COVID-19 Update | May 11, 2021

Staff Contact: Mat Reidhead or Jackie Gatz

A stark pattern is emerging in the statewide rates of COVID-19 vaccine coverage and poverty at both the county and ZIP code levels in Missouri (additional information is available to authorized users of HIDI Analytic Advantage in the interactive vaccine distribution dashboard).

Evaluating data for the St. Louis metropolitan area illustrates the disparities in vaccination rates for individuals living in low-income communities. St. Louis, one of the nation’s top-10 most segregated cities, and considered the country’s northernmost southern city, has long suffered from what is known locally as the “Delmar divide.” Delmar Blvd. runs east to west, dividing the city of St. Louis and part of the county in a north-south bisection. North of Delmar, the population is 98% Black, the median home value is $73,000, and 10% of the adult population has a bachelor’s degree or higher education. South of Delmar, the population is 78% white, the median home value is $335,000, and 70% of adults have a bachelor’s degree or higher.

Additionally, due to a variety of social determinants of health, including early misinformation on the virus, dense household composition, and labor market dynamics that are prohibitive to remote work and physical distancing, the COVID-19 pandemic has had a disproportionately devastating effect on the communities north of Delmar.

Unfortunately, disparities in the rate of COVID-19 vaccine initiation have been equally pronounced along the Delmar divide. Through the first week of May, the average percent of the adult population with at least one dose for St. Louis city and county ZIP codes north of Delmar Blvd. was 37.6%, while the average initiation rate for communities to the south was 47.7%, a relative difference of 27%.

Ensuring equal access and education surrounding decisions on vaccine initiation is a critical step in deconstructing barriers to health and well-being along divisive lines of poverty and race, such as the Delmar divide.

Staff Contact: Daniel Landon

Gov. Mike Parson and key leaders of his administration participated in a conference call with the MHA membership on the state’s response to the COVID-19 emergency. It was the 40th such call with the MHA membership since the pandemic began. The calls provide an opportunity for an update on state activities and hospital issues, and for hospital executives to ask questions and make comments.

The governor provided updates on the progress of COVID-19 vaccination and said that the National Guard’s role in vaccination will be scaled back by Tuesday, June 1. State employees will be returning to their offices beginning Monday, May 17. Regarding Medicaid expansion, the governor and his staff are considering their options based on the legislature’s action, but he indicated that litigation is certain to be the result. The governor’s staff also discussed the search for a permanent Director of the Department of Health and Senior Services and the state’s public education campaign to promote vaccination. Responding to questions, they encouraged collaboration to enable employee vaccinations arranged by businesses. Also, they discussed plans for pediatric vaccinations against COVID-19.

Staff Contact: Keri Barclay

Gov. Parson announced that the Missouri National Guard will begin drawing down their COVID-19 response mission with an end date of Tuesday, June 1. Targeted vaccination teams will continue in the coming months at vaccination clinics in the St. Louis and Kansas City areas. This decision coincides with a sharp reduction in COVID-19 vaccine demand. The State Emergency Management Agency will continue its efforts in providing clinical and nonclinical volunteers as needed for local events.

Staff Contact: Daniel Landon or Meghan Henderson

Missouri Attorney General Eric Schmitt filed a lawsuit against Saint Louis County Executive Sam Page, M.D., and public health officials in the county. It alleges “arbitrary, capricious and unreasonable application of COVID-19 restrictions in St. Louis County.”

Staff Contact: Andrew Wheeler

The U.S. Department of Treasury released an interim final rule with details about the American Rescue Plan Act’s $350 billion in State and Local Fiscal Recovery Funds. State governments and the District of Columbia will receive $195.3 billion; counties will receive $65.1 billion; certain metropolitan cities will receive $45.6 billion; and the remaining funds will be distributed to tribal governments, territories and nonentitlement units of local government. The SLFRP funds “provide substantial flexibility for each jurisdiction to meet local needs.” Generally, the funds can be used for the following.

• support public health expenditures by funding COVID-19 mitigation efforts, medical expenses, behavioral health care, and certain public health and safety staff
• address negative economic impacts caused by the public health emergency, including economic harms to workers, households, small businesses, impacted industries and the public sector
• replace lost public sector revenue, using this funding to provide government services to the extent of the reduction in revenue experienced due to the pandemic
• provide premium pay for essential workers, offering additional support to those who have borne and will bear the greatest health risks because of their service in critical infrastructure sectors
• invest in water, sewer and broadband infrastructure, making necessary investments to improve access to clean drinking water, support vital wastewater and stormwater infrastructure, and to expand access to broadband internet

To receive funds, states and local governments will need to request the Coronavirus State and Local Fiscal Recovery Funds though the Treasury Submission Portal.

Staff Contact: Keri Barclay

The U.S. Food and Drug Administration expanded the emergency use authorization for the Pfizer-BioNTech COVID-19 vaccine to include adolescents ages 12 to 15. The vaccine was 100% effective in preventing COVID-19 in trials. The vaccine is administered with the same dosage and dosing regimen for individuals 16 years of age and older. Fact sheets for health care providers and vaccinators, and for recipients and caregivers, have been updated with information to reflect the use of the vaccine in the adolescent population.

The Advisory Committee on Immunization Practices is holding an emergency meeting at 10 a.m. CDT Wednesday, May 12, to provide recommendations and vote on this COVID-19 vaccine update. The state standing orders will be updated as needed to reflect the recommendations of this committee. Adolescents could begin receiving the vaccine as early as Thursday.