Monday, MHA released new research on Missourians’ attitudes regarding the COVID-19 vaccine. The results were a mix of good and less good news. Among the state’s 800 adults participating in the survey, more than half had received the vaccine. However, among those not yet vaccinated, only 11% signaled they will get the vaccine. Worse yet, 28% of participants indicate they will not seek a vaccination.
The progress made in the past month — especially as vaccination expanded to all Missourians ages 16 and older on April 9 — has been spectacular. On the 9th, 80,471 doses were delivered to Missourians. That is the highest daily number of vaccines administered in the state since the mass vaccination campaign began. During the first partial week of universal eligibility, an average of 52,267 doses were administered each day in Missouri. However, the following week’s dose administration dropped precipitously. In the first full week of the state’s Phase 3 activation, we witnessed a softening of demand as the average daily number of doses administered was 35,845 — a one-week, 31% decline.
Polling released in January foreshadowed vaccine hesitancy issues in Missouri. Until this month, the constraints of limited vaccine supply and risk-based eligibility tiers allowed for an equilibrium of sorts. Demand tended to outstrip supply. Now, we’re entering into a period where supply is outpacing demand. This changes everything.
Estimates from MHA’s research, and similar national data, suggest that demand for vaccines and the protection provided by an earlier infection is unlikely to provide the level of immunity needed to inhibit the path of the virus. By Friday, May 7, current linear trends suggest that roughly one-quarter of Missourians will have completed the vaccine series, while 58% will have protection from the virus derived from either vaccination or from a previous infection — well below the 65% to 85% coverage needed to prevent community spread of COVID-19.
However, there is hopeful news included in the research. Specifically, there are populations that can be reached to expand vaccination and information that can decrease hesitancy. For example, the uninsured have remarkably low rates of immunization. This isn’t necessarily demand-driven. Among this population — and among low-income and Medicaid-eligible Missourians — the fact that the vaccine is no cost to patients could help build demand.
There’s still work required to vaccinate vulnerable populations. More than one-third of African American and Black Missourians are among those indicating they are not likely to seek vaccination. Communities of color have been hit especially hard by COVID-19. Converting these hesitant Missourians will require targeted, community-based outreach by trusted voices. These efforts will require hospitals to forge new, or foster existing, community connections to convince and convert.
Even as vaccination location options and vaccine supplies expand, front-line clinicians remain essential messengers. Trust is strongest between patients and their primary care physician or regular caregiver. Nearly two-thirds of Missourians trust local and national public health experts, but 90% trust their doctor. Elected leaders’ voices are much less powerful in this decision-making process.
Three messages were particularly effective with those on the vaccine sidelines. First, the vaccine is free to patients. For the uninsured or underinsured, cost should not be a factor in decision-making. Second, the vaccines are safe and effective. Real-world results have borne out the results of clinical trials, including that they help prevent serious illness and death. Finally, corners were not cut in the vaccine development process. The speed of vaccine to market was possible through reduced regulatory barriers, not scientific shortcuts.
All Missourians have a stake in the state reaching herd immunity. Getting there will increasingly be about trusted voices reaching those who are skeptical and need to know more.
ACIP Votes To Resume Johnson & Johnson COVID-19 Vaccine With Warning
Senate Appropriations Committee Advances State Budget
MHD Announces PDMP Policy Change
Board Of Pharmacy Releases Sterile Compounding Emergency Rule
MLN Connects Provider eNews Available
Updated COVID-19 Vaccine Dashboard Available
National Prescription Drug Take Back Day Is Saturday
USDA Offers Distance Learning And Telemedicine Grant
Centerpointe Hospital Names CEO
The Advisory Committee on Immunization Practices met today to analyze evidence of increased risk of thrombosis with thrombocytopenia syndrome and voted to resume rollout of the Johnson & Johnson COVID-19 vaccine. Specifically, the ACIP motion passed stating, “The Janssen COVID-19 vaccine is recommended for persons 18 years of age and older in the U.S. population under the FDA’s emergency use authorization.”
The pause was noted to be effective in educating individuals with TTS symptoms on the need to seek medical care early and promoting provider awareness of appropriate treatment protocols. The CDC has produced clinical care guidance in these patients. Improved outcomes were noted in patients who did not receive heparin and did receive IV IG. The Centers for Disease Control and Prevention will hold a Clinician Outreach Communication Activity call at 1 p.m. CDT Tuesday, April 27. Registration is not required.
Missouri currently does not have a J&J standing order, but one is anticipated in the near future based upon these recommendations and FDA approval.
The Senate Appropriations Committee completed its work on the state budget for fiscal year 2022 Thursday afternoon. The panel’s budget does not include funding explicitly designated for Medicaid expansion, but it does include a new $500 million Medicaid stabilization fund. A proposal by Senator Lincoln Hough to include appropriations to directly fund the expansion failed on a 7-7 tie vote. Also, the committee added a $50 million appropriation to reduce the losses some hospitals will experience from a new Medicaid outpatient fee schedule. The full Senate will debate the committee’s recommendations and pass its version of the budget next week. The Senate and House then must reconcile the differences in their respective budgets by Friday, May 7, the constitutional deadline for enacting a state budget for the upcoming fiscal year.
The MO HealthNet Division announced it will require Medicaid providers to check an available prescription drug monitoring program before prescribing controlled substances beginning Oct. 1, 2021. The policy change has been updated in Section 13.22 of the Pharmacy Manual. In the case that the provider does not have access to a PDMP, there will need to be documentation in the participant record about why the prescriber was unable to perform the check and they must make such documentation available to the state upon request.
The Missouri Board of Pharmacy promulgated an emergency amendment to mitigate potential shortages of sterile compounded medications. The emergency amendment would remove the requirement that Risk Level 3 preparations must remain Risk Level 3 for the life of the preparation. As a result of the amendment, compounded preparations made from a properly tested Risk Level 3 stock solution would not have to undergo additional sterility/endotoxin testing for each individual patient dose. This emergency rule is effective Wednesday, April 28. An emergency amendment and proposed rule covering the same content will be filed in the Missouri Register on Monday, May 17.
The Centers for Medicare & Medicaid Services issued updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.
Chronic care management: comparative billing report in April
National Minority Health Month
Dialysis facilities: partnership to vaccinate dialysis patients and health care personnel
Achieving health equity web-based training – revised
The interactive Vaccine Administration dashboard now is available with doses administered through April 22. This dashboard is accessible to authorized users of HIDI Analytic Advantage. If you need a user ID and password or have questions about accessing these dashboards, contact HIDI.
The Drug Enforcement Administration is hosting a National Prescription Drug Take Back Day on Saturday, April 24, which provides a safe, convenient and responsible way to dispose of prescription drugs, while also educating the public about the potential for medication misuse. Visit the Take Back Day website to learn more and locate a local collection site.
The U.S. Department of Agriculture is accepting applications for Distance Learning and Telemedicine program grants to help rural communities use the unique capabilities of telecommunications to connect to each other and to the world, overcoming the effects of remoteness and low population density. The application deadline is Friday, June 4.
Karen Kasten has accepted the CEO position at CenterPointe Hospital, located in St. Charles, Mo. Kasten has served as interim CEO since Scott Williams’ retirement in March. Kasten has more than 23 years of experience in the behavioral health field working with children, adolescents, adults and older adult populations.