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Below, federal officials are gearing up to distribute coronavirus shots for kids (once they're authorized, that is) and Texas's “heartbeat” abortion ban is in effect again. But first: 

Nursing home staff in Maryland have been required to get vaccinated for more than a month

Nursing homes are bracing for the Biden administration to issue national rules mandating staff vaccinations. The rules are expected mid-to-late October, once officials hammer out key details.

But some states have forged ahead with their own mandates. Today, we take you to Maryland, one of the first states where a nursing home vaccine mandate went into effect last month.

On Aug. 18, Republican Gov. Larry Hogan laid out the case for the mandate in a news conference. About 79 percent of all nursing home staff had received at least one dose. Some 18 facilities were averaging 95 percent or more of their workforce immunized. But others were just below 50 percent.

“We are concerned that the delta variant surge has led to an increase in infections among staff in nursing homes, which has been a consistent source of outbreaks in these facilities throughout the pandemic,” Hogan said. 

Since Sept. 1, nursing home workers must have at least their first dose of a coronavirus vaccine — and over 87 percent have complied. The rest are subject to frequent tests.  

But some experts — and those in the nursing home industry — have expressed concerns that strict mandates could exacerbate facilities’ long-standing staffing shortages. 

  • “I’m supportive of mandates… [but] I think we have to recognize that we undervalued and underpaid these staff for a long time and now to sort of layer a mandate on top of the sector, I just don't know that that'll lead to where we want it to lead,” said David Grabowski, a Harvard professor who studies the long-term care industry.

This is how Dennis Schrader, Maryland’s health secretary, says the state attempted to strike that balance through a “step-by-step” process:

  • In May, the state began requiring nursing homes to report staff vaccinations weekly.
  • In July, Maryland essentially began naming and shaming facilities. It issues a press release on the 10 most vaccinated homes — and the 10 least vaccinated homes — each week.
  • In August, officials began implementing heavy fines for facilities that didn’t report their data. So far, the state has issued 102 civil monetary penalties totaling about $345,000.
  • In September, the mandate rolled out, and the state is sending teams to help out the roughly 20 to 30 homes with lagging vaccination rates.

Yet, it’s unclear how many staff have quit. Schrader said the state isn’t tracking this number. Joe DeMattos — the president of the state’s nursing home association — said “small numbers of employees” have left due to the mandate and those reports are largely anecdotal. 

Across the country

Nursing home staff have been less willing to get vaccinated than one might expect. Nationwide, roughly 67 percent of nursing home staff per facility are vaccinated. The effort to boost that number comes as coronavirus cases among workers and residents grew 440 percent between July and August. 

Kaiser Family Foundation:

Maryland serves as just one test case for a mandate as the federal government weighs its approach and other states implement their own. More than 20 states have announced some form of vaccine requirements. Over a dozen apply to health-care workers, though not all of them have gone into effect. 

For instance: 

  • In Maine, state officials will begin enforcing its vaccination requirement at the end of the month. So far, an average of 83 percent of nursing home staff per facility are immunized. 
  • In Oregon, where roughly 74 percent of staff are vaccinated, workers must be fully immunized by next week. 
  • And in Massachusetts, where a mandate went into effect yesterday, about 87 percent of staff have received the shot. (All data is according to the Centers for Medicare and Medicaid Services.) 

Kentucky’s nursing home staff are among the 10 least vaccinated states in the country — at roughly 57 percent — and the nursing home association is eyeing the expected federal mandate closely. 

  • “With everybody understanding that we're facing a federal mandate, I'm not sure what it's going to take for the holdouts among our staff to get vaccinated,” said Betsy Johnson, the president of the Kentucky Association of Health Care Facilities. “Maybe they're waiting for the federal mandate to come down — time will tell.”


New this morning: Drugmaker Merck asks federal regulators to authorize its experimental pill to treat covid-19.

  • Treatment cut the risk of hospitalizations and deaths by about half in early trials. 
  • It could "revolutionize the global public health effort to end the coronavirus pandemic by making it easy and inexpensive to treat covid-19 patients — particularly in poor countries, where vaccine supply is low,” Annabelle Timsit and Carolyn Y. Johnson write.

Shots for kids are ready as soon as regulators give the green light

Federal officials say they are prepared to begin pushing out as many as 20 million doses of the Pfizer-BioNTech pediatric coronavirus vaccine as soon as regulators authorize the shots for younger children — possibly as soon as early November, The Post’s Lena H. Sun reports. 

The government will likely allocate shots based on a state’s population of eligible children, a federal health official told The Post.

A key challenge: While overall supply will be sufficient, officials need to develop a plan for where kids will get the shots. Some parents may prefer the pediatrician’s office over pharmacies, but the size of Pfizer’s packages — 10 vials each containing 10 doses — may make it hard to share vaccines between many providers. Officials may also look to community health centers to play a part in the roll out.

Fauci says go trick-or-treating

Anthony Fauci, the Biden administration’s chief medical adviser, said families should celebrate Halloween, although he urged those who are eligible to get vaccinated.

But: Fauci said it’s still too early to declare victory over the virus and cautioned that vaccinated Americans should continue wearing masks indoors while community transmission is high. He characterized the seven-day average of 95,000 cases a day as “still way too high.” 

  • “We want to get way, way down. I mean I’d like to see it well below 10,000 and even much lower than that,” he said.

Chart check

Hundreds of thousands of troops have not yet complied with vaccine mandates

The vaccination rate has climbed since the summer, when Defense Department leaders — acting on a directive from Biden — informed the nation’s 2.1 million troops that immunizations would be mandatory. Yet, even as deadlines for the mandates near, vaccination rates vary widely between services, The Post’s Alex Horton reports.

Here’s the latest: 

Reproductive wars

A U.S. appeals court temporarily reinstated Texas's restrictive abortion law on Oct. 8. The law bars the procedure as early as six weeks into pregnancy. (Reuters)

A federal appeals court reinstated Texas’s abortion ban

The U.S. Court of Appeals for the 5th Circuit late Friday reinstated the nation’s most restrictive abortion law, which bars abortions once cardiac activity has been detected, which can be as early as six weeks into pregnancy. 

The appeals court granted a request by the Texas attorney general to temporarily suspend a judge’s order blocking the law. The decision brought an end to a brief 48-hour period in which the ban was lifted, and many abortion providers scrambled to decide whether to resume the procedure.

What’s next: A three-judge panel of the conservative-leaning court gave the Justice Department until 5 p.m. on Tuesday to respond to the appeal. A decision from the appeals court could put the issue back before the Supreme Court, The Post’s Ann E. Marimow reports.

Medical missives

Long wait lists prevent many from getting home care

The Post’s Rebecca Tan tells the story of Tiffanie Rivers, a Maryland woman desperate for a Medicaid waiver that will provide home-based care for her mother, who is struggling with dementia. Many people die or enter nursing homes before they ever get off the state's waiting list.

For context: As the coronavirus swept through facilities, demand for home-based care for the disabled and elderly skyrocketed and wait lists ballooned.

Across the country, some 820,000 people are on wait lists for waivers that could help them afford home care, according to the Kaiser Family Foundation. 

The politics: Biden proposed $400 billion for states to expand home-based care. But Democratic lawmakers have already proposed cutting that number roughly in half in their major social spending bill.

Here's what else you need to know:

  • Biden’s proposal for a new multibillion biomedical research agency will be left out of the Democrats’ spending package, Politico’s Sarah Owermohle and Alice Miranda Ollstein report. That’s because it’s outside the scope of what can be done under the budget maneuver Democrats are using to bypass GOP votes.
  • California is requiring public schools and colleges to provide free period products to students, starting next year, The Post’s Bryan Pietsch report.
  • The World Health Organization will meet in Geneva this week to discuss an herbal supplement known as kratom, which produces narcotic effects, Politico’s Lauren Gardner reports. The U.S. government has twice tried to restrict its use as a controlled substance, but some advocates say it could help wean people off opioids.


Coming soon: Major decisions on booster shots.

  • Happening this week: The Food and Drug Administration’s independent advisers will meet Thursday and Friday to discuss booster shots for coronavirus vaccines from Moderna and Johnson & Johnson.
  • Next up: The Centers for Disease Control and Prevention’s advisory committee will hold its own meeting on boosters Oct. 20 and 21. The CDC also announced Friday that its advisers will meet Nov. 2 and 3 to discuss pediatric vaccines.

Sugar rush

Thanks for reading! See y'all tomorrow.