Axios Vitals: States fed up with feds

Plus, COVID can't hold us back from vacation | Tuesday, August 16, 2022

Open in app View in browser     Axios Vitals By Tina Reed · Aug 16, 2022 Good morning, Vitals readers. Today's newsletter is 982 words or a 4-minute read. Situational awareness: Biden is due to sign the IRA today, sealing the biggest health legislation since the ACA.     1 big thing: States fed up with feds over monkeypox Data: CDC, U.S. Census; Chart: Erin Davis/Axios Visuals The Biden administration is facing increasing criticism from frustrated state health officials over a hard-to-use system for distributing monkeypox vaccines that's slowing their ability to quickly reach patients, Axios' Arielle Dreher and I write. Why it matters: Every delay intensifies concern that the government is fumbling the early response to another emerging health threat that could lead to uncontrolled disease spread in the general population. Typically vaccines, including COVID-19 shots, are distributed through a CDC-run system that is integrated with state databases that track vaccinations and doses, the New York Times reports. But the monkeypox vaccine is being distributed by the National Strategic Stockpile, overseen by a different agency under the Department of Health and Human Services, which is not linked to state databases, per the Times. It's led to instances in which hundreds of doses were routed to the wrong states or lost in transit. What they're saying: "We had no way to track vaccine shipments, when they actually shipped or when they were going to arrive," Chris Van Deusen, a spokesperson for the Texas Department of State Health Services, told the Times. "They just showed up with no notice." Driving the news: HHS announced Monday it's accelerating its planned delivery of additional Jynneos vaccine, making up to 442,000 doses available for states and jurisdictions to order weeks earlier than originally planned. That's in part a response to the nation's new strategy to stretch supplies via intradermal injection, between skin layers. This will allow providers to use one vaccine vial for five injections. But there's been limited CDC training to administer shots that way, which could further delay vaccinations, Jennifer Mahn, clinical and sexual health director at the National Coalition of STD Directors, told Axios. The manufacturer of Jynneos also warned senior Biden administration health officials about splitting the shots due to limited safety data, the Washington Post first reported. Between the lines: The frustration with the response is spreading to Congress, where some lawmakers are questioning why HHS isn't freeing up a smallpox drug called tecovirimat, or TPOXX, for treating monkeypox from the Strategic National Stockpile. What to watch: Though the government has ordered more vaccine, the immediate pressure is on local public health providers to get what's available in the arms of people most at risk.     2. Axios-Ipsos poll: Vacations trump COVID worries Data: Axios/Ipsos poll; Chart: Danielle Alberti/Axios Americans aren't taking steps to avoid COVID-19 before going on vacation and appear to have little bandwidth for another health crisis like monkeypox, Axios' Adriel Bettelheim writes about the latest installment of the Axios/Ipsos Coronavirus Index. Why it matters: Our perception of personal risk has fallen to a point where travelers' most common precaution is just to wash or sanitize their hands more frequently — and fewer than half even do that. "We're dealing with the scar tissue of the pandemic," said Cliff Young, president of Ipsos U.S. Public Affairs. "Public opinion has been beaten down, and many people don't know if it's just easier to go on without taking extra precautions." By the numbers: Half of the 1,047 adults interviewed said they'd gone on vacation or taken trips to see family or friends in the past three months. More than seven in 10 said they didn't take precautions like wearing masks or limiting socializing to reduce the risk of getting COVID-19 before vacation. What to watch: The findings also suggest that while 53% say they've heard about the monkeypox outbreak, the public largely views it as a problem affecting others. Share this story.     3. Extension is likely for public health emergency The administration appears headed toward extending the COVID-19 public health emergency for another three months, allowing special powers and programs to continue past the midterm election, Adriel writes. Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice before it ends. Why it matters: Lifting the emergency would bring major policy shifts to insurance markets, drug approvals and telehealth. It also keeps in place a higher share of federal Medicaid spending if states offered continuous coverage to enrollees, avoiding the program's usual churn. Ending the emergency would lead states to determine whether their Medicaid enrollees are still eligible for coverage — a huge undertaking that could result in millions of Americans being removed from the program. Where things stand: After a long plateau, the number of new COVID cases have been falling and wastewater surveillance data has shown declines for three straight weeks, per Evercore ISI. And yet, about 400 Americans still die every day from COVID-19.     A message from Axios For you, your team or your company     Contact our dedicated account team and learn how Axios Pro Corporate Subscriptions can help you achieve your business goals. Get in touch, and we'll build you the best plan for your organization. Contact us.     4. Estimated insulin savings from IRA Medicare beneficiaries who pay for brand-name insulin would save $840 a year in drug costs to cost-sharing caps included in the Inflation Reduction Act, according to a report from the Council for Informed Drug Spending Analysis. Zoom in: Under the IRA, Medicare beneficiaries would pay a maximum of $35 a month, or $420 a year, for insulin using their Part D benefit. Those who use more expensive insulins, like Tresiba, could save more than $1,500 a year, per CIDSA. Yes, but: Language that would apply the $35 monthly cap on insulin to private insurance was stripped from the bill.     5. Scoop: Dr. B raises $8M for COVID telehealth Illustration: Gabriella Turrisi/Axios   Vaccine waiting list startup Dr. B raised $8 million as it pivots to the next phase of the pandemic: virtual COVID treatment distribution, CEO Cyrus Massoumi told Axios' Erin Brodwin. Why it matters: As COVID surges continue and public health agencies relax their safety guidelines, demand for antiviral medications such as Paxlovid is on the rise — but data suggests the drugs aren't getting to those who need them most. Massoumi, who also founded doctor-patient matching startup Zocdoc, plans to offer the antivirals free to those who can't afford them. "My greatest regret at Zocdoc is we never did enough to help the people who couldn't afford coverage," says Massoumi. "I always told myself with my next health care company I'd solve both parts of that equation — accessibility and equity." Read the rest in Axios Health Tech Pro.     A message from Axios For you, your team or your company     Contact our dedicated account team and learn how Axios Pro Corporate Subscriptions can help you achieve your business goals. Get in touch, and we'll build you the best plan for your organization. Contact us.   Why stop here? Let's go Pro. 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