The Washington PostDemocracy Dies in Darkness

Power Up: The coronavirus vaccine is on its way. But where's the public education campaign?

with Brent D. Griffiths

Happy first night of Hanukkah 💫 (Highly recommend homemade challah that I'll be baking today). Tips, comments, recipes? You know the drill. Thanks for waking up with us. 

🚨: “President-elect Joe Biden will travel to Georgia next week to campaign with Jon Ossoff and Raphael Warnock, hoping to boost the Democratic candidates in runoff elections that could decide the balance of power in the Senate — and with it the fate of his Cabinet and his governing agenda,” NBC News's Mike Memoli reports. 

  • Biden's trip to Atlanta on Tuesday will be his first campaign event since he secured the presidency last month, timed to coincide with the beginning of early voting in Georgia on Monday.” 

At the White House

TURNING POINT: The novel coronavirus killed a record 3,140 people on Wednesday in the United States. So it's welcome news the Food and Drug Administration is expected to today recommend approval of the emergency authorization for America's first coronavirus vaccine, marking the start of an extraordinary push to inoculate the public against the deadly disease.

The FDA's vaccine advisory committee will meet today to decide whether to give a thumbs up to a vaccine by Pfizer and German biotech firm BioNTech's — which Britain has already started distributing and Canada yesterday approved.

But it's then the real challenge could start. Misinformation about the virus, and political polarization about how to stem its spread, means Americans have found “a mixed willingness” to be vaccinated, according to recent polling.

The Trump administration's vaccination confidence campaign, which launched last week, has sparked criticism from public health officials who fear the administration's approach to educating the public is insufficient. 

A senior official at the Department of Health and Human Services confirmed to Power Up the agency plans on spending $250 million to communicate vaccine and health information to the public in the next weeks and months. In addition to public service announcements released on YouTube last week about the coronavirus vaccines, radio ads covering the topic launched this week, too. 

  • The senior HHS official added opportunities to highlight the vaccine's safety and efficacy and the trust that notable figures have in it are being explored by senior administration officials and will be rolled out “in the near future.” 

Thursday's FDA open committee meeting is seen by the agency as a “critical part of its effort to be transparent and convince people to take the vaccine,” our colleague Laurie McGinley reports. And HHS officials point to the administration's partnerships with CVS, Walgreens, and other pharmacy chains to offer on-site vaccination  as strong validators of vaccine confidence at a more local level. “The messenger matters,” the senior HHS official told us. 

But some experts and medical professionals say that administration efforts have so far fallen short.

  • “The science of education is no less important than the science of vaccine development or the science of epidemiology,” Georgetown law professor Lawrence Gostin, who has previously advised the World Health Organization on vaccine planning, told Power Up. “It’s no good having a 95 percent effective vaccine if you don’t have at least 70 percent of the population willing and able and do get the jabs in their arm.”
  • “For this administration, the vaccine has been the silver bullet. But they aren't explaining to people that they need to be patient,” one health-care official told CNN's Kristen Holmes and Ellie Kaufman. “What happens when mobs of people show up on December 15, demanding the vaccine? That's why we need an education component.”

By the numbers: Since Nov. 1, “five pollsters … have found a mixed willingness to receive [a vaccine among Americans], with a range of 45 to 61 percent of the public saying they will or are likely to get the injections,” our colleagues Reis Thebault and Scott Clement report. 

  • “Both Pew and Gallup polls show vaccine interest has rebounded after a significant drop in September, but it is unclear how Americans’ attitudes toward the vaccines will change as time passes, final regulatory hurdles are cleared and they are actually presented with the opportunity to be inoculated.”

HHS's original $250 million taxpayer-funded public awareness campaign to “defeat despair” was derailed after Trump political appointees and the contractors they hired inserted “partisan political interests” into the process, our colleague Yasmeen Abutaleb reported in October

  • The overtly partisan effort weeded out various celebrities under consideration to be a part of the campaign based on their political leanings and was ultimately halted until new spots began Dec. 4.

The vaccine influencer: Past vaccination campaigns have featured presidents and celebrities getting a shot early on to boost public confidence and awareness. Former Presidents Barack Obama, George W. Bush and Bill Clinton have all volunteered to get their covid-19 vaccinations on camera, CNN's Jamie Gangel and Shelby Lin Erdman reported last week. 

  • “People like Anthony Fauci, who I know, and I've worked with, I trust completely,” Obama said in an interview on SiriusXM. “So, if Anthony Fauci tells me this vaccine is safe, and can vaccinate, you know, immunize you from getting Covid, absolutely, I'm going to take it.”
  • “I may end up taking it on TV or having it filmed, just so that people know that I trust this science, and what I don't trust is getting Covid,” he added.

Senior administration officials said Monday President Trump has “expressed his willingness” to be a part of such a public campaign. But because Trump contracted the virus in October, “there is an open question as to whether, ultimately, he will be one of the ones to take it on air … given the fact that he's a recovered patient,” per a senior administration official. 

  • “But there are other sort of famous, shall we say, vaccine influencers and experts who I think have come forward and volunteered to participate in an effort to help instill public confidence, and we're certainly considering such offers,” the official added.

Israeli Prime Minister Benjamin Netanyahu vowed to be the first in his country to receive Pfizer's vaccine after final approval by U.S. and Israeli regulators. 

  • “I expect the citizens of Israel to vaccinate, and in order to ensure that, I would like to serve as a personal example,” Netanyahu said as workers unloaded the first shipment of the vaccine to reach Jerusalem. 

But other top elected officials in the United States, including President-elect Joe Biden, Vice President-elect Kamala D. Harris, House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Mitch McConnel (R-Ky.), have been much more noncommittal on personally getting their vaccine. Some experts are pushing them to act quickly both to ensure Americans get vaccinated and to also protect themselves, given many top officials are old enough to be considered high risk.

  • “I would vaccinate the president-elect and the vice president-elect as soon as the vaccine is available,” Jonathan Reiner, a cardiologist who treated former vice president Richard B. Cheney, said on CNN earlier this week. He explained that Pfizer's vaccine takes time to build immunity and that if Biden acted quickly, he could be immune before being sworn-in on Jan. 20.
  • This wouldn't be that unusual: Reiner pointed out that shortly after the Sept. 11, 2001 terrorist attacks, both President George W. Bush and Cheney were vaccinated for anthrax as a precaution.

Some past efforts have gone horribly wrong: President Gerald Ford raced to come up with a response to a mysterious strain of swine flu that appeared in 1976 — “a completely novel strain of influenza was causing hundreds of respiratory infections at Fort Dix, an army post located in central New Jersey,” per Discover Magazine. 

During the election year, Ford enlisted the help of the world's foremost vaccine experts, Jonas Salk and Albert Sabin, the scientists behind the polio vaccine, and pitched an ambitious plan to vaccinate “every man, woman and child in the United States,” Michael S. Rosenwald reported earlier this summer.

  • “Emergency legislation for the ‘National Swine Flu Immunization Program’ was signed shortly thereafter on April 15, 1976 and six months later high profile photos of celebrities and political figures receiving the flu jab appeared in the media. Even President Ford himself was photographed in his office receiving his shot from the White House doctor,” according to Discover Magazine's Rebecca Kreston. 

But it is now regarded as one of the worst public-health debacles in our history: 

  • fast-tracking the vaccine for broad distribution among the public carried risks,” Rick Perlstein wrote for the New York Times. “Of the 45 million vaccinated against the swine flu, an estimated 450 people developed the paralyzing syndrome Guillain-Barré and of those, more than 30 died. The National Academy of Medicine subsequently concluded that people who received the 1976 swine flu vaccine had an increased risk for developing Guillain-Barré.” 

‘Salk hops’ and the king of rock-and-roll: Salk is best known for his role in the breakthrough polio vaccine in 1955. Vaccination efforts first focused on children but even after supply increased, the rate of vaccination among American teens was dangerously low, leading to a third of new polio cases arising from those 15 or older, historian Stephen E. Mawdsley documents.

Enter what Gostin said is one of the most well-known vaccination campaigns: The National Foundation for Polio, now known as the March of Dimes, partnered with teenage activists to create a campaign that could speak to them. 

  • School dances featured a move called the “Salk hop,” female speakers enticed college students by saying they wouldn't get a date unless they got a shot in the arm, and celebrities were enlisted to show it was easy to get the vaccine.
  • See Elvis Pressley: Backstage before appearing on the “Ed Sullivan Show” in 1956, Pressley rolled up his sleeve and let an assistant New York City health commissioner administer the vaccine. Photos of the scene were then distributed around the country.

The people

THE DEADLIEST DAY: “The United States set a single-day record on Wednesday of more than 3,000 deaths linked to the coronavirus, according to a Washington Post analysis. Texas, Colorado, Illinois and Pennsylvania led the way, with each state reporting more than 200 deaths,” Anne Gearan, William Booth and Erin Cunningham report.

Hospitals are running out of space: “More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show, revealing a newly detailed picture of the nation’s hospital crisis during the deadliest week of the pandemic,” the New York Times's Lauren Leatherby, John Keefe, Lucy Tompkins, Charlie Smart and Matthew Conlen report.

  • Key stat: “Hospitals serving more than 100 million Americans reported having fewer than 15 percent of intensive care beds still available as of last week, according to a Times analysis of data reported by hospitals and released by" HHS. 
  • What ICU nurses want you to know: “There is no room left, essentially, and I think that’s really what people don’t seem to understand …  It’s hard for us to convey that to the public because they don’t seem to want to take our word for it — but take our word for it. Take our word for it,” Catie Carrigan, a 28-year-old ICU nurse at University of Mississippi Medical Center in Jackson, Miss., told our colleagues.

From the courts

BIG MOVE: The U.S. government and 48 state attorneys generalfiled landmark antitrust lawsuits against Facebook on Wednesday, seeking to break up the social networking giant over charges it engaged in illegal, anti-competitive tactics to buy, bully and kill its rivals," Tony Romm reports.

  • The lawsuit focuses on the social media giant's acquisiton of Instagram and WhatsApp: “Investigators said the purchases ultimately helped Facebook remove potentially potent rivals from the digital marketplace, allowing the tech giant to enrich itself on advertising dollars at the cost of users, who as a result have fewer social networking options at their disposal."
  • Long term: “The lawsuits together represent the most significant political and legal threats to Facebook in its more than 16-year history, setting up a high-profile clash between U.S. regulators and one of Silicon Valley’s most profitable firms that could take years to resolve.”
  • Who: The federal lawsuit was brought by the Federal Trade Commission led by a Republican, while the state one was led by New York AG Leticia James (D).
  • Context: Read the state and federal lawsuit's against the Silicon Valley behemoth.
  • More context: “The social network has made a habit of buying up, threatening, spying on and outright copying rivals, a strategy so successful that some investors have said in recent years that there was no point in even funding or building social apps anymore,” reports Elizabeth Dwoskin.
  • Beware: The cases against Facebook are far from a slam dunk,” the New York Times says.
  • It's about privacy: “Together, the lawsuits confront a question that has long shadowed the push for antitrust enforcement against tech platforms: How do you prove people are being harmed by a product that’s offered for free? Judging by the complaint filed by the states, which is more thorough than the FTC’s, the answer will hinge on privacy,” Wired writes.

The campaign

TEXAS GETS SUPPORT FOR A NEW(ISH) LEGAL EFFORT: “Despite dozens of judges and courts rejecting challenges to the election, Republican attorneys general in 17 states on Wednesday backed Trump in his increasingly desperate and audacious legal campaign to reverse the results,” the New York Times's Jeremy W. Peters and Maggie Haberman report.

  • Trump himself asked to join the suit in his personal capacity: Late Tuesday, the president asked Sen. Ted Cruz (R-Texas), if he would be willing to argue the case …” The high court would need to agree to hear the case first, which experts predict will not happen.
  • Context: “The move is an effort to bolster a lawsuit filed on Tuesday by the pro-Trump attorney general in Texas that seeks to delay the certification of the presidential electors in four battleground states the president lost. Mr. Trump has been holding out hope that the Supreme Court will hear the case and ultimately award him a second term. Legal experts are skeptical, however, and have largely dismissed it as a publicity stunt.”

Legal experts panned the suit's arguments:

Parts of the GOP are divided over it: Trump reportedly warned Georgia Attorney General Chris Carr (R) not to rally other Republican officials to oppose the Texas lawsuit, which seeks to toss out results in Georgia, Pennsylvania, Michigan and Wisconsin, the Atlanta Journal Constitution's Greg Bluestein reports

Carr's office called the action “constitutionally, legally and factually wrong,” but Georgia's GOP Sens. Kelly Loeffler and David Perdue, who will be in runoffs next month, both endorsed it.

  • It's not just Georgia: Utah Gov. Gary Herbert  (R) and Lt. Gov. Spencer Cox (R), the state's governor-elect, slammed the suit and criticized Utah Attorney General Sean Reyes (R) for joining Texas, deeming his decision “an unwise use of taxpayers' money.”
  • There's even some dissension in Texas:

On the Hill

STILL NO STIMULUS DEAL: “The House of Representatives approved a one-week extension in funding for the federal government, a move aimed at giving lawmakers more time to hammer out agreements on spending bills and emergency economic relief,” Jeff Stein and Mike DeBonis report.

  • The short-term extension needs to pass quickly: "Majority Leader Mitch McConnell (R-Ky.) has signaled he will hold a vote in the Senate ahead of Friday’s deadline. If Trump doesn’t sign the measure into law by midnight on Friday, a government shutdown would commence on Saturday morning."
  • Where things stand: “Appropriators have continued to make progress on a set of spending bills to fund federal agencies, with only a few outstanding policy issues left to be resolved by congressional leaders."

Relief talks are not looking good: “They seemed at risk of breaking down after the White House on Tuesday proposed a relief bill that would offer only minimal benefits to unemployed Americans, a nonstarter for congressional Democrats,” our colleagues write.

  • A bipartisan group of lawmakers still hasn't released actual legislative text: Lawmakers did release a six-page summary, "but it left unresolved the two most contentious issues facing lawmakers — aid to state and local governments and protections against coronavirus-related lawsuits for businesses and other entities. Both of these issues have divided Congress for months. Pelosi and Senate Minority Leader Charles E. Schumer (D-N.Y.) backed the initial $908 billion proposal as a starting point for negotiations, but McConnell has rejected the compromise framework."

The transition

HUNTER BIDEN CONFIRMS FEDERAL PROBE: “Federal prosecutors have been investigating Hunter Biden, the president-elect's son, to determine if he failed to report income from China-related business deals — a politically explosive probe that is likely to challenge the Justice Department in the incoming administration,” Matt Zapotosky, Devlin Barrett and Colby Itkowitz report.

The investigation began in 2018, “though little could be learned immediately about what, if any, wrongdoing it had found," our colleagues write.

  • Where things stand: “According to a person familiar with the matter, who like others spoke on the condition of anonymity to discuss an ongoing and politically sensitive investigation, FBI agents had been seeking to talk to Hunter Biden as part of the case on Tuesday — though an interview has not yet been scheduled or taken place — as well as serve subpoenas on Hunter Biden and his associates.”
On Dec. 9, 2020, President-elect Joe Biden's son Hunter Biden said the U.S. attorney's office in Delaware was investigating his tax affairs. (Video: Reuters)

THE SEARCH FOR AN AG IS NARROWING: “Biden’s top advisers have asked at least one outside advocacy group for input about Sen. Doug Jones as a potential attorney general, one indication that his team is giving serious consideration to the Alabama Democrat as the nation’s top law enforcement official,” Matt Viser, Matt Zapotosky and Amy B Wang report.

  • No decision is expected this week: “At least four candidates remain under serious consideration for the position … In addition to Jones, top Biden advisers are eyeing former deputy attorney general Sally Yates, federal appeals court judge Merrick Garland and former Massachusetts governor Deval Patrick. All but Patrick are White.”

BIDEN PICKS TRADE REP: “The president-elect plans to nominate nominate Katherine Tai to be U.S. trade representative,” Amy B Wang and David J. Lynch report.

  • If confirmed, this would be an unusual jump: “Tai, who has been the chief trade counsel on the House Ways and Means Committee since 2017, is the lead adviser to Democrats and the committee chairman on international trade issues … She is well regarded by both the moderate and liberal wings of the party and is backed by prominent lawmakers, including Sen. Sherrod Brown (D-Ohio). A group of 10 female House Democrats led by Reps. Suzanne Bonamici (Ore.) and Judy Chu (Calif.) wrote Biden last month backing Tai as ‘uniquely qualified’ for the job.”

She would also be the second Asian-American woman to named to a Cabinet-level position by Biden: “Her planned selection comes after members of the Congressional Asian Pacific American Caucus and several advocacy groups met with Biden’s transition team this week to express their growing concern that there would be insufficient Asian American representation in top-tier spots in Biden’s administration,” our colleagues write.

In the media

SOME AIDES SAY DIFI DOESN'T HAVE IT ANYMORE: “Some former Sen. Dianne Feinstein aides insist that rumors of her cognitive decline have been exaggerated, and that video clips taken out of context can make almost anyone look foolish … But many others familiar with Feinstein’s situation describe her as seriously struggling, and say it has been evident for several years,” the New Yorker's Jane Mayer reports.

  • Feinstein is the Senate's oldest member: “Speaking on background, and with respect for her accomplished career, they say her short-term memory has grown so poor that she often forgets she has been briefed on a topic, accusing her staff of failing to do so just after they have. They describe Feinstein as forgetting what she has said and getting upset when she can’t keep up. One aide to another senator described what he called a ‘Kabuki’ meeting in which Feinstein’s staff tried to steer her through a proposed piece of legislation that she protested was ‘just words’ which ‘make no sense.’”

Tensions with fellow Democrats have bubbled up around Supreme Court confirmations: “According to several sources, Schumer was so worried that Feinstein would mismanage then-Judge Amy Coney Barrett’s confirmation hearings that he installed a trusted former aide, Max Young, to ‘embed’ in the Judiciary Committee to make sure the hearings didn’t go off the rails,” Mayer reports.

  • Schumer reportedly told Feinstein after the Barrett hearings that she needed to step down from her perch as the top Democrat on the panel: “He had wanted her to step aside on her own terms, with her dignity intact, but ‘she wasn’t really all that aware of the extent to which she’d been compromised,’ one well-informed Senate source told me. ‘It was hurtful and distressing to have it pointed out.’ Compounding the problem, Feinstein seemed to forget about the conversations soon after they talked, so Schumer had to confront her again. ‘It was like Groundhog Day, but with the pain fresh each time.’”