From the Delta variant front, AHIP informs us that
Today, the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) convened its final day of a scheduled meeting to discuss and vote on recommendations for booster doses of the Moderna and Janssen (Johnson & Johnson) COVID-19 vaccines, and to review data from the National Institutes of Health on mix-and-match booster doses.
The Committee unanimously voted (15-0) to approve the use of a single COVID-19 vaccine booster dose as follows:
1. Single booster dose of Moderna COVID-19 vaccine to be administered at least 6 months after completion of the primary series for individuals:
2. Single booster dose of the Janssen COVID-19 vaccine to be administered at least 2 months after completion of the primary regimen to individuals 18 years and older
3. Use of each of the available COVID-19 vaccines can be used as a heterologous (or “mix and match”) booster dose in eligible individuals following completion of primary vaccination with a different available COVID-19 vaccine
Data presented by Moderna showed a slow decline in neutralizing antibodies generated from the primary series over time. Data from Janssen showed lower overall vaccine effectiveness compared to those who received an mRNA vaccine, and that evidence is not sufficient to determine if vaccine effectiveness is waning.
ACIP evaluated the benefits and risks of a booster dose for both the Moderna mRNA vaccine and for the Janssen vaccine. The booster dose for the Moderna vaccine is half the dosage of the primary series shots, while those receiving a Janssen booster will receive the same dosage as the primary series. CDC recommends that people receiving a booster dose receive the same vaccine as the primary series unless unavailable or another product is preferred. Today’s vote created the pathway for heterologous booster doses for all vaccines, following FDA authorization yesterday.
The Committee also reviewed updates on the safety of all approved COVID-19 vaccines regarding incidences of myocarditis, pericarditis, and thrombocytopenia (TTS) and found no increased rates of these serious adverse events following additional booster doses of the vaccines. The data indicated that serious side effects for all vaccines are extremely rare. More research needs to be done on the safety of heterologous vaccine administration.
The final stop for these recommendations is the CDC Director Rochelle Walensky. The Wall Street Journal reports that Dr. Walensky approved the Committee’s recommendations this evening.
STAT News points out
When the [COVID] shots arrived late last year, the message from health officials was simple: Get vaccinated when you become eligible, and get whichever jab is offered to you. But with boosters becoming available for select groups of people, and a lower-dose shot for young children expected shortly, the campaign is moving from a simple set of instructions to more of a messy flow chart for people organizing and delivering the jabs. * * *
Sorting all this out will fall to pharmacies, immunization programs, pediatricians, and vaccine administrators, many already stretched thin, who will also have to track inventory and try to minimize waste. It will be a quick turnaround, as well: As soon as the CDC checks the final box for boosters with its recommendations, people will start demanding them.
Under ACA FAQ 50 issued October 4, 2021, health plans must immediately begin to cover administration of these boosters without member cost-sharing.
From the vaccine mandate front, Federal News Network reports that
A memo released by the Defense Department states that civilian [employees] will ultimately be fired from their jobs if they are not fully vaccinated. DoD wants all of its civilians to get the shot and go through the required waiting period for antibodies to flourish by Nov. 22.
DoD civilians who refuse to get the shot will go through “progressive enforcement actions,” the first of which is a five-day counseling and education period.
If an employee is still recalcitrant, they will be suspended without pay for less than 14 days. If the refusal continues, DoD will then terminate the employee for “failing to follow a direct order.”
The memo states that DoD will designate officials to handle the disciplinary process and “ensure consistent application of disciplinary measures.”
There are some exceptions to the rule. DoD will provide waivers to those who cannot get the vaccine due to medical conditions or for religious reasons. Further guidance will be available soon on the exceptions and DoD is currently not taking any action on exemption requests.
From the FEHB Open Season front, OPM made the following edit to its FEHB 2022 Significant Events chart:
| State | FEHB Carrier | Plan Name | TerminatingOptions (endof 2021) | TerminatingCodes (end of2021) | Automatic EnrollmentOption and Codes for2022 |
| Indiana | Humana Health Plan,Inc. | Humana Health Plan,Inc. | High | LouisvilleMetropolitan areaMH1, MH3, MH2 | StandardLouisville Metropolitanarea – MH4, MH6, MH5 |
| Indiana | Humana Health Plan of Ohio, Inc. | Humana Health Plan of Ohio, Inc | High | A61, A63, A62 | BasicW61,W63,W62 |
| Kentucky | Humana Health Plan of Ohio, Inc. | Humana Health Plan of Ohio, Inc. | High | A61, A63, A62 | Basic W61,W63,W62 |
From the federal employment benefits front, Reg Jones in Fedweek discusses death benefits available to surviving beneficiaries following a federal annuitant’s post-retirement death.
From the HLTH2.0 conference, Healthcare Dive provides more Amazon Health news and Fierce Healthcare discusses how to attract younger health plan members.
From the the Capitol Hill front, Healthcare IT News explains that why this may be the year that Congress finally restores funding for a HIPAA patient identification number. Fingers crossed.