Vax mandate rules finalized as many children get their first shots

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THE CORONAVIRUS FILES

ByĀ Amber Dance

Well-vaccinated tribes face renewed surgeĀ 

Despite a vaccination rate well above the national average, the Navaho Nation and other tribes are experiencing a new wave of COVID-19 cases, report Alyssa Lukpat and Adeel Hassan atĀ The New York Times. The Navajo Department of Health recently reportedĀ 80 new cases, but no recent deaths. The Indian Health Service has also noted more cases in the Billings and Great Plains areas.

Tribal communities, despite their best efforts, have been affected by lower rates of vaccination or lack of masking in surrounding areas. Many tribal members are at risk of exposure in the border towns or urban areas they work in, and others have brought the virus back after visiting neighboring areas. ā€œWe do have multigenerational families living under one roof, and when someone brings COVID home, it spreads quickly in the house,ā€ Navajo Nation President Jonathan Nez told The Times.

Dr. Mary Owen, president of the Association of American Indian Physicians and member of the Tlingit tribe, has encouraged those not yet vaccinated ā€” includingĀ newly eligible childrenĀ ā€” to get their shots. Advocates have also blamed cases among American Indian and Alaska Native populations to a ā€œdata genocide,ā€ reports Jenna Kunze atĀ Native News Online. Sixteen states donā€™t report COVID statistics on Indigenous peoples separately, but just classify them as part of a catchall ā€œotherā€ category.

Pfizer offers another pill to reduce COVID severity

Pfizer announced on Friday that its experimental COVID-19 treatment slashed hospitalization rates by 89% in unvaccinated people at risk for severe disease. The antiviral, pill known as PF-07321332 or ā€˜332 for short, also seemed to prevent death in the 389 people who took it. None of those people died, while there were 7 deaths among 385 study participants who received a placebo medication. Studies are ongoing in low-risk and vaccinated patients, as well as to test if the medication can prevent infection in people who are probably going to be exposed to the coronavirus.

ā€œWith an oral antiviral, patients have more time and greater access to a treatment that will keep them out of the hospital,ā€ Nahid Bhadelia, director of the Center for Emerging Infectious Diseases Policy at Boston University, toldĀ STATā€™sĀ Matthew Herper. ā€œBut the promise of oral antivirals will only be recognized if theyā€™re available at your local pharmacy, and you can afford it, and you can get the test that tells you that youā€™re positive for COVID, so you can actually take advantage of this drug.ā€ While Pfizerā€™s chief scientific officer Mikael Dolsten expressed a desire to make the drug accessible worldwide, some experts who spoke with Herper expressed doubt that would happen.

Pfizerā€™s medication works on a viral protein, unlike Merckā€™s drug molnupiravir that interferes with viral genes. The early results from ā€˜332 also suggest higher efficacy than molnupiravirā€™s 50% reduction in hospitalization rates. Merckā€™s drug got its first authorization, for useĀ in the U.K., last week; an FDA committee is scheduled to review molnupiravir on Nov. 30.

Mandate deadlines loom as some workers resist

The Biden administration released new rules and guidelines on vaccines at work last week, extending mandates to approximately two-thirds of people employed in America, reports Shannon Firth atĀ MedPage Today. An official rule from the Occupational Safety and Health Administration requires companies with 100 or more employees to ensure employees are vaccinated by a Jan. 4 deadline, or that they test negative once a week. Employers are not required to pay for that testing, ā€œin a move that appears designed to push workers to choose vaccinations over testing,ā€ notes Andrea Hsu atĀ NPR. All workers at any clinics that receive Medicare or Medicaid funding must also be vaccinated by Jan. 4, with no testing option.

The administration also pushed back the deadline for federal employees and contractors to be vaccinated to Jan. 4, but new White House guidance gives the job of enforcement to individual contractors, note Spencer Kimball and Leslie Josephs atĀ CNBC.

Republican leaders haveĀ argued against the federal mandates, stating the regulations would damage the ā€œalready-too-tight labor market.ā€Ā The Biden administration tried to head off such criticism by pointing out that with more than 745,000 Americans dead ā€” andĀ 5 million deaths worldwideĀ ā€” workers are facing a ā€œgrave dangerā€ that OSHA must mitigate.Ā On Saturday, a federal appeals court in LouisianaĀ issued a temporary stayĀ on the rule pertaining to large employers, citing “grave statutory and constitutional issues.” The government has until 5 p.m. Monday to respond.

Some workers, too, areĀ pushing back against mandates, walking off the job or choosing unpaid leave over the vaccine. Among workers as a whole,Ā GallupĀ reports that 56% support a mandate but 37% are opposed.

The U.S. military and Department of Veterans Affairs mandated vaccination a couple of months ago, and officials toldĀ The New York Timesā€™Ā Jennifer Steinhauer itā€™s granted ā€œfewā€ requests for exemptions. Nearly all active-duty service members have had at least one dose. The Air Force, which had the earliest deadline of Nov. 1, has discharged a few dozen service members, mainly trainees, over vaccine refusal, reports Paul D. Shinkman atĀ US News & World Report. But the Biden administration, wary of losing too many service members, contractors and civilian staffers, will initiate an ā€œeducation processā€ for vaccine resisters rather than discharging them immediately, writes John M. Donnelly atĀ Roll Call.

Shots reach the smallest arms yet

With both the FDAā€™s andĀ CDCā€™s official blessing as of last week, children aged 5 through 11 can now receive the Pfizer COVID-19 vaccine. President Joe Biden called this ā€œaĀ turning pointĀ in our battle against COVID-19.ā€ More than 6 million children of all ages haveĀ tested positiveĀ for COVID-19, and more thanĀ 650 have died. Notably, children have been a big driverĀ in case rates in the U.K.Ā In the U.S., a computer simulation from theĀ COVID-19 Scenario Modeling HubĀ predicts a small drop in case rates, hospitalizations and deaths if children are vaccinated, but the effect of child vaccinations could be much greater if a new variant arises.

About one in three parents say theyĀ wonā€™t get their children vaccinated. But the vaccines for young children will likely boost vaccination rates among minority groups, particularly Hispanics, writes Mary Biekert atĀ Bloomberg. AnĀ August pollĀ suggested Hispanic parents were less likely than white families to say they definitely wouldnā€™t get older kids vaccinated ā€” but getting time off work to take their children for vaccination was a concern.

The new eligibility of elementary-age children raises the possibility of new vaccine mandates, writes Marisa Fernandez atĀ Axios. Only a handful of school districts have mandated vaccination for teens 12 and up, who were already eligible for vaccination. Bree Dusseault, principal at the Center on Reinventing Public Education, told Fernandez that mandates for the younger group would be challenging to impose, given parental hesitation, low risk of severe disease in kids, and the fact that many parents were against mask mandates. ā€œDistricts may feel that asking students to vaccinate crosses a line theyā€™re not willing to cross,ā€ Dusseault said. ā€œIt puts them at risk of potentially losing some of the students they serve.ā€

CDC says vaccines beat natural immunity

Do the tens of millions of Americans whoā€™ve had COVID need to be vaccinated? Republican lawmakers such as Rep. Diana Harshbarger of TennesseeĀ have suggested not, but a new CDC report says yes, write Lena H. Sun and Joel Achenbach atĀ The Washington Post. The CDC, after reviewing nearly 100 studies, concluded that natural immunity can be quite good, but it varies between individuals, and thereā€™s no reliable test to determine if a COVID-19 survivor is well-protected or not. Vaccines, on the other hand, produce much more consistent protection from future infection. However, The Post notes that some nations and experts consider a bout of COVID to be equivalent to a single shot. ā€œIf youā€™ve had it, get at least one dose of the vaccine,ā€ recommended Dr. David Rubin, director of the PolicyLab at Childrenā€™s Hospital of Philadelphia.

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