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The Health 202

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

Just a few school districts are imposing coronavirus vaccine mandates

The Health 202

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

Good morning and happy Thursday from your researcher McKenzie. A quick programming note: The Health 202 will be off next week. Enjoy your Labor Day weekend, and we’ll see you back here on Sept. 6.

Today’s edition: A judge blocked part of Idaho’s near-total abortion ban in a win for the Justice Department. A new House report revealed the Trump White House stalled federal regulators’ coronavirus vaccine guidance. But first …

D.C. Public Schools is a rare outlier with its coronavirus vaccination requirements

D.C. Public Schools is mandating middle school and high school students be vaccinated against the coronavirus to return to the classroom next week. 

The District’s back-to-school plans set it at odds with most of the rest of the country, where youth vaccine mandates have so far failed to gain traction. Schools have overwhelmingly declined to impose such requirements on kids, whose coronavirus vaccine uptake nationwide remains low; about 30 percent of children aged 5-11 and 60 percent of adolescents aged 12-17 are fully vaccinated. 

D.C. officials insist their mandate will boost those rates, minimize the spread of infection and keep students in the classroom. 

This was always about protecting our community,” said Christina Henderson, a D.C. Council member and the lead sponsor of the legislation behind the mandate. “We’ve made huge strides in our attempts to inform and vaccinate, but there is still more to be done to keep our schools protected and ensure in-person learning can go on without disruptions.”

The new requirement has been celebrated by some as an additional safeguard to protect D.C. schools should a new wave of the coronavirus hit this fall. But infectious-disease experts are divided on whether such mandates would be effective at this stage in the pandemic, and key concerns remain about whether requiring the shots could keep some students from attending class this fall.  

D.C. Council member Christina Henderson:

The mandate 

The new law applies to all D.C. students for whom there is a federally, fully approved coronavirus vaccine. Students over the age of 12 will have 20 days from the first day of school, Aug. 29, to be in compliance with the policy before they are barred from attendance. However, students can seek religious or medical exemptions that are reviewed on a case-by-case basis.

In addition to the shots — which are also required for adults — students and faculty must provide proof of a negative coronavirus test before the first day of class.

D.C. Public Schools have loosely enforced a long-standing mandate that says students need to be up to date on their vaccines against childhood diseases like chickenpox and polio to attend classes, a spokesperson for DCPS admitted. But city officials vow this time will be different

On the first day of classes, school officials will notify families whose students have yet to submit immunization certificates and provide them with information about where to get the vaccine, according to enforcement documents shared with The Health 202 by the Office of the State Superintendent of Education

After the 20 school day grace period, unvaccinated students will be removed from class and their attendance will be recorded as unexcused absences. Should intervention attempts by school officials fail to bring the student into compliance, prolonged absences could trigger truancy, educational neglect and referrals to Child and Family Services and the Office of the Attorney General as a final resort. 

Whether online school options will be made available for students not in compliance with the mandate will vary across the city and be determined by Local Education Agencies, according to Henderson. 

D.C. Health ramped up its community outreach over the summer to bring up the city’s low youth compliance rates for the coronavirus vaccine and other childhood immunization requirements, which have fallen behind considerably during the pandemic. 

However, gaps in vaccine coverage remain. Across the District, roughly 87 percent of students age 12-15 have completed their primary series of shots against the virus. But that number drops to just 61 percent among Black students compared with 99 percent of their White peers, per D.C. Health.

Paige Veliz-Gilbert, a teacher for DCPS, supports the mandate, but acknowledged that it likely wouldn’t affect all of her students in the same way. “When I hear a hard-and-fast rule like 'no vaccines, no schools,’ I think it favors families who are able to drop everything and get to the doctor and puts families with less resources or flexibility in a more precarious situation.”

Black Coalition Against Covid-19:

Outside the District

New Orleans public schools is one of the only other districts in the country to add the shot to its list of required immunizations for children 5 years old and older for the upcoming academic year, Superintendent Avis Williams told The Health 202. 

Ultimately, the city elected to move forward with the mandate after the rest of the state pivoted against plans to enforce the requirement in May, partly to protect the community as other control measures eased. 

Williams noted the CDC recently revised its operation guidance for schools; now, the agency no longer recommends schools conduct routine testing to detect asymptomatic cases, and the quarantine rule for the unvaccinated and people exposed to the virus is gone. The agency has yet to weigh in on whether schools should mandate the shots. 

“The vaccine is the best tool we have to ensure our children are able to stay in the classroom,” Williams said. 

Reproductive wars

Judge blocks part of Idaho’s abortion law from taking effect

The Biden administration convinced a federal judge to block a portion of an Idaho law that would criminalize performing an abortion on a woman to protect her health, The Post’s Perry Stein reports.

It’s the first legal victory for President Biden since the Supreme Court overturned Roe v. Wade. But much of the law ban is still slated to go into effect today, which would ban most abortions except in cases involving rape, incest or when a woman’s life is in danger.

In a ruling late Wednesday, U.S. District Judge B. Lynn Winmill — an appointee of President Bill Clinton — said the statute violates a federal law requiring hospitals participating in the Medicare program to provide medical care when a person’s life or health is at stake. 

But a judge in Texas ruled earlier this week that the statute in question doesn’t mandate that states allow abortions when the patient’s health is at risk — which sets up a potential clash in the federal court system, Perry notes.

Agency alert

The majority of seniors may soon get their Medicare benefits through private plans

Enrollment in Medicare Advantage plans is growing, and could hit a critical threshold next year, according to a Kaiser Family Foundation report out this morning.

By 2023, over half of Medicare beneficiaries may receive their health benefits by signing up for insurance companies’ private plans. That’s a significant shift for the federal health insurance program for older adults and those with disabilities. 

As of this year, roughly 48 percent of Americans with Medicare are enrolled in Medicare Advantage plans, which equates to roughly 28.4 million people. That number has steadily risen over the years. For instance: In 2007, only 19 percent of those in Medicare received their benefits through private plans.

On the Hill

Senate health panel chair presses HHS on monkeypox vaccine strategy

Sen. Patty Murray (D-Wash.) is calling on the Biden administration to address “alarming” shortages of the monkeypox vaccine and detail its vaccination plan as the virus rapidly spreads across the country, our colleague Dan Diamond writes. 

  • “The Administration must do more to address existing, unacceptable shortages in vaccine supply, institute comprehensive distribution and communication strategies, and develop long-term procurement plans,” Murray wrote in a letter to Dawn O’Connell, the assistant HHS secretary who oversees the vaccine stockpile.

Public health experts and some Democrats have criticized the administration for failing to quickly procure additional supply and taking other measures to curb the global surge. Murray is also pressing for the Department of Health and Human Services to develop “long-term strategies for the procurement of vaccines, to ensure that the United States is better prepared for future outbreaks.”

Not so fast: To alleviate supply issues, federal health officials announced a plan earlier this month to split each single-dose vaccine vial into five shots by injecting them under the top layer of the skin. But that plan hasn’t necessarily borne out as intended, and some providers appear to be having difficulty extracting five doses, Dan notes.

Meanwhile …

Bavarian Nordic, the maker of the only approved monkeypox vaccine, is looking to a different strategy to stretch out the limited supply of doses.

The company is exploring the possibility of evaluating whether millions of expired doses are still viable — and could thus be used to help alleviate the supply crunch, CEO Paul Chaplin told Reuters. The decision whether to greenlight such a plan ultimately lies in the hands of federal regulators. 


House panel: Trump sought to pressure FDA on coronavirus vaccines, treatment

Trump officials repeatedly stalled the Food and Drug Administration’s plan to extend safety studies of the coronavirus vaccine in fall 2020, while President Donald Trump urged a faster timeline to authorize the shots before the election. That’s according to a new report from the House panel probing the pandemic response. 

Here are the highlights, per our colleague Dan Diamond: 

  • Trump publicly and privately campaigned for the FDA to expedite safety studies of coronavirus vaccines, accusing it of deliberately postponing decisions until after the Nov. 3 election to undercut his reelection prospects.
  • White House officials like trade adviser Peter Navarro and outside allies such as TV host and physician turned Republican Senate candidate Mehmet Oz pressed federal officials to authorize the antimalarial drug hydroxychloroquine to treat covid-19. Navarro worked behind the scenes to have a hospital craft a request to the FDA for widespread access to the debunked therapy touted by Trump.

The other side: Republicans have decried the Democratic-led panel’s work as politically motivated and vowed to launch their own investigations into the Biden administration’s coronavirus response should they retake one or both chambers of Congress this fall.

More from Dan:

Health reads

Congressman’s Wife Died After Taking Herbal Remedy Marketed for Diabetes and Weight Loss (By Samantha Young | Kaiser Health News)

Fetterman criticizes Oz campaign’s eat-your-vegetables health advice (By Azi Paybarah | The Washington Post)

The FDA stands by as the vaping industry flouts its orders (By Nicholas Florko and Elissa Welle | Stat)

Sugar rush

Thanks for reading! See y'all tomorrow.