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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Time's up for unvaccinated medical workers

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Hellooo, good morning. Got questions? Like will my mask protect me? What's going on with Pfizer and the FDA? How long is someone contagious? The Post's health care reporters got answers.

Today: The Senate is expected to narrowly confirm Biden's pick to lead the Food and Drug Administration. Meanwhile, a big challenge for state Medicaid programs lies ahead. But first:

No more delays: medical workers must now be vaccinated

It’s a big moment for President Biden’s vaccine requirement: health-care workers now must be vaccinated in all but one state.

The White House originally sought to increase the country’s lagging vaccination rate through measures like a vaccinate-or-test rule for large employers and a mandate for federal workers. Both have been halted by the courts. The rule for health-care workers appears to be the only major federal requirement that will almost definitely remain in effect, despite strong opposition from GOP states. 

The details: Last month, the Supreme Court allowed the mandate for health-care workers to go forward in facilities receiving Medicare and Medicaid funds. The vaccine rule covers roughly 10.4 million staff at 76,000 facilities. 

The timeline: Health-care workers in roughly half the states had to get their first dose of a coronavirus vaccine by Jan. 27. 

But the effective dates were staggered, since the rule had been originally blocked in Republican-led states that argued the federal government didn’t have the power to require the shots. As of yesterday, staff in 24 other states had to have had at least one shot, and workers in the last state — Texas — must be vaccinated next week. 

  • “At the health system level or local level when mandates have gone into effect, there's been relatively low amounts of people leaving their jobs,” said MaryBeth Musumeci, an associate director at the Kaiser Family Foundation. “So we'll have to see if that pattern plays out in this broader initiative.”

MaryBeth Musumeci, KFF:

How it's going

It’s hard to say for sure.  

It’s still early so there’s not yet data on how many health-care workers around the country are vaccinated. (Though there are for nursing homes, and on average, nearly 83 percent of staff per facility are vaccinated). But a CMS spokesperson said the agency has heard from states and providers that compliance is going well. 

  • For the agency’s part: CMS officials have held best practice sessions with facilities; provided technical assistance and trainings; and encouraged nursing homes and other facilities to share methods that have worked to boost their vaccination rates.
  • Assessing compliance: That largely falls to the states. State survey agencies will help determine whether providers are complying, such as when they investigate a complaint or during the standard recertification process.

Some hospitals had forged ahead with mandates months ago. For instance, Shira Doron, an infectious-disease physician at Tufts Medical Center, said her hospital required vaccinations well before omicron hit.

  • Staff that were infected with the contagious variant were “largely able to return early because they didn't get very sick,” she said.

Most of the Association of American Medical Colleges’ members already had such requirements. But for the American Hospital Association, roughly 40 percent of its members had their own requirements in place before Biden’s rules were issued — and states that had sued over the rules had been wary to move forward until there was a decision from the high court, both groups told The Health 202 last month. 


There’s one vaccine move that hasn’t gained statewide traction: Vaccine mandates for entering businesses. 

On the Hill

🚨 Biden’s FDA pick clears key procedural hurdle: The Senate is poised to confirm Robert Califf to lead the Food and Drug Administration today after the agency has lacked a permanent head for nearly 13 stress-filled months.

Last night, the Senate voted to limit debate on the nomination in a 49 to 45 vote, The Post’s Laurie McGinley and your host report. The nomination of Califf, a cardiologist who led the FDA briefly for the last year of the Obama administration, had become tougher than expected. But despite opposition from a handful of Democrats and most Republicans, his nomination now appears on track. 

Here’s a breakdown of yesterday’s vote:

  • Democrats voting against Califf: Sens. Richard Blumenthal (Conn.), Maggie Hassan (N.H.), Joe Manchin (W.Va.) and Ed Markey (Mass.). Sen. Bernie Sanders (I-Vt.), who caucuses with the Democrats, also opposed the nominee.
  • Republicans voting for Califf: Sens. Roy Blunt (Mo.), Richard Burr (N.C.), Susan Collins (Maine), Lisa Murkowski (Alaska) and Mitt Romney (Utah).
  • Not voting: Sens. Shelley Moore Capito (R-W.Va.), Lindsey Graham (R-S.C.), John Hoeven (R-N.D.), John Kennedy (R-La.), Ben Ray Luján (D-N.M.) and Pat Toomey (R-Pa.).

Agency alert

How a looming deadline could result in millions without coverage

State Medicaid agencies are currently prohibited from terminating coverage amid the pandemic, but millions of Americans are at risk of losing their health coverage when the public health emergency expires, Kaiser Health News reports. 

What’s next: When the public health emergency ends, enrollees will be reevaluated by state Medicaid officials to see if they still qualify for the safety net program based on job, income or housing changes during the pandemic. 

Before the pandemic: States used to regularly review Medicaid eligibility, but suspended the process after the Families First Coronavirus Response Act placed a moratorium on terminating coverage during the pandemic in exchange for extra federal funding for states that comply. Enrollment climbed to record levels while that process was suspended, KHN’s Rachana Pradhan writes.

  • Meanwhile, pressure to return to “normal” mounts: Over 70 House Republicans in Congress are calling on the Biden administration to start the process of unwinding the public health emergency declaration for the coronavirus pandemic.

More from Rachana:


The race for a universal coronavirus vaccine

Tired of chasing after the latest variant, some vaccine scientists are eager to develop a new shot that would offer more broad protection against the coronavirus, The Post’s Carolyn Y. Johnson reports. 

A universal vaccine would protect against the original and existing variants, in addition to safeguarding people from new strains of the coronavirus and preventing future pandemics. 

Anthony Fauci, Biden’s chief medical adviser, has publicly stressed the importance of patience in creating such a shot, though scientists say that behind closed doors, the infectious disease expert has urged them to pick up the pace.

But developing such a shot would be tricky. Vaccines teach the immune system how to recognize and fight a disease by mimicking characteristics of the virus, which can become more complex as new variants evolve. Some scientists think the key is developing a vaccine that mimics physical features of multiple strains of the coronavirus in a patchwork fashion, but such a shot has yet to be successfully produced. 

While the approach to create a universal vaccine is under debate, one thing is certain: To safeguard people globally, it must have greater longevity than existing coronavirus vaccines, which start to wane in effectiveness after six months. 

  • “We’re looking for a tetanus-like shot,” said Barton Haynes, an immunologist and vaccine expert at Duke University School of Medicine. “We all have to get a tetanus shot every 10 years. That would be really terrific.”

In other coronavirus news…

First in The Health 202: Over 1,000 doctors, nurses and medical students are urging the Biden administration to press the World Trade Organization to waive certain coronavirus-related intellectual property protections on vaccines, treatments and test kits amid the pandemic, among other asks.

  • “As we continue doing all in our power to bring an end to this deadly pandemic, we ask that you please do the same by using the full power of the presidency to get vaccines, diagnostic tools and therapeutics to everyone who needs them around the globe,” the group led by the Trade Justice Education Fund write.
  • The view from the administration: A United States Trade Representative spokesperson said the country has been “deeply engaged” in conversations “to facilitate an outcome that gets consensus from all 164 WTO members and leads to increased production and distribution of COVID-19 vaccines.” The White House says it’s investing billions in manufacturing.

And…new book alert. Deborah Birx will release “Silent Invasion” this spring, a memoir detailing her time as President Trump's coronavirus task force coordinator, the Associated Press reports.

State scan

In North Dakota: More than 1.5 million free coronavirus at-home testing kits are available for pickup statewide starting today, the state’s health department announced. Officials say the new program was paid for by using funds from the Federal Emergency Management Agency and was created to supplement Biden’s initiative to ship tests to Americans for free.

In Maryland: House leaders are supporting a constitutional amendment to protect abortion rights in the state, the Associated Press reports. If the Maryland General Assembly approves the measure, it’ll be placed on voters’ ballots in November.

In Virginia: Gov. Glenn Youngkin (R) pledges quick action on legislation to allow parents to opt their children out of school mask mandates without having to provide a reason, The Post’s Gregory S. Schneider reports. 

In California: The state's school mask mandate will stay in place until at least the end of the month, per our colleague Reis Thebault, as the state prepares to lift similar requirements for face coverings in most other indoor places.

Sugar rush

Thanks for reading! See y'all tomorrow.