Overnight Healthcare

Overnight Health Care: Moderna says booster likely needed before winter | Fauci: Booster shots for immunocompromised ‘very high priority’ | Vaccinations rise as cases surge

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Welcome to Thursday’s Overnight Health Care.

The message from Maryland Gov. Larry Hogan (R): “Just get the damn vaccine.” 

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Today: It’s about boosters. Moderna says boosters are likely going to be needed before the winter, and Anthony Fauci indicated the administration is looking to move on the issue at least for one group. Meanwhile, the White House says it hasn’t actually decided on a vaccine mandate for incoming foreign travelers.

We’ll start with Moderna: 

Booster debate heating up: Moderna says booster likely needed before winter

Moderna said Thursday that its COVID-19 vaccine maintained 93 percent efficacy six months after the second dose but added that a booster shot will likely still be needed before the winter.

The efficacy rate was announced by the company ahead of an earnings call on Thursday, and is higher than the 84 percent efficacy rate of the Pfizer vaccine after the same amount of time.

Still, Moderna CEO Stephane Bancel said on CNBC Thursday that the data was collected before the delta variant became prevalent in the United States, meaning the equation could change now that the delta variant is widespread.

While there is strong data for six months, the company said in a presentation that it believes antibody levels will “continue to wane and eventually impact vaccine efficacy.”

It added that the combination of delta, fatigue with wearing masks and people moving indoors as the weather gets colder will cause an “increase of breakthrough infections in vaccinated individuals.”

“Given this intersection, we believe dose 3 booster will likely be necessary prior to the winter season,” the company said.

Read more here.

And one group in particular could need booster especially soon: the immunocompromised

The Biden administration is working to get immunocompromised people booster shots of the COVID-19 vaccine “as quickly as possible,” Anthony Fauci said Thursday, calling the group “vulnerable.”

Administration health officials have said that booster shots overall are not needed at this time, but Thursday’s comments from President Biden‘s chief medical adviser signal a new urgency for additional shots to those with compromised immune systems.

That group includes people who have received organ transplants, are undergoing chemotherapy or are taking medications that suppress their immune system. Slides presented at a Centers for Disease Control and Prevention (CDC) advisory committee meeting last month estimated the group accounts for 2.7 percent of all U.S. adults.

“Immunocompromised individuals are vulnerable,” Fauci, the government’s top infectious disease expert, said at a White House press briefing on Thursday.

With some exceptions, he said, they “do not make an adequate response [to the COVID-19 vaccine] that we feel would be adequately protective.”

“It is extremely important for us to move to get those individuals their boosters, and we are now working on that and will make that be implemented as quickly as possible, because for us and for the individuals involved it is a very high priority,” Fauci said

Read more here.  

But Mississippi is already recommending boosters for vulnerable people

Mississippi is encouraging COVID-19 booster shots for certain high-risk groups, as one of the least-vaccinated states in the country faces an onslaught from the delta variant of the coronavirus.

According to a memo from the state department of health, physicians should consider giving a booster dose of a COVID-19 vaccine to anyone who is immunocompromised, including organ transplant recipients, people taking immunosuppressive drugs, and people with underlying medical conditions such as chronic kidney disease.

While the overwhelming majority of cases, hospitalizations and deaths in Mississippi are among unvaccinated individuals, the number of deaths among fully vaccinated people has been increasing.

Paul Byers, a physician with the state Department of Health, said in the memo that since April 1, more than 35 vaccine breakthrough deaths have been confirmed. For the deaths where the person’s medical history was known, 58 percent had either a known immunocompromising condition or history of kidney disease.

Guidance: The memo recommends waiting at least four weeks after the final dose of the original vaccination series before administering a booster. It also recommends physicians perform spike protein antibody testing to determine the presence, or absence, of detectable antibodies prior to booster dosing. 

If a patient was originally given an mRNA vaccine, either Pfizer or Moderna, the recommendation is to consider using the same manufacturer for the booster dose. If the original vaccine was Johnson & Johnson, the recommendation is to consider using the Pfizer mRNA vaccine.

Read more here.  

White House says no decision yet on foreign traveler vaccination rule

The White House on Thursday said that the U.S. is strongly considering requiring foreign visitors to be fully vaccinated against COVID-19, but that there has not been a final decision on whether such a requirement will be adopted.

“That is certainly under strong consideration, but it is under a policy process review right now that I won’t get ahead of myself,” White House press secretary Jen Psaki told reporters at a briefing.

White House coronavirus response coordinator Jeff Zients on Thursday also said no decision has been made about how to reopen international travel and suggested other options were being considered beyond requiring foreign travelers to have vaccinations.

“That’s one of the paths that’s being looked at and considered, but there are alternative paths being looked at, at the same time,” Zients told reporters during a coronavirus briefing. 

Shift in guidance: The comments represented a shift from guidance that a White House official provided a day prior. The official told The Hill that interagency working groups are working to develop a plan “for a consistent and safe international travel policy, in order to have a new system ready for when we can reopen travel.”

“This includes a phased approach that over time will mean, with limited exceptions, that foreign nationals traveling to the United States (from all countries) need to be fully vaccinated,” the official said.

Reuters first reported that the Biden administration is developing a plan to require foreign visitors to have COVID-19 vaccinations. There was not an indication on Wednesday that requiring vaccinations was among a handful of options being considered, or that the ultimate goal was not definitively to require vaccinations.

Read more here

Biden administration sees ‘significant’ rise in vaccinations as cases surge

Top White House officials highlighted a significant rise in vaccination rates on Thursday as the U.S. endures surging COVID-19 cases, hospitalizations and deaths, especially in Florida and Texas.  

The national vaccination rate reached its highest level since early last month with 864,000 doses administered, White House coronavirus response coordinator Jeff Zients told reporters. About 585,000 of those doses were the patients’ first shots, suggesting more unvaccinated people are getting the jab.

Zients stated that the vaccination rates in Louisiana, Arkansas, Missouri, Alabama, Oklahoma and Mississippi have hit levels not seen since April. 

“Importantly, we’re seeing the most significant increases in the states with the highest case rates,” Zients said.

But: The rise in vaccinations comes as the country struggles with COVID-19 — almost 83 percent of counties have “substantial” or “high” viral transmission. 

Seven states with some of the lowest vaccination rates account for about half of new cases and hospitalizations this week, even though they make up less than a quarter of the population, Zients said. 

Florida and Texas make up one-third of the U.S.’s new cases and more than one-third of the country’s new hospitalizations over the past week. 

Read more here

What we’re reading

Delta variant increases demand and wait times for Covid-19 tests (The Wall Street Journal)

2+2=? Senate uses murky math as it shelves drug pricing rule to fund infrastructure (Kaiser Health News)

Thousands of patients were implanted with heart pumps that the FDA knew could be dangerous (ProPublica)

Covid-19 cases now fall into 3 distinct categories (Vox)

State by state

Feds to nix work requirements in Montana Medicaid expansion program (Kaiser Health News)

How Provincetown, Mass., stress-tested the coronavirus vaccine with summer partying and delta (The Washington Post)

Florida’s second summer of COVID is different: Vaccines, ban on restrictions change landscape (Tallahassee Democrat)

Op-eds in The Hill 

Simone Biles and the loss of ability to perform previously automatic skills explained

Expanding telehealth is vital to the trans community

Back to school shouldn’t mean a field trip to the hospital

Tags Anthony Fauci Jeff Zients Jen Psaki Joe Biden
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