HEALTH CARE BRIEFING: Vaccine Doubts Undermine Warp Speed Effort

Health officials responsible for distributing future Covid vaccines, particularly in areas where distrust has long been high, face both a resurgent anti-vaccination movement and worries that the White House will force out a remedy that isn’t safe.

Many of the plans to distribute vaccines submitted to the U.S. Centers for Disease Control and Prevention by health officials across the country lack details about how to persuade Americans to take them, according to researchers. If government officials can’t speak more loudly and convincingly than anti-vaccine voices online, the U.S. risks spending billions of dollars to fast-track a vaccine many won’t take.

“We’re at risk of blowing all the benefits of Operation Warp Speed if not enough people want it,” Alison Buttenheim, a professor at the University of Pennsylvania who studies vaccine hesitancy, said, referring to the White House initiative to speed a Covid-19 vaccine.

More than 70% of U.S. children received all seven recommended vaccines by the time they were 3 years old in 2017, federal data show. More than 90% of children were given measles and mumps vaccines. By contrast, about half of U.S. adults, 51%, said they wouldn’t take a Covid-19 vaccine in September, down from 72% in May, a Pew Research Center survey found.

Fears of a politically motivated approval may dissipate after the election, but Americans will still need information about a new vaccine, said Claire Hannan, lead director of the Association of Immunization Managers. “This challenge of communicating and educating and making sure that people accept and trust the vaccine, that may be the biggest one we have,” Hannan said.

Researchers who studied vaccine use and public sentiment say past isn’t prologue for promoting a new Covid-19 vaccine. It’s likely to be designed for adults, not children who receive the bulk of immunizations, so encouraging people to take it will require many public health agencies to use new communication tactics.

“Anyone who tells you that we know how to promote this new vaccine is not correct,” Buttenheim said. “There’s no playbook.” Read more from Alex Ruoff.

Battle for the Senate

Democrats are on the brink of capturing the Senate to give the party full control of Congress, though the final outcome depends heavily on the strength of Joe Biden’s performance.

Polls and independent analysts indicate that Democrats have a solid chance at winning at least a narrow Senate majority, with Republicans on the defensive in 12 of the 14 most competitive races. And two years after Democrats gained control of the House by winning 41 GOP-held districts they are looking to add at least a dozen in 2020.

For both parties, the Senate largely hinges on the presidential contest between Biden and President Donald Trump.

Biden has healthy poll leads in two states with vulnerable GOP incumbents down the ballot, in Maine and Colorado. He and Trump are essentially deadlocked in several other states with competitive Senate races, including Arizona, Iowa and North Carolina. At the same time, Trump is under-performing in many of the other states he won in 2016, giving Democrats opportunities in traditionally Republican strongholds such as Georgia and South Carolina, Laura Litvan, Steven T. Dennis and Billy House report.

  • Sen. Susan Collins(R-Maine), a member of the Senate Appropriations Agriculture-FDA Subcommittee and chairwoman of the Senate Aging Committee, faces an uphill battle against Maine House Speaker Sara Gideon (D).
  • Sen. Martha McSally (R-Ariz.), who sits on the Aging Committee, represents a formerly reliable territory for a Republican, but demographic shifts, a backlash against the president and changing politics around health care have put her on the defensive. She’s up against one of the Democrats’ best-funded challengers, astronaut Mark Kelly.
  • Sen. Lindsey Graham (R-S.C.), who sits on the Senate Appropriations Committee’s Labor-Health and Human Services Subcommittee and chairs the Foreign Relations Committee’s panel on global health policy, faces a fierce challenge from Democrat Jaime Harrison. Most polls show them tied.
  • Sen. David Perdue (R-Ga.), who sits on the Senate Foreign Relations Committee’s Africa and Global Health Policy Subcommittee, is largely tied with Democratic challenger Jon Ossoff, who narrowly lost a special election in 2017 for the Atlanta-area House seat. The race is close enough it could lead to a runoff, potentially leaving control of the chamber in doubt until January.
  • Sen. Kelly Loeffler (R-Ga.), who sits on the Senate Health, Education, Labor and Pensions Committee—where she’s a member of the Children and Families; Primary Health and Retirement Security; and Employment and Workplace Safety subcommittees—is staring at a challenge on two fronts. She’s fighting Rep. Doug Collins (R), who claims to be the true conservative, and Democrat Raphael Warnock, senior pastor of the Ebenezer Baptist Church in Atlanta.
  • Sen. Steve Daines (R-Mont.), a member of the Senate Finance Committee’s Health Care panel, wields a 3-point lead over Gov. Steve Bullock (D), according to recent polling averages.
  • Sen. Doug Jones (D-Ala.), who sits on the Senate Aging panel as well as the Health, Education, Labor, and Pensions Committee, appears poised to lose his seat, as Republican challenger Tommy Tuberville holds an 11-point lead in the latest Auburn University poll of likely voters in reliably Republican Alabama.

Race for the White House: The final stretch of the race for the White House between Trump and Biden has been fraught with dramatic twists—a hospitalized president, a resurgent pandemic, the death of an iconic Supreme Court justice, and the rapid confirmation of her successor. Yet, none of it seems to have altered the direction of the race set months ago. Ahead of Election Day, Trump finds himself significantly trailing his Democratic challenger and looking to defy public opinion polls—as he did four years ago—to salvage a victory. Josh Wingrove has the state of play on the race.

Follow Results With Bloomberg: Starting tomorrow, Bloomberg News will report live election results for the presidential, Senate, House and gubernatorial races.

Trump’s Dismissal of Virus Paved Way for White House Outbreak: As the virus tightened its grip on the U.S, the White House itself became an incubator for infection. Since the onset of the pandemic, more than three dozen people close to the president have contracted the virus, though no one associated with the White House is known to have died.

Yet at the White House he shunned one of the simplest and most effective ways of preventing transmission — wearing a mask. “Take that f—ing thing off,” he demanded more than once to aides who showed up wearing masks in the early days of the virus, when he’d been told they weren’t a fail-safe. “It doesn’t look good.” Read more from Jennifer Jacobs.

More on the Pandemic

Trump Claims Doctors Lie About Virus for Money: Trump claimed without substantiation that doctors are lying about the number of Americans who died from Covid-19, saying they inflate the figure because they are paid more for deaths attributed to the virus. There is no evidence for the president’s assertion, and physician groups have castigated him for maligning their profession. “Our doctors get more money if someone dies from Covid. You know that, right?” he said at a rally in Michigan. Trump has made similar claims before, and medical groups have called them false and appalling. Read more from Jordan Fabian.

  • Separately, Trump Friday said there would be a “tremendous stimulus package immediately after the election,” despite the stalling of negotiations between Treasury Secretary Steven Mnuchin and Speaker Nancy Pelosi (D-Calif.), Jordan Fabian and Catherine Larkin report.
  • A “Fire Fauci” chant erupted at one of Trump’s campaign rallies, with the president quipping that he’d wait until after the election if he were to do anything. The chant, which started shortly after midnight this morning, was the latest development in Trump’s ongoing critique of Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who was once a prominent figure in Trump’s coronavirus response but who has since been marginalized. Read more from Mario Parker and Josh Wingrove.

Trump Rallies May Have Killed 700 People: Trump’s rallies likely led to thousands of coronavirus cases and hundreds of deaths, according to a Stanford University report published last week. The economists’ study, which hasn’t been peer reviewed, estimated that 18 Trump election rallies over the summer were linked to more than 30,000 confirmed cases of Covid-19 and 700 deaths. “Our analysis strongly supports the warnings and recommendations of public health officials” regarding the risk of Covid’s transmission at large group gatherings,” the researchers wrote. Read more from Naomi Nix.

Atlas Apologizes Over Interview to Russian Agency: One of Trump’s top medical advisers issued an apology yesterday for giving an interview to a Russian news agency that’s registered as a foreign agent in the U.S. Scott Atlas, a physician and one-time Fox commentator who rose to the president’s inner circle after repeatedly downplaying the risk of the coronavirus, issued an apology in a tweet, in particular to U.S. national security officials. “I regret doing the interview and apologize for allowing myself to be taken advantage of. I especially apologize to the national security community who is working hard to defend us,” he said. Read more from Josh Wingrove.

Panel Rips Trump Response to Pandemic: The Trump administration’s response to the pandemic has been “inefficient, ineffective and inequitable,” according to a report by the House Select Subcommittee on the Coronavirus Crisis. The 69-page report, based in part on hearings and briefing by administration officials, calls the pandemic“an American fiasco” and the administration’s response “among the worst failures of leadership in American history.” Relief programs for workers and businesses were weakened by the administration’s giving priority to bigger companies and that inadequate financial controls led to “significant fraud, waste, and abuse,” according to the report. Read the report here.

Covid Straining Hospitals From Poland to Utah: Surging cases of coronavirus across Europe and North America are filling intensive-care beds, straining hospitals and prompting some to warn of shortages, as the global pandemic takes a worrying turn. Hospitalizations skyrocketed in more than a dozen countries in Europe, with new admissions soaring beyond the peak reached last spring in a swathe from Austria to Portugal. In the U.S., where new daily cases topped a record 92,000 on Friday, hospitalization rates have climbed 12% over the past month, with over one in six inpatients in South Dakota having the coronavirus, government data show. Read more from Jason Galle.

Testing, Treatment & Research:

Global Response & Coordination:

What Else to Know

Georgia Moves to Begin Obamacare Exit: Georgia yesterday won approval of its plan to walk away from the federal Obamacare exchange, marking the most far-reaching departure yet from the signature health-care law. The Georgia Access Plan will require consumers wanting to enroll in Obamacare to shop for and buy coverage directly from insurers or through web brokers. The state will transition from the federal HealthCare.gov exchange to a private sector platform starting in plan year 2023, the Centers for Medicare & Medicaid Services said in a statement announcing the approval. Read more from Alexis Kramer.

Block on LGBTQ Health Rule Capped: A federal district court in New York said it can’t temporarily block some provisions of a Health and Human Services Department rule that allows health-care providers and insurers to discriminate against LGBTQ people. The U.S. District Court for the Eastern District of New York last week clarified the scope of a preliminary injunction it issued in August against the HHS rule. Because the transgender women who fought the HHS rule didn’t allege specific instances of discrimination from insurers and because neither is enrolled in Medicare or Medicaid, the court said it can’t temporarily block provisions of the rule. Read more from Lydia Wheeler.

Texas Abortion Law to Get Rehearing: A Texas law restricting dilation-and-evacuation abortion will be reviewed by the entire Fifth Circuit, the court announced Friday, withdrawing a recent opinion in which a split three-judge panel struck the law as unconstitutional. The court opted to rehear the case on its own motion, after a majority vote by active, non-disqualified judges. This move vacates an opinion in October striking abortion restrictions in Texas Senate Bill 8, which barred D&E abortions except if the doctor first ensures “fetal demise” in utero. Read more from Jacklyn Wille.

Texas Surprise Billing Ban Points to Fight in Congress: A new Texas law that settles hospital payment disputes through arbitration so far favors physicians over health insurers, and illustrates why efforts to pass a federal ban on surprise medical bills have hit a roadblock on Capitol Hill. The state’s law against surprise billing (S.B. 1264) enacted in January has been a success by some metrics, resulting in a 95% drop in consumer complaints over unexpected bills and a 70% decrease in provider complaints. But insurers are paying the price. Read more from Sara Hansard.

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To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com

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