Late last week, the U.S. Food and Drug Administration and Centers for Disease Control and Prevention approved COVID-19 vaccine booster doses for all individuals ages 18 and older. The added guidance provides expanded eligibility for all adult prime series recipients of the two-dose mRNA Pfizer-BioNTech and Moderna vaccines six months following vaccine completion. Adult recipients of the single-dose Johnson & Johnson vaccines previously were approved for booster doses of any type two months following prime series completion.
The expanded eligibility for booster doses came on the heels of the Missouri Department of Health and Senior Services releasing some of the most comprehensive national data on breakthrough infections through a partnership with MHA and the Hospital Industry Data Institute. Initial analyses show that while only 1.8% of fully vaccinated Missourians have experienced a breakthrough infection, the portion of new cases among fully vaccinated individuals has grown sharply with waning protection over time, as well as the introduction of the Delta variant as the dominant circulating strain. Historical hospital claims data from HIDI also reveal that underlying risk factors and age are significantly associated with those experiencing breakthrough infections.The data also show variation in the likelihood of experiencing a breakthrough infection by the type of vaccine originally received, with 3.1% of J&J recipients having a breakthrough infection compared to just 1.8% of all fully vaccinated individuals.
During the previous three weeks and leading into the holiday season, new COVID-19 cases have increased by 46%. Considering emerging data on the efficacy of booster doses, COVID-19 vaccines offer a significant opportunity to moderate the impact of potential seasonal surges during the winter of 2021-2022 in Missouri.
Based on clarification from the Centers for Medicare & Medicaid Services regarding medical exemptions under its vaccination interim final rule, MHA revised its CMS COVID-19 Vaccine Mandate Guidance. Under the rule, medical exemptions only may be granted for “recognized clinical contraindications” to one or more of the vaccines. CMS previously pointed to the two conditions for which the Centers for Disease Control and Prevention advise against vaccination — anaphylactic reaction to a dose of the vaccine or known allergy to a component of a vaccine — as qualifying for medical exemptions. Recently, one of the agency’s medical officers acknowledged on a national conference call that there may be other recognized conditions for which vaccination would be inadvisable. Because the rule allows exemptions for recognized contraindications only, CMS suggests exemptions be based on documented findings from medical studies or the vaccine literature.
Last week, the Florida Attorney General filed a lawsuit challenging the Centers for Medicare & Medicaid Services’ vaccine mandate. Days later, a federal judge issued an order declining the state’s motion for a temporary injunction. As grounds, the judge found the evidence regarding staffing shortages and disruption to health care services speculative. She further stated that the plaintiff primarily alleged financial harm, for which injunctive relief is not proper, as the parties would have an adequate legal remedy through the course of the litigation. Similar cases are pending in federal courts in Missouri, Louisiana and Texas.
The American Rescue Plan Act included $8.5 billion in relief funding to help providers caring for patients located in rural areas serving Medicare, Medicaid and Children’s Health Insurance Program beneficiaries. Today, the U.S. Department of Health and Human Services, through the Health Resources and Services Administration, began distributing $7.5 billion to providers. Within Missouri, 1,121 providers are expected to receive a total of $275.5 million.
The Flex Monitoring Team released a new report, “Critical Access Hospitals’ Initial Response to COVID-19 by System Affiliation,” which presents data on the initial response to COVID-19 in system-affiliated and independent CAHs. The data come from a survey of CAH CEOs in eight states about their response to COVID-19 from February to August 2020. Findings include information on COVID-19 case volume, personal protective equipment supply, and the perceived impact of being a system-affiliated or independent CAH on their overall response to COVID-19.
The Assistant Secretary for Preparedness and Response’s Technical Resources, Assistant Center and Information Exchange published a resource that highlights strategies in which health care workforce decision-makers could adopt to optimize health care workforce assets, assess ongoing staffing needs and identify resources to meet patient surge during the COVID-19 pandemic.
The Health Resources and Services Administration, Bureau of Health Workforce is hosting an upcoming event, “Clinical Leaders Peer-to-Peer Forum Webinar: A Focused Discussion on the Nursing Workforce,” at 2 p.m. CST Wednesday, Dec. 8. During the forum, participants will hear from a panel of nursing experts and share best practices around growing and sustaining the health center nursing workforce during a pandemic using an integrated care team model.