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It’s been a big vaccine week with the Pfizer vaccine moving from emergency use to full approval by the U.S. Food and Drug Administration, and President Biden’s announcement that a third dose, or “booster,” will be coming soon. These factors will have implications for all Americans.

It’s too early to know how much the vaccine-hesitant will be moved by the full authorization of Pfizer. On Thursday, competing headlines from CBS News and The Washington Post indicated that it would make a difference among some and also, that it won’t. This really isn’t surprising, given the polling trends that indicate a significant minority of the population seem fully entrenched against vaccination. Moreover, it’s possible that new data on breakthroughs and reduced efficacy against the Delta variant will provide new fodder for those who are looking for a reason to reject vaccination.

A story from The Washington Post identifies an emerging challenge of full approval of Pfizer’s vaccine — pressure to administer the shots off-label to children younger than 12 years old. With the school year beginning, and growing evidence that Delta affects the young more acutely, pediatricians can expect parents — especially those with vulnerable kids — to seek off-label care in greater numbers. The Centers for Disease Control and Prevention and American Academy of Pediatrics are strongly urging physicians not to accommodate them given the lack of data on possible harm.

There’s good news on vaccination overall. Delta is increasing vaccination rates, which — as individuals gain immunity — will reduce pressure on hospitals for COVID-19 care. And, with full approval, more businesses and organizations are announcing mandates for their workforce. This includes hospitals where the EUA was a consideration in some mandate decision-making. Unfortunately, the full value of the shots generally are four to six weeks from the first dose.

Even with slightly reduced efficacy and boosters likely in the future, all signs point to vaccination as the best way to reduce hospitalization and death. We don’t have full data on breakthrough hospitalizations, but they seem rare — perhaps 10% or less — and mortality among the vaccinated remains extremely rare among the otherwise healthy.

Early evidence suggests that statewide, and in Southwest Missouri, cases are beginning to plateau. I hope that’s true. However, care isn’t delivered to individuals statewide, it’s delivered in a hospital. That requires resources that are presently constrained in many communities. Hospital capacity remains tight everywhere — and that matters for hospitals’ ability to deliver care to COVID-19 patients and all critically ill patients — especially those requiring ICU-level care. At the same time, it appears that other regions are facing growing pressure on hospital resources, including the Kansas City region and Southeast Missouri.

Many of this week’s announcements are good news in the long run. Unfortunately, the challenge remains in the short run. For now, the state’s investments in monoclonal antibodies provide a tool to reduce hospitalizations. It’s a pound of cure, not an ounce of prevention. However, until we see the results of higher uptake in vaccination, it’s what we’ve got.

Let me know what you’re thinking.

Herb B. Kuhn
MHA President and CEO

P.S. — Today, Gov. Parson extended the health care-related waivers that have allowed hospitals and our health care partners to manage the COVID-19 crisis. More than a dozen organizations — representing business and health care — weighed in throughout the past two weeks about the need for this extension. We appreciate the administration’s support during this crisis. MHA released a statement about the extension earlier today.

In This Issue

Advocates Support Extending Emergency Declaration And Waivers
Missouri Board Of Pharmacy Issues Ivermectin Bulletin
MLN Connects Provider eNews Available
MHA Provides Information On Regional Monoclonal Antibody Infusion Centers
Analytic Tool Available To Assess Wage Index Reclassification For FFY 2023
HRSA Extends Deadline To Apply For Health Care Workforce Resilience Grants
CMS Announces Hospital Quality Reporting Programs Webinar
MRHA Provides New Telehealth Resources