Overnight Healthcare

Overnight Health Care — Presented by Carequest — Key CDC panel backs Moderna, J&J boosters

Welcome to Thursday's Overnight Health Care, where we're following the latest moves on policy and news affecting your health. Subscribe here: thehill.com/newsletter-signup.

Sports players and entertainers continue to face decisions on how to handle COVID-19 requirements. The Australian immigration manager said tennis player Novak Djokovic needs to be vaccinated to participate in the Australian Open, while country star Travis Tritt said he's canceling shows at concert venues that require masks, testing or vaccination. 

And a Centers for Disease Control and Prevention (CDC) advisory panel voted to recommend that some Moderna and all Johnson & Johnson coronavirus vaccine recipients be able to get booster shots. 

For The Hill, we're Peter Sullivan (psullivan@thehill.com), Nathaniel Weixel (nweixel@thehill.com) and Justine Coleman (jcoleman@thehill.com). Write to us with tips and feedback, and follow us on Twitter: @PeterSullivan4, @NateWeixel and @JustineColeman8.

Let's get started.

CDC advisory panel unanimously endorses more COVID-19 vaccine boosters 

A Centers for Disease Control and Prevention (CDC) advisory panel recommended the agency allow Moderna and Johnson & Johnson coronavirus vaccine booster doses to be administered, the latest step toward expanding access to extra doses nationwide. 

The committee backed widening booster accessibility for people who initially received Moderna or Johnson & Johnson after the CDC previously approved the Pfizer-BioNTech booster shots for specific populations.

The panel, in a 15-0 vote, endorsed a third shot for certain populations at least six months after their second dose of an mRNA vaccine, either Moderna or Pfizer-BioNTech. It also unanimously suggested allowing a second dose for all adults who initially received Johnson & Johnson at least two months after their first shot. 

What the votes mean: The vote brings recommendations for Moderna recipients in line with those who got the Pfizer-BioNTech vaccine and opens up opportunities for Johnson & Johnson recipients to get another shot. 

The panel did not take a position on whether any vaccine booster was better, and did not recommend giving people the flexibility to mix and match, after the Food and Drug Administration (FDA) amended its emergency use authorization to permit mix-and-match booster doses. The panel was not able to express a preference for people using a different brand for a booster, but they asked CDC to give more details in clinical guidance. So mixing and matching will be allowed, but there wasn't an official recommendation.

What's next: CDC Director Rochelle Walensky will next consider the committee's suggestions before ruling on these boosters.

If she approves the other two booster populations, about 99 million Americans in total will be considered eligible to get a booster. ​​The director generally goes along with the recommendations, but she overruled aspects of the committee's decision in a rare departure on the Pfizer booster.

Read more here.

A MESSAGE FROM CAREQUEST

'MIX AND MATCH' BOOSTERS COULD POSE LOGISTICAL HURDLES FOR STATES

The CDC is poised to let people get a different booster than their primary shot. Experts say it will give doctors and states flexibility, and smooth over confusing messages over boosters.  

However, public health officials have expressed concern about more transient populations, like migrants and the homeless, who received the one-shot regimen of the Johnson & Johnson vaccine. These groups, experts say, may be harder to reach for a second dose.  

States are ready to go find those people, but acknowledge it could be difficult.

"We very well might miss some of those people in this next round, but we continue to work on ways that we can provide access and messaging, so that you know we are able to connect to people," West Virginia COVID czar Clay Marsh said. 

Other medical professionals hope that the federal government issues a more nuanced guidance on mixing booster shots, with a focus on receiving a dose of a person's original series.  

Experts said if people need a booster, they may be better off getting the same vaccine as their initial series. But in some places, like nursing homes, access to the original vaccine may not be possible.  

Federal officials have been trying to balance the differing and sometimes contradictory messages surrounding the Biden administration's booster campaign. While the administration initially told the public everyone over the age of 18 who wanted a booster could get one, the reality is more complicated. 

Read more here.

DeSantis to call special session of legislature to fight vaccine mandates

Florida Gov. Ron DeSantis (R) announced Thursday that he is calling a special session of the state legislature to pass bills aimed at fighting COVID-19 vaccine mandates.  

DeSantis has been in an escalating clash with the Biden administration over vaccine mandates.

Earlier this month he announced that he planned to sue over the requirements and he said at a press conference on Thursday that he also wants to enact protections for workers against employers' vaccine mandates through legislation. 

"In Florida, your right to earn a living is not contingent upon whatever choices you're making in terms of these injections," DeSantis said. 

Among several ideas he floated: "If anyone has been forced to do an injection and has an adverse reaction, that business should be liable for that, any damages, you have to do it because that's on them, it wasn't an individual choice." 

Many health experts have praised COVID-19 vaccine mandates as a key step in getting more people vaccinated after voluntary efforts like incentives hit a ceiling, and have pointed to the track record of millions of shots given already to show the vaccines are very safe and effective. 

"When the vaccines first came out, we worked very hard to provide it, particularly to our elderly, but we said from day one: we will make it available for all, but we will mandate it on none because ultimately we want individuals to make the determinations about what is right for them," DeSantis said. 

Big picture: Republicans across the country have fought back against vaccine mandates. In September, every GOP senator voted for an amendment to block Biden's regulation on businesses.  

Read more here

GOP SENATORS CALL ON BIDEN TO BACK DOWN FROM VACCINE MANDATES

A group of Republican senators on Thursday sent a letter to the White House calling on President Biden to back down from his COVID-19 vaccine mandate policies.

The senators, led by Dan Sullivan (R-Alaska) and Tommy Tuberville (R-Ala.), said the administration's executive order requiring all federal employees and contractors to be vaccinated, as well as a forthcoming Labor Department rule that will require many companies to implement coronavirus vaccination or testing protocols for their workers, are unconstitutional.

The White House has sought to argue that GOP governors like DeSantis and Texas's Greg Abbott are putting politics ahead of health, while opponents of mandates have cast the White House as abridging personal freedoms and of overreach.

Health experts have praised mandates as an effective way to get people vaccinated, and the White House has fully leaned into them as a way to turn the tide of the pandemic, after initially steering clear of federal intervention.

Not public yet: The Labor Department rule has yet to be published. Groups are racing to meet with the White House to get clarity, and it could be issued at any day. But the delay since the WHite House initially announced it was coming, an durgent, shows how complicated the policy is likely to be.

Read more here

A MESSAGE FROM CAREQUEST

Democrats jostle over health care priorities for scaled-back package 

Jockeying is intensifying over a range of competing health care priorities as Democrats shrink their social spending package in an attempt to shore up enough support to advance the legislation.

​​Sen. Bernie Sanders (I-Vt.) is pushing for expanding Medicare to include dental, vision and hearing benefits, saying the provisions are "not negotiable."

But House Majority Whip James Clyburn (D-S.C.) says that expanding Medicaid for low-income people living in the 12 GOP-led states that have so far declined the expansion should take precedence, noting that Medicare includes coverage for "millionaires and billionaires."

Sen. Joe Manchin (D-W.Va.), a key centrist vote, has also expressed concern with expanding Medicare benefits, saying he wants to shore up the finances of the current Medicare program before expanding it. 

Speaker Nancy Pelosi (D-Calif.), meanwhile, has prioritized a third health care move: extending enhanced financial assistance to help people afford premiums under the Affordable Care Act (ACA), a key part of her legacy.

With the overall size of President Biden's Build Back Better package shrinking, Democrats are searching for ways to fit in all of the health care priorities, leading to tensions in the party over the differing initiatives.

Democrats are discussing making the Medicare, Medicaid and ACA provisions all temporary as a way to save money and avoid completely eliminating any one of them. But even with this approach, lawmakers have indicated there are still contentious debates that need to be worked out.

Read more here

WHAT WE'RE READING

    • WHO estimate: 115,000 health workers have died from Covid-19, as calls for vaccine access grow (Stat
    • Moscow is going back into lockdown as Covid-19 deaths multiply in Russia (CNN)
    • UK PM says sticking with current plan for COVID-19 despite high case numbers (Reuters)

STATE BY STATE 

  • As COVID rages on Rikers, staffing crisis delays vaccine mandate for jail staff (Gothamist)
  • DC's Harllee Harper is using public health tools to prevent gun violence. Will it work? (Kaiser Health News)
  • New study reveals why Provincetown did not become a COVID super-spreader event (Boston Globe)

OP-EDS IN THE HILL

That's it for today, thanks for reading. Check out The Hill's healthcare page for the latest news and coverage. See you Friday.

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