Weekly Roundup COVID-19 Vaccine Development, Policy, and Public Perception in the United States

People, Perceptions, and Polls

OP-ED Black Americans should face lower age cutoffs to qualify for a vaccine. In the first half of 2020, Black Americans’ life expectancy declined almost three years to an average of 72 years, compared with a loss of almost one year for White Americans (now 78 years). Meanwhile, Black Americans are not only twice as likely to die of covid-19 as White Americans but also dying at rates similar to those of White Americans who are 10 years older. (Washington Post, 2/19/21) See also: No, the Tuskegee Study Is Not the Top Reason Some Black Americans Question the COVID-19 Vaccine (KQED, 2/25/21) Vaccine Hesitancy Is No Excuse for Systemic Racism (The Hastings Center, 2/25/21)

NEWS Delay a Shot? Skip One? Vaccine-Dosing Messaging Is a Nightmare. During a crisis, public-health messaging requires both consistency and trust. Vaccine makers will need to maintain transparency about their products; health officials will need to build sustainable partnerships with underserved communities; advocates will need to complement data with true narratives that support the shots’ safety and effectiveness. (The Atlantic, 2/18/21) See also: Biden Let His Scientists Speak. The Results Were... Messy. (Daily Beast, 2/23/21) Pfizer’s vaccine works well after one dose and doesn’t always need ultracold storage (Japan Times, 2/20/21) People Who Have Had Covid Should Get Single Vaccine Dose, Studies Suggest (New York Times, 2/22/21) When experts say COVID-19 vaccines are 95% effective it doesn't mean you'd have a 5% chance of getting sick (Business Insider, 2/16/21)

OP-ED Millions of Americans Qualify for the COVID-19 Vaccine Based on BMI. Why Should We Apologize for It? Absent much widely disseminated guidance about the process of receiving the still-new vaccine, many people whose BMI qualifies them are relying on others in the same position to gather information and help dispel some of the very real anxiety and trauma of having public attention called to your weight. (Vogue, 2/23/21)

OP-ED Without Women, COVID-19 Vaccination Efforts in the U.S. Would Fail. Rosemary Morgan, PhD, a researcher and a professor of gender analysis in health research at Johns Hopkins Bloomberg School of Public Health, tells Verywell that traditional roles many women take on in the household have been exploited during the pandemic, and vaccines are quickly becoming the boiling point. (Verywell Health, 2/24/21)

NEWS Facebook political ad ban blocks pro-vaccine messages. Paid-for messages from at least 110 groups aimed at raising awareness of how the vaccines work or where to get inoculated were flagged and sent to Facebook’s register of political messages, a POLITICO review of barred ads dating from last September shows. (POLITICO, 2/21/21) See also: A New Way to Inoculate People Against Misinformation (Behavioral Scientist, 2/22/21) The Disinformation Vaccine: Is There a Cure for Conspiracy Theories? (Rolling Stone, 2/24/21)

NEWS False claims tying coronavirus vaccines to infertility drive doubts among women of childbearing age. “I’m worried, frankly,” said Francis Collins, director of the National Institutes of Health. “There are stories out there on the Internet about how vaccination can lead to infertility. There’s absolutely nothing to that. But when we look at people who are expressing hesitancy, in many instances those are women of childbearing age.” (Washington Post, 2/22/21)

RESEARCH A Mega-Study of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment. Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N=47,308) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest text messages sent prior to a primary care visit can boost vaccination rates by up to 11%. (SSRN, 2/19/21) See also: A Mega-Study of Text-Message Nudges Encouraging Patients to Get Vaccinated at their Pharmacy (SSRN, 2/19/21)

NEWS 7 Ways to Reduce Reluctance to Take COVID Vaccines. Vaccine reluctance looms large among certain subgroups: 42 percent of Republicans, 35 percent of Black adults and 33 percent of essential workers, for varying reasons, said they would probably or definitely refuse the vaccine in a December poll conducted by the Kaiser Family Foundation (KFF). Experts say efforts to overcome hesitancy should address specific concerns from these groups and include transparency about vaccine benefits and risks. (Scientific American, 3/21) See also: Op-Ed: Stop Emphasizing What's Bad About COVID Vaccines (MedPage Today, 2/16/21) COVID-19 anti-vaxxers use the same arguments from 135 years ago (Novel Science, 2/22/21)

POLL More Americans now say academic concerns should be a top factor in deciding to reopen K-12 schools. Compared with last summer, a higher share of U.S. adults now say the possibility that students will fall behind academically without in-person instruction should be given a lot of consideration as schools decide whether to reopen. And smaller shares now say the health risk to teachers or students should be given a lot of consideration. Majorities of Black (80%), Hispanic (69%) and Asian (72%) adults say schools should wait to reopen until teachers have been vaccinated, compared with about half of White adults (51%). (Pew Research Center, 2/24/21)

NEWS Is It Fair To Give Weaker COVID-19 Vaccines To Low-income, At-Risk Groups? If certain demographics have fallen behind, then policymakers must now wrestle with who should get the more effective mRNA vaccines, which require super-cold temperatures and two shots. The Johnson & Johnson vaccine may be less effective at preventing symptoms and transmission, but only requires one dose and can be stored in normal refrigerators—so it is more likely to be used in under-resourced settings. (Gothamist, 2/25/21)

POLL Coronavirus: Vaccination. Civiqs reports findings from an analysis of 34,932 responses to the question "Do you plan to take a coronavirus vaccine if it becomes available?" Respondents are disaggregated by age, educational attainment, race, gender, and political party affiliation. (Civiqs, 2/21)

ANNOUNCEMENT The Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA. The Lancet has established the Commission for Vaccine Refusal, Acceptance, and Demand in the USA to design a multisectoral plan for public policy to support high acceptance of safe and effective vaccines in the USA. Our goal is to understand and report on the state of vaccine acceptance and its potential link to vaccine hesitancy. Additionally, we will work to identify and predict future trends in vaccine acceptance and impacts on the public health community. We will also identify and assess demand-side vaccine uptake interventions and solutions to counter anti-vaccine information. (The Lancet, 2/24/21)

SURVEY U.S. General Population COVID-19 Vaccine Uptake Survey: A Psychobehavioral Approach to Promoting COVID-19 Vaccine Uptake. Our survey (conducted from December 20, 2020 - January 4, 2021) found that 40% of Americans are highly likely to get the vaccine, with the remaining 60% falling into less likely segments with a variety of concerns and barriers shaping their likelihood. But by digging deeper into that 60% of Americans—specifically by prioritizing three psychobehavioral segments (43% of Americans) who we identified as persuadable, we believe we can increase COVID-19 vaccine uptake as we need to in order to reach community immunity and overcome the pandemic. (Surgo Ventures, 2/21)

Research, Development, and Clinical Practice

NEWS FDA scientists endorse J&J’s Covid vaccine, as new data shed light on efficacy. Johnson & Johnson also revealed new, encouraging data showing the vaccine may do a better-than-expected job at protecting patients against new variants of the virus that causes disease. At the same time, FDA experts said the company’s study, results of which were originally made public in a Jan. 29 press release, includes insufficient information to draw conclusions on efficacy in people older than 75. (STAT, 2/24/21) See also: The J&J Vaccine at the FDA (Science Magazine, 2/24/21)

NEWS Pfizer COVID-19 vaccine found to be 94% effective in real-world study. According to the independently reviewed study out of Israel's Clalit Research Institute, published Wednesday in the New England Journal of Medicine, two doses of the Pfizer/BioNTech shot were 94% effective at cutting symptomatic COVID-19 cases across all age groups. (CBS News, 2/25/21) See also: How to Understand COVID-19 Variants and Their Effects on Vaccines (Quanta, 2/25/21) Is more simply better? Why Pfizer thinks a booster of its Covid vaccine might work against new variants (STAT, 2/25/21) Moderna ready to test version of Covid-19 vaccine aimed at worrisome variant (STAT, 2/25/21) Moderna Announces it has Shipped Variant-Specific Vaccine Candidate, mRNA-1273.351, to NIH for Clinical Study (BusinessWire, 2/24/21)

NEWS Pfizer to begin Covid vaccine clinical trial in pregnant women. The drugmaker aims to enroll about 4,000 pregnant women in the trials, which will include participants in the U.S. as well as Argentina, Brazil, Canada, Chile, Mozambique, South Africa, Spain and the U.K. Women over 18 and who are 24 to 34 weeks into their pregnancy will be eligible. (NBC, 2/18/21)

NEWS Why We Can’t Make Vaccine Doses Any Faster. President Biden has promised enough doses for all American adults by this summer. There’s not much even the Defense Production Act can do to deliver doses before then. (ProPublica, 2/19/21) See also: Drug executives: Big jump in vaccine supply is coming soon; 140M doses over next 5 weeks (Pittsburgh Post-Gazette, 2/23/21) For mRNA Vaccines, COVID-19 is Just the Beginning (JHU Hub, 2/15/21)

OP-ED Does the Vaccine Stop Transmission? Many scientists are reluctant to say with certainty that the vaccines prevent transmission of the virus from one person to another. This can be misinterpreted as an admission that the vaccines do not work. That’s not the case. The limited data available suggests the vaccines will at least partly reduce transmission, and the studies to determine this with more clarity are underway. (New York Times, 2/23/21) See also: You're Far Less Likely to Spread Covid-19 If You Get the Vaccine, Real-World Data Suggests (Gizmodo, 2/22/21)

NEWS So You Got Vaccinated…And Then You Got COVID. Now What? One thing we’ve learned from flu vaccine studies is that the vaccine can reduce the severity of the disease, even if you do still contract it post-vaccination. These studies will help us figure out what’s going on with COVID-19 as well. Stuff like that matters. (FiveThirtyEight, 2/23/21)

Law, Policy, and Politics

BLOG Assessing The Legality Of Mandates For Vaccines Authorized Via An Emergency Use Authorization. One recent study found that 72 percent of major company CEOs would consider vaccine mandates. Other groups have floated the idea of “vaccine passports,” in which a person can gain access to travel, education, work, etc. only if they have proof of immunization. As a practical matter, vaccine passports are functionally equivalent to mandates. (Health Affairs, 2/16/21) See also: Vaccinating Health Care Employees — Do They All Deserve Early Access? (New England Journal of Medicine, 2/19/21) Can Employers Mandate a Vaccine Under Emergency Use Authorization? (Bill of Health, 2/24/21)

OP-ED No One Is Safe Until Everyone Is Safe. Recognizing that “no one is safe until everyone is safe,” the G7 recently announced additional steps to facilitate globally more “affordable and equitable access to vaccines, therapeutics, and diagnostics” to combat COVID-19. But translating stated intent into effective action will require both bold political leadership at home and support for developing countries that goes well beyond financial aid. Getting it right won’t be easy, but the effort is essential if rich countries wish to avoid living in a fortress with the mentality to match. (Project Syndicate, 2/22/21) See also: ‘Held to ransom’: Pfizer plays hardball in Covid-19 vaccine negotiations with Latin American countries (STAT, 2/23/21) An Open Letter to President Biden: A People’s Vaccine – Free and Fair for All – to End the COVID-19 Crisis (Physicians for Human Rights, 2/23/21) Fact Sheet: President Biden to Take Action on Global Health through Support of COVAX and Calling for Health Security Financing (White House, 2/18/21)

NEWS No-fault compensation programme for COVID-19 vaccines is a world first. As the first and only vaccine injury compensation mechanism operating on an international scale, the programme will offer eligible individuals in AMC-eligible countries and economies a fast, fair, robust and transparent process to receive compensation for rare but serious adverse events associated with COVAX-distributed vaccines until 30 June 2022. (Gavi, the Vaccine Alliance, 2/21)

HEARING Pathway to Protection: Expanding Availability of COVID-19 Vaccines. The Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce held a hearing on Tuesday, February 23, 2021, at 10:30 a.m. via Cisco WebEx. The hearing is entitled, "Pathway to Protection: Expanding Availability of COVID-19 Vaccines." (U.S. House Committee on Energy & Commerce, 2/23/21)

Public Health Practice

NEWS Why Native Americans Are Getting COVID-19 Vaccines Faster. Twenty-five tribal members, mostly elders, have died from COVID-19 so far on the isolated and long-neglected Rosebud Reservation. Hundreds more here were sickened or hospitalized. Everyone knows someone who has it or had it, or worse, died from it. Native Americans across the country have been disproportionately hit by the virus — dying at twice the rates as white people. (NPR, 2/19/21) See also: The Navajo Nation has its exceeded vaccination goal for February (Arizona Public Media, 2/23/21) Blackfeet Reservation Vaccinations near 50% (Cut Bank Pioneer Press, 2/24/21)

NEWS Philly Black doctors clinic outpaced the city in vaccinating Black residents, but group says there’s "room for improvement." Over 24 hours, the Black Doctors COVID-19 Consortium vaccinated nearly 4,000 people, on their own, surpassing the city’s daily vaccination average this month of 3,500 first doses per day. And three out of four Philadelphians vaccinated at the city’s first round-the-clock walk-up site were people of color — a particularly notable number in a city where 55% of people who have received the vaccine are white, even though they make up just 40% of residents. (Philadelphia Inquirer, 2/25/21)

COMMENTARY Taking Vaccine to Where the Virus Is—Equity and Effectiveness in Coronavirus Vaccinations. This article outlines an approach to achieve equity, efficiency, and ultimately effectiveness in the COVID-19 vaccination campaign. (JAMA, 2/18/21) See also: Vaccine equity: If we build it, will they come? (STAT, 2/24/21) For the most vulnerable Americans, these clinics are trusted, accessible and vital to vaccine rollout (USA TODAY, 2/23/21)

Q&A Vaccination plans must include disability community's needs. Bonnielin Swenor and Sabrina Epstein from the Disability Health Research Center discuss their new vaccination dashboard for people with disabilities and why it is essential to ensure equitable access to vaccines for vulnerable groups. (JHU Hub, 2/23/21)

COMMENTARY How Philanthropy Can Support Equitable Vaccine Distribution. As we move into this new phase of attempting a historic mass-vaccination campaign in the United States, many in the philanthropic sector are eager to support the process in ways big and small. But given the unpredictable nature of the vaccination roll out, foundations and donors aren’t always sure how to leverage their investments most effectively. (Stanford Social Innovation Review, 2/17/21)

NEWS First 100: The Biden Vaccine Rollout Is Working. In the 49 days since January 3, the U.S. has delivered 58.8 million shots, with the seven-day average really moving in a straight line upward until Valentine’s Day, when that average topped out at 1.7 million shots per day. Early on, about 30 percent of vaccines shipped had been delivered; now the number is 84 percent. (The American Prospect, 2/22/21) See also: The One Area Where the U.S. COVID-19 Strategy Seems to Be Working (The Atlantic, 2/22/21) Biden targets diverse groups with vaccine hesitancy for COVID-19 funds (CBS, 2/24/21)

NEWS West Virginia's Vaccination Rate Ranks Among Highest In World. West Virginia has administered almost 450,000 doses of COVID-19 vaccine. More than 9% of its population has gotten both doses. Alaska and West Virginia trade off for first place among states for the percentage of the population that have received both doses of the COVID-19 vaccine. If broadened out to look at the whole world, the percentage of the population of West Virginia already fully vaccinated would rank third. (NPR, 2/22/21)

NEWS Who is giving the Covid vaccines? States scramble to find vaccinators. With the recent expansions, those qualifying include pharmacy interns and recently retired doctors and nurses, as well as physicians, nurses and pharmacists. The government estimates there are about half a million inactive physicians and 350,000 inactive registered nurses and practical nurses in the United States. (NBC News, 2/21/21)

NEWS Nursing Homes, Once Hotspots, Far Outpace U.S. in Covid Declines. Since the arrival of vaccines, which were prioritized to long-term care facilities starting in late December, new cases and deaths in nursing homes, a large subset of long-term care facilities, have fallen steeply, outpacing national declines, according to a New York Times analysis of federal data. (New York Times, 2/25/21) See also: First-Dose COVID-19 Vaccination Coverage Among Skilled Nursing Facility Residents and Staff (JAMA, 2/24/21)

NEWS Governor admits problems with vaccine rollout in Latino and Black communities. Of the 7.3 million doses administered in California, 2.9% have gone to Black residents, 16% to Latinos and 13% to Asian Americans, compared with 32.7% to white people, according to state data. (Los Angeles Times, 2/21/21) See also: Wealthy LA residents gain access to COVID-19 vaccination codes meant for Black and Latino communities (Business Insider, 2/23/21) COVID-19 vaccines: Who's jumping the line - and how to stop it (Thomson Reuters Foundation, 2/24/21) Two Federally Supported Vaccination Sites Open In California, More to Follow (Department of Defense, 2/17/21)

NEWS ‘A full court press’: Banking on tech backup, CDC launches nationwide VaccineFinder tool. On vaccinefinder.org, users can enter an address or ZIP code and select a search area — say, within 10 miles — and get a list of providers with contact information, eligibility criteria, and, when available, a link to a vaccine scheduler. Critically, users will also be able to see whether each provider has doses available. (STAT, 2/24/21)

NEWS Short of Vaccine, States Find Hidden Stashes in Their Own Backyards. Millions of doses of coronavirus vaccine are still sitting in freezers, allocated in excess to nursing homes or stockpiled for later use. Now states are claiming them. (New York Times, 2/19/21) See also: Pharmacists say 'pooling' Covid vaccines could save thousands of doses (NBC News, 2/22/21) Maryland Vaccine Hunters Facebook group helps people find appointments (WBALTV, 2/23/21) What Are the Vaccine Roadblocks Where You Live? (New York Times, 2/25/21)

This newsletter supports CommuniVax, a research coalition convened by the Johns Hopkins Center for Health Security and the Texas State University Department of Anthropology, with support from the Chan Zuckerberg Initiative.