both these issues be remedied.
  • The Biden administration announced Thursday that it is overturning a rule implemented by the Trump administration that restricted immigrants’ ability to apply for permanent status in the U.S. if they had received government subsidies.
  • The U.S. Department of Veterans Affairs said it will now provide limited abortions for veterans and their eligible dependents at VA facilities in states that have restricted access to the procedure. The care will be available to veterans and dependents if the pregnancy is a result of rape or incest or is jeopardizing the life of the woman.
  • In Michigan, a state judge ruled that a 1931 ban on abortions is unconstitutional, but that is expected to be appealed. In the meantime, abortion-rights supporters are seeking to get a ballot measure that would guarantee access approved for consideration in the November election. The supporters have enough signatures, but the measure was drafted with a typographical error that could invalidate it. A court is expected to rule on the issue soon.
  • New covid-19 booster immunizations are rolling out to health centers and pharmacies across the country. The administration is encouraging anyone 12 or older (who hasn’t had a vaccination in the past two months) to get the shot. Administration health experts suggest this is the beginning of an effort to simplify the vaccination schedule and hope that most people will need only one shot a year after this. But that goal will depend on how the virus continues to mutate.
  • The Senate is back at work on Capitol Hill, and the House will return next week. The lawmakers still must come up with funding for the fiscal year that begins Oct. 1. Most people expect that they will turn to a temporary funding measure for the short term.
  • Three senators are out with covid, and one key Republican, Sen. Richard Burr of North Carolina, is absent because of a hip replacement. His absence comes at an inopportune time because he has worked with Democrats to try to push through a bill that extends the FDA’s ability to charge user fees to drugmakers to help pay for the agency’s assessments of drugs. He has also helped pull together a bill with Sen. Patty Murray (D-Wash.) to fund more efforts for public health preparedness.

Also this week, Rovner interviews KHN’s Lauren Sausser, who reported and wrote the latest KHN-NPR “Bill of the Month” installment, about a patient in need of a biopsy who did all the right things in advance and still got stuck with a giant bill. If you have an enormous or outrageous medical bill you’d like to send us, you can do that here.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: KHN’s “When Does Life Begin? As State Laws Define It, Science, Politics, and Religion Clash,” by Sarah Varney

Alice Miranda Ollstein: The New Yorker’s “When Private Equity Takes Over a Nursing Home,” by Yasmin Rafiei

Joanne Kenen: ProPublica’s “‘The Human Psyche Was Not Built for This,’” by Marilyn W. Thompson and Jenny Deam

Sarah Karlin-Smith: Stat’s “Study Raises Concerns About the Effectiveness of the Monkeypox Vaccine,” by Helen Branswell

Also mentioned in this week’s episode:

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