HEALTH CARE BRIEFING: U.S. Urges States to Widen Vaccine Access

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The U.S. government wants states to offer vaccines to millions more Americans as Covid-19 infections continue to soar, in a bid to bolster an immunization campaign that’s off to a rocky start.

In recommending that states start immunizing all residents 65 and older, along with all those between 16 and 64 with medical conditions that make them more vulnerable to serious disease, U.S. health officials are clearing a path for about 128 million more Americans to be vaccinated.

About 10 million people have received the first dose of a Covid vaccine since immunizations started in late December, according to Bloomberg’s vaccine tracker. The rapid shift in strategy has raised worries that an accelerated rollout, for which many states may not be ready, could lead to new shortfalls down the road.

“The first couple of weeks it was all: Why aren’t they all done, why aren’t you getting them out fast enough?” Maryland Gov. Larry Hogan (R) said in a briefing yesterday. “The next story is going to be: There’s hundreds of thousands of people waiting for the vaccines and we don’t have any.”

Expanding eligibility is intended to speed up vaccination by increasing demand and giving providers more flexibility, resulting in fewer wasted doses. Yet such a strategy with supplies still limited risks exacerbating the frustration and chaos already playing out in some states. Striking a balance between immunizing quickly and establishing confidence in the U.S. vaccination campaign will be crucial in the weeks ahead.

In a briefing yesterday, Health and Human Services Secretary Alex Azar also urged states to open up vaccination to younger people with medical conditions that put them at higher risk of severe illness from Covid-19. States can ultimately decide how to prioritize the shots they receive.

If the entire country follows the guidelines Azar recommended, another 128 million Americans would immediately become eligible for vaccinations, according to population estimates from the Centers for Disease Control and Prevention. That would expand the pool to 58% of those 16 and older in the U.S. Read more from Angelica LaVito and John Tozzi.

Happening on the Hill

Biden Aims for Deal With GOP on Covid-19 Relief Package: Biden will seek a deal with Republicans on another round of Covid-19 relief, rather than attempting to ram a package through without their support, according to two people familiar with the matter. The approach could mean a smaller initial package that features some priorities favored by Senate Republican leader Mitch McConnell (R-Ky.). The idea is to forgo using a special budget process that would remove the need to get the support of at least 10 Republicans in the Senate, which will be split 50-50 and under Democratic control only thanks to the vice president’s vote.

Sen. Chuck Schumer (D-N.Y.), who is set to become the chamber’s majority leader, in a letter yesterday outlined his agenda for the 117th, stating the “first order of legislative business” would be additional Covid-19 emergency relief legislation, including vaccine distribution help. He also said he wants to “significantly” improve health care and child care systems. Sen. Kirsten Gillibrand (D-N.Y.) said she thinks the House-passed Heroes Act, a $2.2 trillion measure—some of which became part of the $900 billion bipartisan compromise enacted in December—would be the framework for an “updated” bill that could pass in a few weeks. Read more from Erik Wasson.

House Adopts Measure to Fine Maskless Lawmakers: The House last night adopted a resolution that would implement a fine system for non-compliance with mask requirement on the House floor. The rule would establish a $500 fine for first offense and $2,500 for second offense deducted from the member’s pay. The move comes after several House Democrats tested positive for the virus after they were forced into a secured room with Republicans who refused calls to put on face masks during the Capitol attack, Megan Howard reports.

  • Rep. Brad Schneider (D-Ill.) yesterday became the third lawmaker who has tested positive for Covid-19 after being forced during the Capitol riot into a secured space with maskless Republicans. He is isolating and said he is “worried that I have risked my wife’s health and angry at the selfishness and arrogance of the antimaskers who put their own contempt and disregard for decency ahead of the health and safety of their colleagues,” according to a statement.

More on the Pandemic

U.S. to Require Negative Tests for Foreign Visitors: The U.S. will require proof of a negative Covid-19 test before allowing visitors to fly into the country from other nations, in an effort to help airlines regain some of their most lucrative international travel. The Centers for Disease Control and Prevention said it approved the new anti-pandemic measure that will take effect on Jan. 26. It requires travelers receive a test within three days before leaving for the U.S. and provide documentation of the negative test. Alan Levin and Mary Schlangenstein have more.

U.S. to Continue Needing 2.2 Billion N95s Per Year: The U.S. will continue to need 2.2 billion N95 masks a year, and potentially more, after the pandemic is under control, a senior Trump administration official said in an interview with Bloomberg Law. Domestic production for now is meeting the demand for N95s, with about 181 million expected to be produced by the end of January, said David Sanford, the head of the supply chain task force. Shira Stein has more.

Uber, Moderna to Use In-App Messaging to Boost Vaccine Awareness: Uber customers could be getting notifications in the app about more than just the status of their ride. The company is partnering with Covid-19 vaccine developer Moderna to provide vaccine information, and eventually even help schedule rides to appointments. Read more from Lizette Chapman.

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What Else to Know

On-Demand Presidential Transition Process: BGOV has been in discussion with the Center for Presidential Transition to provide insights on the presidential transitions process, the mechanics involved, and first 100 days in office. This two-part series features an on-demand discussion on the transition process itself; and part two will be a live event on Friday featuring BGOV reporters alongside David Marchick (Center for Presidential Transition), former Health and Human Services secretary Kathleen Sebelius and former Homeland Security secretary Janet Napolitano.

SCOTUS Halts Mail Delivery of Abortion-Inducing Pills: A divided U.S. Supreme Court reinstated a requirement that women visit a medical facility to obtain abortion-inducing pills, granting a Trump administration request to end the mail deliveries a judge had allowed during the coronavirus pandemic. The order, which came over three dissents, marks a shift for a court that let mail deliveries continue temporarily in October. That was before Justice Amy Coney Barrett joined the court and strengthened its conservative majority. Read more from Greg Stohr.

AstraZeneca Sues HHS Over Advisory Opinion on Drug Discounts: AstraZeneca Pharmaceuticals LP is suing the Department of Health and Human Services over a policy push for drugmakers to provide discounts to pharmacies that contract with low-income health centers and hospitals, arguing the approach misrepresents the point of a federal drug pricing program.

HHS General Counsel Robert Charrow issued an advisory opinion in December requiring drug manufacturers to give the same substantial discounts provided to institutions serving vulnerable populations under the 340B program to their contract pharmacies.
Read more from Ian Lopez.

  • Separately, a pharmacy benefit manager group is suing the HHS over a rule it says threatens its members with “significant criminal and civil liability” for negotiating drug rebates with manufacturers. The Pharmaceutical Care Management Association yesterday challenged the final rule from the Department of Health and Human Services, which was released in November as an attempt to curb drug price fluctuations. Read more from Ian Lopez.

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To contact the reporter on this story: Brandon Lee in Washington at

To contact the editors responsible for this story: Zachary Sherwood at; Giuseppe Macri at; Michaela Ross at

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