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GOP Presidential Hopefuls Use Trump’s Covid Record to Court Vaccine Skeptics

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Darius Tahir and Daniel Chang
Wed, 29 Nov 2023 10:00:00 +0000

Former often seems proud to advertise his administration's record on speedily developing vaccines.

On the campaign trail to win another term in the White House, though, he also has knocked the use of those very vaccines. In October, for example, he unleashed a barrage of social media attacks on Ron DeSantis' pandemic record by reposting claims that the Florida governor — who is running against him in the Republican presidential primaries — was too active in vaccinating Sunshine residents.

In a further twist, Trump simultaneously circulated an MSNBC article suggesting DeSantis wasn't vaccinating his constituents enough.

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Trump's tap dance — touting Operation Warp Speed's success at developing vaccines while criticizing vaccine use — is emblematic of how pandemic politics are intensifying broader vaccine politics. Republican presidential candidates currently trailing the former president in polls are contorting their messaging to court the party's vaccine-skeptical voters. No one embraces, without qualification, the utility of a public measure that has saved millions of lives.

Like Trump, even the more establishment candidates can't seem to avoid embracing the anti-vaccine leanings of the party's base. Take Nikki Haley, who formerly served as governor of South Carolina and ambassador to the United Nations and has been rising in the polls. In the waning days of the Trump administration, she was pro-vaccine. But by the end of November 2021, in an interview with the Christian Broadcasting Network, she repeated dubious anti-vaccine claims: for instance, that the vaccine could undermine a woman's fertility. (Studies consistently show no effect.)

The GOP has gained the allegiance of “a minority of people who feel very strongly about the safety of vaccines,” Robert Blendon, a Harvard professor of public health, told KFF Health . Presidential candidates are trying to use this sensibility as “a cultural issue” to signal distrust in scientists, other experts, and authority in general, he said.

The resulting dynamic carries the risk of reaching beyond the current election cycle to affect public health policy in years to , leading to lower rates among schoolchildren and seniors of vaccinations that protect them from measles, shingles, and HPV. Even as candidates try to weaponize this rhetoric, they've had little luck in changing the former president's front-runner status.

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A recent KFF survey of adults about their plans to get vaccinated against the flu, respiratory syncytial virus, known as RSV, and covid found that partisanship remains a key predictor of how people view vaccines. Confidence in the safety of the updated covid vaccines split sharply along party lines, with more than 8 in 10 Democrats saying they trust the new shots, with 1 in 3 Republicans.

But unease about covid or the vaccines is not Republican primary voters' top issue — Blendon said concerns around the border, crime, and inflation are — and it's not clear vaccine-focused attacks hurt Trump.

“I didn't like his response to covid,” says an Iowa business owner featured in a critical ad from a well-funded political action committee that questioned Trump's handling of the pandemic. “I thought he probably got led a little bit by the bureaucrats,” he says, hitting Trump on his bragging about the of the vaccine and contrasting Trump unfavorably with certain governors the man in the ad thought performed better against covid. (Images of DeSantis, otherwise unnamed, flash by.)

The result? The ad “produced a backlash” and, when audience-tested with focus groups, improved the former president's support, according to a memo summarizing the political action committee's attempts to dent the front-runner.

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Candidates nonetheless are trying to make hay, acknowledged Joe Grogan, who led the Domestic Policy Council during the Trump administration. But “I think people have a lot of other targets for ire about the pandemic.”

“Trump is not at the top of the list for Republican primary voters,” Grogan said. “He's not on Page 2. Or 3, or 4. It begins with the media, the public health bureaucracy, or Big Tech companies.”

Voters have strong, yet divided and sometimes inconsistent, opinions. Some, like Joshua Sharff, 48, of Chesapeake, Virginia, are opposed to the covid vaccines and to candidates who support the shots as safe and effective. Sharff himself as a conservative voter who intends to support the Republican nominee for president. Though he's vaccinated, he said, “If you're a governor or a president and you tell me that I have to take a vaccine that has not been tried, that has not been tested, and ignores the science, that's a problem for me. You're taking away my freedoms as an American citizen.”

These positions have led Sharff away from Trump — and toward DeSantis, who has promoted anti-vaccine and anti-public health positions in his quest for the nomination.

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Trump “pushed the vaccine very hard and recently came out, when he began to get pushback on it, that it was somebody else's fault,” Sharff said. “That's not true.”

Other Republican voters said the vaccine is not key to their vote.

“It will not sway my vote one way or another,” said Kimberly Hunt, 59, of Melville, Tennessee.

In chasing these voters, some candidates are distancing themselves from initial, pro-vaccine positions to embrace outspoken views against the shot. Vivek Ramaswamy, a biotech entrepreneur, started out as a vaccine cheerleader. But then he flipped, coming out against vaccine mandates and saying this summer that he regretted getting vaccinated. (His wife, a doctor, said she had no regrets.)

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The most vocal of all is DeSantis.

Appearing on the right-leaning “PBD Podcast” on Oct. 30, DeSantis attacked Trump and “the corrupt medical swamp in D.C.” for overselling a vaccine that, despite the initial federal guidance, could not prevent infection or transmission of covid. The Centers for Disease Control and Prevention recommends the vaccine for anyone 6 months and older to protect against serious illness.

Though he initially encouraged people to get vaccinated in early 2021, DeSantis pivoted months later, banning vaccine passports for businesses and government entities, and later approving legislation prohibiting vaccine mandates in the state. That fall, he also appointed a new Florida surgeon general, physician Joseph Ladapo, whose guidance on covid vaccines contradicts CDC recommendations. DeSantis formed a Public Health Integrity Committee to assess, and generally dispute, federal health recommendations.

When the CDC released new vaccine guidance in September, Florida responded with its own advisory casting doubt on the safety of the boosters.

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This anti-vaccine positioning hasn't helped DeSantis. He has been losing support nationally and is generally polling third behind Haley and Trump in New Hampshire, a key early primary state. He headlined a “medical freedom” town hall in Manchester on Nov. 1 with Ladapo as a special guest.

Among the candidates remaining, DeSantis may be the most famous convert to the politics of anti-vaccination, but, with this subject, Haley has more experience.

In the 2021 CBN interview, she said “mandates are not what America does.” But the forceful declaration is merely the end of an ambivalent record, and, for critics, demonstrates her willingness to get in sync with the demands of the GOP base. As a state legislator, she supported 2007 legislation that included a mandate for HPV vaccines before voting against it; and later, as governor, she vetoed an effort to promote those vaccinations.

Bakari Sellers — now a commentator on CNN, but at the time a lawmaker who spearheaded that bill — told KFF Health News, “That's the biggest Nikki Haley issue that there is: She kind of has her finger in the air.”

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The issue of vaccines may affect the general election: Even as Trump defends his vaccine record, it's nevertheless clear he has support from the anti-vaccine crowd. An analysis by Politico, for example, found overlap among donors to independent presidential candidate Robert F. Kennedy Jr., who is staunchly opposed to vaccines, and Trump.

The willingness among politicians to assail what's traditionally looked on as a foundational achievement of public health is likely to lead to turbulence for doctors themselves. Allison Ferris, a primary care physician and an associate professor at Florida Atlantic University, said people should be listening to their doctors and not to presidential candidates about whether to take the new covid vaccines. But that message is hard to deliver in the current climate.

“It is a tricky position to be in,” said Ferris, who co-authored recently released guidance advising doctors to counsel patients that frequent covid vaccination will likely become a necessity.

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By: Darius Tahir and Daniel Chang
Title: GOP Presidential Hopefuls Use Trump's Covid Record to Court Vaccine Skeptics
Sourced From: kffhealthnews.org/news/article/trump-covid-vaccines-primary-opponents/
Published Date: Wed, 29 Nov 2023 10:00:00 +0000

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Kaiser Health News

Union With Labor Dispute of Its Own Threatens to Cut Off Workers’ Health Benefits

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Phil Galewitz, KFF Health
Fri, 26 Jul 2024 09:00:00 +0000

The National Education Association, the nation's largest union, is threatening to cut off health insurance to about 300 Washington, D.C.-based workers on Aug. 1 in an effort to end a bitter contract dispute.

It's a tactic some private employers have used as leverage against unionized workers that has drawn scrutiny from congressional Democrats and is prohibited for employers in California. Experts on labor law say they've never seen a union make the move against its own workers.

“This is like a man-bites-dog situation where the union is now in a position as the employer,” said Paul Clark, a professor of labor and employment relations at Penn State . “It's not a good look for a union.”

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NEA workers with pressing health needs are worried but say they won't fold. Joye Mercer Barksdale, a writer on the NEA's relations team, said she needs coverage for a medical procedure to address atrial fibrillation, a cardiac disorder. “This is insane for the NEA to use our health benefits as a bargaining chip,” she said.

But Barksdale said the threat isn't enough to force her to agree to an unacceptable contract. “I am not ready to give in,” she said.

The NEA Staff Organization, the union representing workers at the NEA's headquarters, launched a strike on July 5 in Philadelphia, during the union's annual delegate assembly. It was its second walkout this summer as the two parties negotiate a new contract, navigating sticking points such as wages and remote work.

In response, the NEA ended the conference early. was supposed to speak at the event but withdrew, refusing to cross the picket line. The NEA on July 24 endorsed Kamala Harris for president.

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On July 8, the day after the conference had been to end, the NEA locked out workers. In a letter the day before, the NEA informed its unionized workers that they would not be paid, effective immediately, and their health benefits would expire at the end of July unless a new deal were reached.

“NEA cannot allow NEASO to act again in a way that will bring such lasting harm to our members and our organization,” Kim Anderson, the NEA's executive director, wrote in the letter, obtained by KFF Health News. “We are, and have always been, committed both to our union values and to the importance of conducting ourselves as a model employer.”

Democrats in Congress, including Sens. Sherrod Brown of Ohio and Bob Casey of Pennsylvania, introduced legislation last year to protect striking workers from losing their health benefits, after several large companies, including General Motors, John Deere, RTX (formerly Raytheon Technologies), and the maker of Kellogg's cereals, threatened to or did cut off coverage during labor disputes.

“Workers shouldn't have to choose between their family's health and a fair contract,” Brown said in a statement to KFF Health News.

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The legislation was endorsed by large labor unions including the Service Employees International Union and United Steelworkers, according to a press release from Brown's office. The NEA wasn't among them.

“This tactic is immoral, and it should be illegal,” United Steelworkers' president at the time, Thomas Conway, said in the release.

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Officials at the NEA, which represents teachers and other administrators, declined an interview request. In a statement, the organization's president, Becky Pringle, said “we are making every effort to reach an agreement as quickly as possible” with its staff union.

“As union leaders who have been on strike, we recognize the significance and impact of these important decisions on a personal and family level. We truly value our employees and look forward to continued collaboration with NEASO to develop a new contract that benefits us all,” she said.

Kate Hilts, a digital strategist who works for the NEA, said she fears losing her coverage will leave her unable to afford treatment for a rare autoimmune disease that attacks her kidneys. Her next treatment was slated for August.

“I wake up every day and can't believe this is ,” she said. “You would expect this from an employer that is antiworker or has a terrible labor record, but I am totally flabbergasted that a labor union would do this that bills itself as pro-worker, pro-family, pro-education, and pro-.”

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The NEA staff union has filed multiple charges with the National Labor Relations Board this year, including allegations that the NEA withheld holiday overtime pay and failed to provide information on the outsourcing of millions of dollars in bargaining unit work.

California is one of the only states that protect striking workers from losing health coverage. The state passed a law in 2021 that blocks the tactic from being used against public employees and another law in 2022 that allows any striking workers who lose their insurance to immediately get heavily discounted coverage through the state's Affordable Care Act marketplace.

If they remain locked out, the NEA workers would be eligible for coverage under COBRA, a federal program that allows people who are fired or laid off to maintain their employer-sponsored insurance for 18 months.

But the coverage can be a financial hardship, as individuals often must pay the entire cost of their insurance premiums, plus a 2% administrative fee.

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Another option for workers would be coverage through the Affordable Care Act marketplace, though that also could be costly. And it may be unclear how soon that coverage would begin or whether insurers would cover their existing .

“I'm hoping the NEA will be so ashamed of what they are doing that, at the very least, they will not take away our health benefits,” Barksdale said.

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By: Phil Galewitz, KFF Health News
Title: Union With Labor Dispute of Its Own Threatens to Cut Off Workers' Health Benefits
Sourced From: kffhealthnews.org/news/article/nea-national-education-association-union-threatens-health-insurance-benefit-lockout/
Published Date: Fri, 26 Jul 2024 09:00:00 +0000

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The CDC’s Test for Bird Flu Works, but It Has Issues

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Arthur Allen and Amy Maxmen
Fri, 26 Jul 2024 09:00:00 +0000

The Centers for Disease Control and Prevention says a glitch in its bird flu test hasn't harmed the agency's outbreak response. But it has ignited scrutiny of its go-it-alone approach in testing for emerging pathogens.

The agency has quietly worked since April to resolve a nagging issue with the test it developed, even as the virus swept through dairy farms and chicken houses across the country and infected at least 13 farmworkers this year.

At a congressional hearing July 23, Rep. Brett Guthrie (R-Ky.) asked about the issue. “Boy, that rings of 2020,” he said, referring to when the nation was caught off guard by the pandemic, in part because of dysfunctional tests made by the CDC. Demetre Daskalakis, director of the CDC's National Center for Immunization and Respiratory Diseases, responded that the agency rapidly developed a workaround that makes its bird flu test reliable.

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“The tests are 100% usable,” he later told KFF Health , adding that the FDA studied the tests and came to the same conclusion. The imperfect tests, which have a faulty element that sometimes requires testing a sample again, will be replaced soon. He added, “We have made sure that we're offering a high-quality product.”

Still, some researchers were unnerved by the news coming four months after the declared a worrisome bird flu outbreak among cattle. The CDC's test is the only one available for clinical use. Some researchers say its flaws, though manageable, underscore the risk of relying on a single entity for testing.

The problem came to light in April as the agency prepared to distribute its test to about 100 public health labs around the country. CDC detected the issue through a quality control system put in place after the covid test catastrophe of 2020.

Daskalakis said the CDC's original test design was fine, but a flaw emerged when a company contracted by the agency manufactured the tests in bulk. In these tests, one of two components that recognize proteins called H5 in the H5N1 bird flu virus was unreliable, eliminating an important safeguard. By targeting the same protein twice, tests have a built-in backup in case one part fails.

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The agency developed a fix to ensure a reliable result: If only one of the two parts detected H5, the test was considered inconclusive and would be again. With the FDA's blessing, the CDC distributed the tests — with workaround instructions — to public health labs.

Wroblewski, director of infectious diseases at the Association of Public Health Laboratories, said the results of the tests have not been ambiguous, and there is no need to discard the tests.

Still, the agency has asked a different manufacturer to remake the faulty component so that 1.2 million improved tests will be available soon, Daskalakis said. Some of the updated tests are already in stock at the CDC, but the FDA hasn't yet signed off on their use. Daskalakis declined to name the manufacturers.

Meanwhile, the outbreak has grown. Farmworkers continue to lack information about the virus and gear to protect them from it. Rural clinics may miss cases if they don't catch a person's connection to a farm and notify health officials rather than their usual diagnostic testing laboratories.

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Those clinical labs remain unauthorized to test for the bird flu. Several of those labs have spent months working through analyses and red tape so that they can run the CDC's tests. As part of the licensing , the CDC alerted them to the workaround with the current test, too.

But outside select circles, the news was largely overlooked. “I'm totally surprised by this,” Alex Greninger, assistant director of the University of Washington Clinical Virology Laboratory, told KFF Health News this . Greninger's lab is developing its own test and has been to obtain CDC test kits to evaluate.

“It's not a red alarm,” he said, but he's worried that as the CDC and the FDA spend months developing and evaluating an updated test, the only one available relies on a single component. If the genetic code underlying that fragment of the H5 protein mutates, the test could give false results.

It's not uncommon for academic and commercial diagnostic labs to make mistakes and catch them during quality control checks, as the CDC did. Still, this isn't the agency's first mishap. In 2016, well before the covid debacle, CDC officials for months directed public health labs to use a Zika test that failed about a third of the time.

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The CDC caught and worked to remediate the situation far more quickly and effectively in this case. Nonetheless, the mishap raises concern. Michael Mina, chief science officer of the telemedicine company eMed.com, said diagnostic companies may be better suited to the task.

“It's a reminder that CDC is not a robust manufacturer of tests” and lacks the resources that industry can marshal for their production, Mina said. “We do not ask CDC to make vaccines and pharmaceuticals, and we do not ask the Pentagon to manufacture missiles.”

The CDC has licensed its updated test design to at least seven clinical diagnostic labs. Such labs are the foundation of testing in the U.S. But none have FDA clearance to use them.

Diagnostic labs are developing their own tests, too. But that has been slow-going. One reason is the lack of guaranteed sales. Another is regulatory uncertainty. Recent FDA guidance could make it harder for nongovernmental laboratories to issue new tests in the early phase of pandemics, said Susan Van Meter, president of the American Clinical Laboratory Association, in a July 1 letter to the FDA.

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Transparency is also critical, scientists said. Benjamin Pinsky, medical director of the clinical virology laboratory at Stanford University, said as a public agency the CDC should make its protocol — its recipe for making the test — easily accessible online.

The World Health Organization does so for its bird flu tests, and with that information in hand, Pinsky's lab has developed an H5 bird flu test suited to the strain circulating this year in the U.S. The lab published its approach this month but doesn't have FDA authorization for its broad use.

The CDC's test recipe is available in a published patent, Daskalakis said.

“We have made sure that tests are out there, and that they work,” he added.

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As the CDC came under fire at the July 23 congressional hearing, Daniel Jernigan, director of the CDC's National Center for Emerging and Zoonotic Infectious Diseases, noted that testing is just one tool. The agency needs money for another promising area — looking for the virus in wastewater. Its current program uses supplemental funds, he said: “It is not in the current budget and will go away without additional .”

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By: Arthur Allen and Amy Maxmen
Title: The CDC's Test for Bird Flu Works, but It Has Issues
Sourced From: kffhealthnews.org/news/article/bird-flu-test-cdc-flaws/
Published Date: Fri, 26 Jul 2024 09:00:00 +0000

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KFF Health News’ ‘What the Health?’: Harris in the Spotlight

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Thu, 25 Jul 2024 18:45:00 +0000

The Host

Julie Rovner
KFF News


@jrovner


Read Julie's stories.

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Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news , “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

As Vice President Kamala Harris appears poised to become the Democratic Party's presidential nominee, health policy in general and reproductive health issues in particular are likely to have a higher profile. Harris has long been the Biden administration's point person on rights and reproductive health and was active on other health issues while serving as California's .

Meanwhile, Congress is back for a brief session between presidential conventions, but efforts in the GOP-led House to pass the annual spending bills, due by Oct. 1, have run into the usual roadblocks over abortion-related issues.

This 's panelists are Julie Rovner of KFF Health News, Stephanie Armour of KFF Health News, Rachel Cohrs Zhang of Stat, and Alice Miranda Ollstein of Politico.

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Panelists

Stephanie Armour
KFF Health News


@StephArmour1


Read Stephanie's stories.

Rachel Cohrs Zhang
Stat News

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@rachelcohrs


Read Rachel's stories.

Alice Miranda Ollstein
Politico


@AliceOllstein

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Read Alice's stories.

Among the takeaways from this week's episode:

  • President Joe Biden's decision to drop out of the presidential race has turned attention to his likely successor on the Democratic ticket, Vice President Kamala Harris. At this late hour in the campaign, she is expected to adopt Biden's health policies, though many anticipate she'll take a firmer stance on restoring Roe v. Wade. And while abortion rights supporters are enthusiastic about Harris' candidacy, opponents are eager to frame her views as extreme.
  • As he transitions from incumbent candidate to outgoing president, Biden is working to frame his legacy, including on health policy. The president has expressed pride that his signature domestic achievement, the Inflation Reduction Act, took on the pharmaceutical industry, including by forcing the makers of the most expensive drugs into negotiations with Medicare. Yet, as with the Affordable Care Act's delayed implementation and results, most Americans have yet to see the IRA's potential effect on drug prices.
  • Lawmakers continue to be hung up on federal government spending, leaving appropriations work undone as they prepare to leave for summer recess. Fights over abortion are, once again, gumming up the works.
  • In abortion news, Iowa's six-week limit is to take effect next week, causing rippling problems of abortion access throughout the region. In , which added the two drugs used in medication abortions to its list of controlled substances, doctors are having difficulty using the pills for other indications. And doctors who oppose abortion are pushing higher-risk procedures, like cesarean sections, in lieu of pregnancy termination when the mother's life is in danger — as states with strict bans, like Texas and Louisiana, are reporting a rise in the use of surgeries, including hysterectomies, to end pregnancies.
  • The Government Accountability Office reports that many states incorrectly removed hundreds of thousands of eligible people from the rolls during the “unwinding” of the covid-19 public health emergency's coverage protections. The Biden administration has been reluctant to call out those states publicly in an attempt to keep the process as apolitical as possible.

Also this week, Rovner interviews Anthony Wright, the new executive director of the consumer health advocacy group Families USA. Wright spent the past two decades in California, working with, among others, now-Vice President Kamala Harris on various health issues.

Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too: 

Julie Rovner: NPR's “A Study Finds That Dogs Can Smell Your Stress — And Make Decisions Accordingly,” by Rachel Treisman.  

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Alice Miranda Ollstein: Stat's “A Pricey Gilead HIV Drug Could Be Made for Dramatically Less Than the Company Charges,” by Ed Silverman, and Politico's “Federal HIV Program Set To Wind Down,” by Alice Miranda Ollstein and David Lim. 

Stephanie Armour: Vox's “Free Medical School Won't Solve the Doctor Shortage,” by Dylan Scott.  

Rachel Cohrs Zhang: Stat's “How UnitedHealth Harnesses Its Physician Empire To Squeeze Profits out of Patients,” by Bob Herman, Tara Bannow, Casey Ross, and Lizzy Lawrence. 

Also mentioned on this week's podcast:

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Credits

Francis Ying
Audio producer

Emmarie Huetteman
Editor

To hear all our podcasts, click here.

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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Title: KFF Health News' ‘What the Health?': Harris in the
Sourced From: kffhealthnews.org/news/podcast/what-the-health-357-kamala-harris-campaign-health-policy-july-25-2024/
Published Date: Thu, 25 Jul 2024 18:45:00 +0000

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