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The Health 202: CDC's 'mask off' guidance unlikely to sway unvaccinated Americans

with Paige Winfield Cunningham

When the Centers for Disease Control and Prevention released its new guidance allowing vaccinated people to drop the masks, public health leaders floated that it could serve as an incentive to get more people vaccinated.

But a large majority of unvaccinated Americans say that the new mask rules will not factor into their decision to get a shot.

Eighty-five percent of unvaccinated adults said the new mask rules did not affect their enthusiasm for the vaccines.

In a new Kaiser Family Foundation poll, only 10 percent of unvaccinated adults said that they were more likely to get a shot because of the new guidance, while 4 percent said the new rules made them less likely to do so.

CDC director Rochelle Walensky has said that the purpose of loosening the mask guidance was not to motivate the unvaccinated. But the finding could provide fodder for those critical of the CDC's recommendation that vaccinated people can go without a mask in most places.

Vaccinated people are at low risk from the virus and unlikely to transmit it, research shows. Some critics of the guidance, however, have warned that by speeding along the end of mask mandates and undermining public norms around masking, the new policies would make it more likely that unvaccinated people might also shed their masks, potentially putting others not fully vaccinated and the immunocompromised at risk.

The poll found that a slim majority of Americans said the CDC’s guidance was clear and easy to follow, while just over 4 in 10 adults found it confusing. Republicans were somewhat more likely than independents or Democrats to say that the advice was hard to follow.

Anthony S. Fauci says the Centers for Disease Control and Prevention’s new guidance that fully vaccinated Americans no longer need masks has caveats associated with it. “It was given as a broad guideline and recommendation, but there are caveats associated with that, one of which is that not everyone is equally protected when it comes to vaccines, particularly individuals such as those who are immunosuppressed.“ (Video: Washington Post Live)
Every bit of increased enthusiasm for the shots may come into play if President Biden hopes to meet his vaccine goals. 

Biden has set a goal that 70 percent of American adults will have at least one dose of the vaccine by July 4. So far, 62 percent of adults have received at least one shot.

The vaccination rate in the United States has fallen sharply from an average of more than 3 million shots a day in early April to around 1.62 million shots. And although the administration only needs to average about half a million shots a day to reach the July 4 deadline, the number of people who say they want a vaccine but haven’t gotten one is quickly shrinking.

Only 4 percent of adults fall in the category of unvaccinated people who say they want a shot “as soon as possible.” A similar proportion of people have an appointment scheduled for a vaccine or plan to make one in the next three months, even though they say they want to “wait and see” before getting a shot, the KFF poll finds.

If both those groups follow through, it may be just enough to reach Biden’s goal.

The administration will have more margin for error if it can convince some who are less enthusiastic about the shots.

About 1 in 5 adults say they will “definitely not” get a shot or will only do so if required for work or school — a proportion that has remained largely unchanged in recent months. A smaller share of adults (12 percent) say they want to hold off to see how other people do with the shots.

The poll points to a few ways to convince holdouts. Among adults who are unvaccinated:

  • Nearly a third said that they would be more likely to get a vaccine once it was fully approved by the Food and Drug Administration. That change could be on the horizon: Pfizer-BioNTech has applied for full FDA authorization for its two-dose vaccine, and Moderna is expected to soon follow suit.
     
  • One in five said that they would be more likely to get a shot if their employer gave them paid time off work to get the vaccine and recover from any side effects. The Biden administration last month called on all employers to offer paid time off for vaccines.
     
  • A modest number of people say that free incentives would make a difference. Fifteen percent said they’d be more likely to be vaccinated if their state offered them $100, for instance, and 10 percent said they’d be more inclined if given a $20 coupon for free food or drink.
Parents are still divided on vaccinating their children.

With the Pfizer-BioNTech vaccine approved for kids as young as 12, families are now deciding whether to vaccinate their teenagers. Around 4 in 10 parents of children between 12 and 17 say that their teenagers has already received a first dose or will do so as soon as possible. 

Vaccines have not been approved for younger kids, and parents of those under 12 are still wary. Just 1 in 4 say that they will get their child vaccinated as soon as a vaccine is approved, while another third plan to wait until more children have been vaccinated.

Biden's budget

Biden’s $6 trillion dollar budget is coming out today.

The president is expected to call for a public option and other top health-care priorities, but don’t expect any numbers attached to those proposals.

“The new budget will include calling on Congress to create a public health-care option and give Americans older than 60 the option to enroll in Medicare, according to a document obtained by The Washington Post, but does not advance specific policies for doing so and is not incorporated into the cost of the budget itself,” The Post’s Jeff Stein reports.

Instead, the White House has decided to focus on major initiatives already proposed by the administration. Biden has called for a $2.3 trillion infrastructure proposal, a $1.8 trillion education and families plan and $1.5 trillion in proposed discretionary spending. 

The president’s American Families Plan included a proposal to extend Affordable Care Act subsidies first approved by Congress as part of a coronavirus relief package in March. His infrastructure proposal includes $400 billion toward expanding long-term care. Under Biden’s plans, the Department of Health and Human Services would see its budget grow by 23 percent.

Biden has said that he hopes to negotiate his proposals with Republicans, and budget numbers could fluctuate depending on the outcome of those talks. Congressional Republicans have accused the Biden administration of trying to spend too much money.

Ahh, oof and ouch

AHH: Booster shots may be on the horizon.

“For people eager to put the health crisis behind them, the relief of being vaccinated is being replaced by a new worry. Is immunity a ticking clock? Should they plan a family wedding this fall? Will everyone need booster shots? When? Are people locked into the same brand or vaccine technology for their next shot?” The Post’s Carolyn Y. Johnson writes. “Scientists know that vaccine-induced immunity against most diseases wanes, but the answers to those questions about the coronavirus will begin to coalesce only in the coming weeks and months.”

Anthony S. Fauci, the government’s leading infectious-disease expert, says we may not need coronavirus vaccine boosters “for quite a while.” ““I really don’t think it’s accurate to say we will need boosters x number of months from now. We may not need it for quite a while. We’re preparing for the eventuality that we might need boosters.” (Video: Washington Post Live)

Scientists are working to determine how quickly immunity against the coronavirus wanes and what level is enough to protect people. Trials are also underway to understand the benefits and drawbacks of switching from one brand of a vaccine to another for booster shots, for instance getting a third shot from Pfizer-BioNTech after two doses of Moderna’s vaccine. Other research on antibodies in vaccinated people and on rare cases of infection in people who have been vaccinated could help scientists pinpoint when people become vulnerable to infection.

Scientists also are watching real-world data for indications of concern, including the number of “breakthrough infections” in vaccinated people, which could indicate that immunity is waning and booster shots are needed. Still, immunity won’t suddenly vanish, and although vaccines may be slightly less effective against some variants, they still strongly protect against severe disease and death.

OOF: HIV rates remain stubbornly high in Mississippi.

The CDC’s 2019 National HIV Surveillance Data System report, released on Thursday, shows that new HIV diagnoses have dropped by 8 percent from 2015 to 2019, and by 33 percent among young gay and bisexual men, probably because of increased use of PrEP to prevent infection. 

“But progress in the prevention of HIV, which can lead to AIDS, has been uneven. Black and Latino Americans continue to be infected at rates much higher than White Americans — eight times and four times higher, respectively. And in Mississippi, new diagnoses have remained high year after year, between 424 and 509 each year from 2014 to 2019,” Sarah Fowler writes for The Post.

Health officials point to a mix of cultural, logistical and economic factors that contribute to Mississippi having the sixth-highest rate of HIV in the country. Among them, according to Thomas Dobbs, Mississippi’s chief health officer, is a reluctance by practitioners to ask patients about their sexual history. When PrEP was introduced in 2012, the health department listed just two PrEP providers on its website. 

State and federal officials have been working to expand access to care in Mississippi and combat new HIV infections. The health department received a $1.6 million grant from the Ending the HIV Epidemic in the U.S. program, part of an $87.5 million effort in fiscal 2021 from the Health Resources and Services Administration. 

OUCH: The Justice Department is ramping up efforts to combat coronavirus-related fraud.

Federal prosecutors have charged around a dozen people in the past week with participation in fraud schemes related to the pandemic. The new cases collectively account for $143 million in fraudulent charges to government health-care programs, the Wall Street Journal’s Aruna Viswanatha reports.

“Several of the alleged schemes appear to have started in the years before the pandemic, escalating as the federal government loosened health care billing restrictions in early 2020 in an effort to speed care to patients around the country and avoid overwhelming health care systems” Aruna writes.

Two Florida residents were indicted on a charge of taking advantage of loosened telemedicine restrictions to bill Medicare $73 million for unnecessary or ineligible genetic tests. Another man with a history of questionable billing activities acquired a lab in California and used it to bill more than $42 million in fake claims.

More in coronavirus news

  • California will give out $116 million in incentives to people who get the coronavirus vaccine, the Associated Press’s Brian Melley and Kathleen Ronayne report. The prizes include $1.5 million each for 10 Californians. 
     
  • Sen. Richard Burr (N.C.), the top Republican on the Senate Health, Education, Labor and Pensions Committee, is calling for major changes at the CDC, blaming poor communication and the agency’s sprawling structure for key missteps in its pandemic response, The Post’s Dan Diamond reports.
  • Many scientists are welcoming Biden’s call for renewed investigation into the theory that the pandemic may have originated in a lab, even though they say the theory is still unlikely and lacks strong evidence, the New York Times’s Carl Zimmer, James Gorman and Benjamin Mueller report. Meanwhile, China has accused the United States of playing politics with its call for a new probe into the origins of the novel coronavirus.

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