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Docs Should Play Bigger Role in COVID Vaccination, Lawmakers Told

WASHINGTON — Vaccine hesitancy could be greatly reduced if people had a better chance to talk about COVID-19 vaccination with their primary care physician, public health specialists told the House Ways & Means Health Subcommittee.

Vaccine efficacy is complex, said Ashish Jha, MD, dean of the Brown University School of Public Health, in Providence, Rhode Island, at a hearing Friday. For example, many people don’t understand that the Johnson & Johnson vaccine, which received emergency use authorization from the FDA on Saturday, was tested in countries such as South Africa that had worrisome COVID variants in its population. That may account for its lower effectiveness compared with the Pfizer and Moderna vaccines, which weren’t tested under such conditions, he said.

And the J&J vaccine did really well where it was important, Jha pointed out — in preventing severe disease, hospitalization, and death.

“The number they report is not actually the number anybody cares about,” Jha said at Friday’s hearing on “The Path Forward on COVID-19 Immunizations,” referring to the vaccine’s 66% overall efficacy rate. “It would be ideal if people would sit down with their physician and have this conversation; the issues are complicated and just don’t fit on a headline.”

The issues surrounding the three available vaccines “are complicated and just don’t fit on a headline,” said Ashish Jha, MD, dean of the Brown University School of Public Health. (Photo courtesy Ways and Means Health Subcommittee livestream)

Ann Lewandowski, executive director of Wisconsin Immunization Neighborhood — a coalition of pharmacists, public health, associations, and healthcare providers focused on reducing vaccine hesitancy in the state — agreed that primary care practices were being underused in another area: providing vaccinations. “Right now, the issue is actually supply; primary care models are not receiving as much supply as they could. We’re underutilizing all of our providers,” she said. “We had requests for over 400,000 vaccines this week, and we only have 120,000 in our federal allocation.”

In addition to lack of supply, the country also is suffering from reliable data on vaccinations and other parts of the pandemic, Jha said. “The lack of reliable public health data has been a major reason why we’ve been consistently slow to respond to changes in the pandemic; it took us month to figure out it was disproportionately impacting people of color,” he said.

“Around vaccines, this shows up pretty consistently day to day. Providers who are providing vaccines don’t always report the data as reliably as they’re supposed to. The key pieces of information, like which vaccine was it, when is the person supposed to come back; that information isn’t always conveyed,” he said. “This is no way to fight a pandemic, when you’re consistently blind, lacking information.”

Witnesses at the hearing also talked about what worked in their states. Clay Marsh, the West Virginia COVID-19 czar and vice president and executive dean for health sciences at West Virginia University, explained that his state realized that the average age of West Virginians who died of COVID-19 was 77, and that half of the deaths came from the state’s nursing home residents, so officials there decided to focus their efforts on the nursing home population, getting 85% of nursing home residents vaccinated with their first shot by the end of December and second shots by the end of January 2021. They also focused on vaccinating essential workers over age 50 and anyone 65 or older.

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West Virginia has focused on vaccinating its older residents first, explained Clay Marsh, MD, the state’s COVID-19 czar. (Photo courtesy Ways and Means Health Subcommittee livestream)

The result? In the first 7 weeks of 2021, “we’ve seen a 85% reduction week-to-week in mortality, a 73% reduction in hospitalizations, and fewer ICU patients and ventilated patients than we’ve seen since November,” he said. “We also control vaccines very carefully and expect vaccines to be used completely at the end of each week.” The state also famously decided against using the federal pharmacy partnership that had contracted with chain pharmacies, instead working with a network of local, independent pharmacies to get the vaccinations done.

However, West Virginia’s approach wasn’t the only successful one, Jha said, noting that Connecticut and New Mexico, which each took different approaches, also have done a great job. For example, Connecticut did use the federal pharmacy partnership for long term care facilities, but was aggressive about making sure they solved any problems that arose, he said.

Rep. Earl Blumenauer (D-Ore.) asked about ideas for communicating the differences between the three available vaccines “so it doesn’t raise more questions. Some people are a little leery; I’m hearing this at home from people I don’t think should be quite this apprehensive.”

“People make decisions about multiple products all the time,” responded Georges Benjamin, MD, executive director of the American Public Health Association. “We have to tell people to take what’s available to them.” He added that, in communities where people may have difficulty taking time from work, the availability of a single-dose vaccine that prevents severe illness is an important selling point.

Rep. Brad Wenstrup, DPM (R-Ohio), urged everyone to appreciate what has gone right with the vaccines, not just what has gone wrong.

“What was also unique about this was that when a drug [sic] got to phase III, we were producing 100 million doses” without waiting for its approval. “That has never happened before,” he said. “We’re so far ahead of the game and we should take a moment to celebrate that, even though we have troubles.”

Last Updated March 01, 2021

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    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow

Source: MedicalNewsToday.com