Health

Pharmacies in most states can’t administer covid vaccines to babies and toddlers

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Good morning, where we forgot to tell you last week that it was Gonna be May. (And then realized that meme is a decade old……) Send news and more up-to-date memes to rachel.roubein@washpost.com.

Today’s edition: President Biden’s marks for handling the pandemic have increased since earlier this year. The Biden administration suspends Georgia’s Trump-era plan to leave Healthcare.gov. But first…

Pediatricians, not pharmacies, will largely be administering covid vaccines to the youngest kids

Cue the doctor: Physicians will play an even bigger role in the last phase of the country’s largest-ever vaccination campaign.

It’s been a difficult road to get coronavirus shots for children under 5, but a vaccine could become available next month. But unlike prior age groups, many children likely won’t be receiving their vaccines in pharmacies.

That’s partly because the majority of states prohibit pharmacists from vaccinating children under 3. Even in areas where it’s allowed, pharmacies are wrestling with whether to administer shots to the youngest kids. Some may decide not to, depending on the comfort level of their staff, corporate rules and whether they have the space for such a setup.

  • “It’s a lot to take on for pharmacies,” said Claire Hannan, the executive director of the Association of Immunization Managers. “We’re really focusing and targeting on the pediatrician.”

On Friday, the Food and Drug Administration laid out a tentative timeline for greenlighting vaccines for the country’s roughly 19 million children under the age of 5. The agency plans to agree meetings with its outside advisers on June 8, 21 and 22 to consider emergency use authorizations for pediatric coronavirus shots, and a top official pledged not to delay the rollout, our colleagues Laurie McGinley and Carolyn Y. Johnson report.

This comes amid muddled messaging and delays in finalizing a shot for young kids. Some health experts fear the confusion has led parents already on the fence to be even more wary of immunizing their child. Across party lines, pediatricians are the most trusted source of vaccine information for parents—relationships that could be key to overcoming vaccine hesitancy.

The Biden administration has heavily relied on pharmacies to disseminate coronavirus vaccines, including first — and even second — booster shots. But among those intimately involved in the vaccination campaign, there’s a recognition that rolling out shots for kids will be different.

During the pandemic, the Trump administration granted permission for pharmacists in every state to vaccinate children ages 3 and up.

For even younger kids … pharmacists in just roughly 23 states are allowed to administer coronavirus vaccines to children under 3 due to state scope of practice laws. Yet, some states may require a prescription before doing so or have other requirements, according to Allie Jo Shipman, the director of state policy, at the National Alliance of State Pharmacy Associations.

But still, some pharmacies may decide not to vaccinate children under 3. For one, it can take more time and is more complex to give shots to squirming or frightened young kids, not to mention vaccines for this age group are generally given in the thigh.

  • The decision whether to administer shots to babies and toddlers is “really going to be much more individualistic to not even just the pharmacy, but perhaps the pharmacist,” Shipman said.
  • The discussion between management and staff comes down to this: “What are we comfortable doing?” said Mitchel Rothholz, chief of governance and state affiliates at the American Pharmacists Association. But he said: “At a minimum, pharmacies are preparing themselves to be able to answer questions and refer individuals if they’re not going to do the vaccinations.”

Some corporate pharmacy chains may put in place their own plans. For instance: A Walgreen’s spokesperson told The Health 202 that its stores would administer vaccines to children 3 and older, but not to those younger due to immunization training requirements. CVS says it’s evaluating the best way to vaccinate children 5 and under across its pharmacies and clinics.

With the authorization looming, state health officials have been pushing to enroll more doctors’ offices to administer the shot. The initial strategy focused on approaching providers already participating in Vaccines For Children (VFC)a federally funded program providing immunizations to nearly half of all American children.

“The enrollment of them has gone pretty well, and then from there, a lot of states have really started to look at how they can expand beyond just the VFC providers,” said Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials. As a perk, some states have offered incentives or grants for other providers to sign up, he said.

The FDA’s newly announced timeline serves as a deadline, of sorts. Some parents are so eager for the shot that some providers say they’ve started keeping an internal list of who to call first. And doctors’ offices are beginning to map out the resources and personnel they’ll need once the vaccines are available.

  • “Giving us a lead time really helps us get our office staff ready for what’s to come,” said Sterling Ranson, who practices in Deltaville, Va., and serves as the president of American Academy of Family Physicians.

white house prescriptions

More Americans approve of Biden’s handling of the pandemic

President Biden’s marks for his handling of the pandemic have ticked up since right after the infectious omicron variant emerged earlier this year, according to a new Washington Post-ABC News chicken

Roughly 51% of Americans surveyed said they approved of Biden’s performance in this area, compared with 44% in late February. The approval level is now similar to where he stood in September, but lower than last June, The Post’s Dan Balz, Emily Guskin and Scott Clement report.

On abortion: Americans say they trust Democrats more than Republicans to deal with the issue, by 47% to 37 percent. This comes as the Supreme Court seems inclined to uphold Mississippi’s 15-week ban on the procedure, which would undermine Roe v. Wade‘s nearly half-century-old protections.

Overall, Biden’s standing with Americans has improved slightly over the past two months, but at 42 percent, the rating still poses a major challenge for Democrats as midterm campaign season is underway. And the elections are just over six months away.

Biden administration blocks Georgia’s plan to leave HealthCare.gov

The Biden administration is suspending Georgia’s plan to let the private sector handle enrollment in Obamacare coverage, a move that could potentially spell the end to the controversial Trump-era approval.

The plan from Gov. Brian Kemp (R) was slated to go into effect in 2023, but Biden’s Centers for Medicare and Medicaid Services began reviewing the state’s Obamacare waiver over the summer. On Friday, CMS told the state it was suspending the implementation of the plan unless Georgia proposes corrective actions by July 28.

At issue: Back in November 2020, the Trump administration approved Georgia’s plan to opt out of the federal website for Affordable Care Act plans. Instead, agents, brokers and other private entities would sell Obamacare plans alongside skimpier coverage options. Republicans argue the plan gives consumers more choices, but Democrats contend it would hurt access to affordable coverage in the state.

In suspending the waiver, CMS Administrator Petite Brooks-LaSure said the state’s plan would no longer provide coverage to a comparable number of residents, citing changes in federal law and other policies. Kemp’s office did not respond to a request for comment, but a spokesperson told the Atlanta-Journal Constitution that the governor was reviewing the Biden administration’s decision.

Conn. lawmakers pass bill to be ‘place of refuge’ for abortion patients

Connecticut is the latest Democratic-led state to pass legislation protecting abortion access. But the state’s plan is novel, essentially turning Connecticut into a safe haven for women who live in conservative states rapidly moving to restrict the procedure, our colleague Caroline Kitchener reports.

Late Friday, the state Senate gave final approval to the legislation, which Gov. Ned Lamont (D) you have pledged to sign. The bill would shield patients and abortion providers from some of the more controversial facets of new laws in GOP states. And experts anticipate it’ll become a model for other states hoping to protect abortion access.

Specifically, the legislation would …

  • Allow anyone in Connecticut sued under a Texas-style enforcement mechanism to countersue for damages, attorneys’ fees and other associated costs.
  • Shield people from out-of-state summonses or subpoenas in cases related to legal abortion procedures in Connecticut.
  • Prevent state authorities from complying with another state’s request to investigate or punish a person involved in facilitating a legal abortion in Connecticut.

Happy May, everyone. The Senate is in session this week, but the House is out again.

Here’s what we got on tap:

Monday through Wednesday: the Milken Institute Global Conference conventions in Los Angeles and will host speakers like former FDA commissioner Scott Gottlieb and Liz Fowler, the head of the CMS Innovation Center. Live stream it here.

Thursday: To Senate Commerce, Science and Transportation subcommittee hold a hearing on transparency in drug prices and for pharmacy benefit managers. The Washington Post Live holds a question-and-answer session on covid-19 with Emily Ostera professor of economics at Brown University, and Leana Wena research professor of health policy and management at George Washington University.

Virus mutations aren’t slowing down. New omicron subvariant proves it. (Joel Achenbach/The Washington Post)

The border wall Trump called unclimbable is taking a grim toll (Nick Miroff l The Washington Post)

Black doctors say they face discrimination based on race (Kate Brumback l The Associated Press)

Thanks for reading! See y’all tomorrow.

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