No PPP for anti-vaxxers! Ten advocacy groups tell SBA to claw back $850,000 in PPP Funding to anti-vaxxers

For immediate release: February 5, 2021

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org(412) 945-3242 or Taun Sterling, tauns@nclnet.org(202) 207-2832

Washington, DC—Ten patient and consumer advocacy organizations are demanding that the Small Business Administration claw back nearly a million dollars worth of Paycheck Protection Program (PPP) monies granted to the leading American anti-vaccine groups.   

The advocacy organizations sent a joint letter to the U.S. Small Business Administration to express their collective concerns about the fact that, according to the Washington Post, five of the most virulent anti-vaccine organizationseach of which has spread misleading information about the coronaviruswere granted more than $850,000 in loans from the federal PPP. 

“Recipients of PPP loans include organizations that engage in conspiracy theories and lies about the safety and efficacy of vaccines generally and in this current environment, have spread misinformation about the COVID-19 vaccine,” stated the letter. 

Operation Warp Speed—the federal government’s program to develop, produce, and distribute enough COVID-19 vaccine doses to inoculate 300 million Americans in record time—has cost the American taxpayer roughly $12 billion so far, a number expected to grow more than two-fold at $26 billion. 

It is unfathomable and utterly counterproductive that taxpayer money was awarded to anti-vaccine groups during this national public health crisis,” the groups wrote. They called upon the Small Business Administration and the Biden Administration to investigate and rescind the loans made to the following anti-vaccination groups:   

Mercola.Com Health Resources ($335,000) 

Mercola.Com Health Resources received an astonishing $335,000 to maintain its operations during the pandemic. In December 2019, Mercola’s founder, Joseph Mercola, authored an article falsely stating that COVID-19 vaccines released via emergency authorization may cause massive side effects. In 2019, Mr. Mercola funded pervasive anti-vaccine efforts while the nation was grappling with widespread spikes of measles cases.  

Informed Consent Action Network ($166,000) 

The Informed Consent Action Network (ICAN), founded by anti-vaccine activist Del Bigtree received approximately $166,000 in PPP funding. Bigtree has attracted more than 43,000 followers via ICAN, and regularly posts about his skepticism regarding the COVID-19 vaccine, actively downplaying the severity of the pandemic. In a December 2020 interview, Bigtree falsely stated that the COVID-19 vaccines would lead to “vaccine-enhanced diseases” and could cause infertility in women, arguing that the antibodies could potentially attack a woman’s placenta, rather than the spike protein as intended. “If it starts attacking placentas, no one will be able to get pregnant. These are legitimate theoretical issues.” 

National Vaccine Information Center (Less than $150,000) 

Robert F. Kennedy, Jr., head of the National Vaccine Information Center (NVIC), took to social media in December of 2020 to call into question the safety of the COVID-19 vaccines: “We clearly have a systematic problem when government health regulators have utterly abdicated their responsibility to safeguard public health and refer safety concerns about shoddily tested, zero-liability vaccines to pharmaceutical companies.” Kennedy’s claims regarding the safety of the COVID-19 vaccines have not been validated and are irresponsible. 

Children’s Health Defense (Less than $150,000) 

NVIC’s Kennedy also founded Children’s Health Defense. His group’s misinformation campaign has contributed to widespread vaccine hesitancy around the country—primarily via social media, stirring up unfounded concerns among the population. 

Tenpenny Integrative Medical Center ($72,000) 

Tenpenny Integrative Medical Center, spearheaded by physician, Sherri Tenpenny, was awarded $72,000 in PPP loans. Tenpenny is the author of a book titled “Saying No to Vaccines: A Resource Guide for All Ages.” Additionally,  Tenpenny’s online forums promote alternative health in lieu of immunization and argue against vaccinations across an individual’s lifespan. One of Tenpenny’s pages was banned from Facebook in December for spreading misinformation. 

In the joint letter to the SBA, the advocacy organizations insist that taxpayer dollars be well spent on efforts to vaccinate 60-70 percent of Americans.

“Operation Warp Speed and other related efforts are the right investment. Funding groups with a long history of using junk science to question the safety and efficacy of vaccines is a colossal waste of taxpayer money. Any funds provided to groups that oppose the rollout of COVID-19 vaccines must be returned to the Treasury. PPP funding should not contribute to efforts aimed at undermining our national efforts to fight the SARS CoV 2 virus,” said the groups. 

The advocacy organizations signing the letter are listed below:  

Alliance for Aging Research
American Immunization Registry Association
American Medical Student Association
American Muslim Health Professionals
Families Fighting Flu
Idaho Immunization Coalition
Kimberly Coffey Foundation
Meningitis B Action Project
National Consumers League
Vaccinate Your Family 

Read the letter here.

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About the National Consumers League (NCL)
The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Mask up! New Executive Order mandating mask-wearing a welcome development

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

On January 20, just hours following a historic inauguration, President Biden signed an Executive Order (EO) requiring mask-wearing on federal property and inside airports, planes, trains, ships, and intercity buses. Effective immediately, refusing to wear a mask in these locations will now be considered a federal offense. The President also called on governors and local health officials to encourage mask-wearing and social distancing. This comes as especially good news for airlines and their employees, as they now have a federal rule protecting them from passengers who refuse to wear masks inflight, in turn ensuring everyone’s safety.

The EO is the latest of many efforts to halt the spread of COVID-19 by influencing behavior around this necessary public health measure. The mandate to require mask-wearing is also poised to complement President Biden’s call to action for the American public to commit to 100 days of mask-wearing, during the early days of his presidency. Epidemiologists agree that concerted efforts towards pandemic-related precautions can significantly reduce COVID-19 cases in the country, providing much-needed relief for health care facilities currently operating beyond maximum capacity.

Over the course of the pandemic, mask-wearing has unfortunately morphed into a highly polarizing political issue. More than 405,000 Americans have perished in the last year, and irresponsible behavior, such as a stubbornness towards wearing masks, will only further exacerbate the crisis. There are many contributing factors behind this phenomenon, but a lot of it distills down to misinformation and propaganda.

The bottom line is that masks save lives and are powerful tools in preventing the spread of COVID-19. They should be worn to protect the wearer, as well as those they come into contact with. The EO mandating the use of masks is a great step in encouraging civic responsibility in containing the virus. As we forge ahead in our persistence against the coronavirus, consumers are encouraged to maintain adherence to federal health guidance pertaining to physical distancing, the usage of masks, and other public health measures.

COVID vaccine: Credit where credit is due

By Sally Greenberg, NCL Executive Director

It’s almost a miracle. We now have safe and effective vaccines to fight SARS CoV2, commonly known as COVID-19, the devastating illness that has swept across the globe and—as of January 16, 2021—has killed more than 390,938 Americans and infected 23.5 million in less than a year.

Nearly 40 percent of those who’ve died were beloved older Americans in long-term care facilities, where the disease spread like wildfire, and who were often unable to say goodbye to loved ones.

Sadly, many who contracted the illness and survived spent lengthy hospital stays clinging to life on respirators. Of those who recovered, millions report COVID’s debilitating long-term effects. The United States has four percent of the world’s population but nearly a fifth of its recorded coronavirus deaths—the most of any country. Think of this: we have lost in less than one year eight times the number of Americans who died in the whole Vietnam war, and nine times the number who die in car accidents each year.

But now there’s light at the end of the tunnel because, in record time, America’s pharmaceutical companies have successfully developed safe and highly effective vaccines. Since the SARS CoV 2’s grip over America in late March of 2020, all medical experts could talk about—beyond washing hands, wearing masks, and social distancing—was getting a vaccine to prevent this illness. But vaccines typically take many years to develop so, we were told, don’t hold your breath. And yet here we are.

Consumer groups and members of Congress have been known to criticize the pharmaceutical industry. I get it; too many drugs are expensive and out of reach for millions of Americans, and that must be addressed. But it’s also important to acknowledge value of the public private partnership and the vast resources these companies have put into the R&D and bringing to market life-saving vaccines.

The COVID-19 pandemic is a prime example. The leading vaccines developed for COVID-19 are here, thanks to the dedication of industry leaders and scientists. Pfizer CEO Albert Bourla shifted the company’s focus to singlemindedly developing a COVID vaccine, leveraging its substantial scientific and medical expertise, as well as 20 years of research on previous SARS-like illnesses. Pfizer committed hundreds of millions of dollars of its own resources to building a manufacturing network, and companies agreed to share their knowhow. These efforts were critical in achieving an effective and safe vaccine in record time. And in creating a distribution system that could maintain the very cold temperatures needed to preserve, especially the Pfizer vaccine, before it is administered.

Our government doesn’t have the resources to make that happen alone. Yes, something close to $10 billion in taxpayer dollars through Operation Warp Speed went to companies to assist with the rapid development of a vaccine, but Pfizer didn’t accept government funding for the initial development of the vaccine (though the company did receive $1.95 billion for manufacturing and nationwide distribution of 100 million doses).

And now we have Moderna, which also received more than $1 billion in funding, joining Pfizer in making available a two-dose vaccine that is safe and 95 percent effective, with Johnson & Johnson, Merck, and Novavax not far behind with vaccines that may only require one dose. The public-private partnership model works. And consumers won’t have to pay to receive these shots. Experts tell us we should have five vaccines available by March or April, which is important because it gives healthcare providers options for different populations.

The next challenge is getting it into the arms of enough of us so that we can reach herd immunity, which means at least 60-70 percent of the population needs to be vaccinated.

And while this process has been disappointingly slow, this is largely because states haven’t been given adequate resources from the federal government to support a massive vaccination program. That said, more than a million Americans and counting have now been vaccinated and, under the incoming Biden-Harris Administration and a Democratic Congress, vast additional resources will be going to support for states and localities. The good news for vaccines is that there is high demand for the shots. My own Washington, DC community has offered thousands of appointments for shots online in the morning and they are taken immediately.

We have many to thank for this vaccine’s rapid development, but we must acknowledge the success of this uniquely American public-private partnership. We applaud the heroic work of Pfizer, Moderna, and the other companies to speed R&D and clinical trials of thousands of patients, to ensure a vaccine that is safe and effective. And kudos also to the trusted scientists at FDA and CDC for reviewing the data, ensuring the safety and efficacy of the vaccines, and approving them.

A special thanks is due to two esteemed FDA directors: former director Dr. Scott Gottlieb and our current FDA head Dr. Stephen Hahn, who gave us the straight scoop this past year and promised and delivered on FDA’s integrity and reliance on science throughout the process. And of course, we owe a deep debt of gratitude to our national hero, Dr. Anthony Fauci, who provided honest, science-based advice to the American people throughout these tense and trying times, despite pressure from the Trump Administration to play down the pandemic. Americans clearly agree, as evidenced by “Thank You, Dr. Fauci” signs on lawns across America!

Ensuring completion of series for the COVID-19 vaccine

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

After 10 dark months and over 350,000 lives lost, there is finally light at the end of the tunnel in the fight against COVID-19. Developing a vaccine for COVID-19 in such a short timeframe was made possible by dedicated efforts on the part of scientists, public health experts, and private and public partnerships. It is truly a triumphant medical achievement.

Now health care providers face another summit to scale—ensuring compliance for the vaccine to encourage efficacy and herd immunity. The leading vaccines for COVID-19, Pfizer BioNTech, and Moderna, will require two doses to ensure efficacy. Evidence has shown that when a vaccine involves multiple doses, nearly 50 percent of patients fail to return for a second dose. Clearly, aside from the distribution and administration, ensuring completion of series for the vaccine will be a critical logistical challenge.

It is estimated that 75 to 85 percent of the population will need to be vaccinated in order to reach herd immunity. That’s a lot of people. And if we account for the odds of those who will receive the vaccine and do not complete their series, we’ve got a long road ahead before the pandemic is behind us.

While both the Pfizer BioNTech and Moderna vaccines were found to be 95 percent effective, require two doses, and use similar mRNA vaccine technology, they differ in timelines. The Pfizer BioNTech vaccine requires two doses that are spaced three weeks apart, and Moderna’s vaccine requires two doses that are spaced four weeks apart. Coordinating efforts to ensure that patients get the correct vaccine in a timely manner, will be a massive undertaking.

There are multiple barriers to address in order to enhance vaccine compliance to end the pandemic. The vaccine is expected to induce flu-like symptoms and may deter some patients from getting their second dose if they aren’t warned about what to expect. Common side effects of the vaccine include headache, fever, chills, soreness at the site of delivery, and fatigue, but patients will need transparency about all potential side effects.

All patients who receive the COVID-19 vaccine will be given vaccine cards (see below). These cards will help track the type of vaccine administered, the dosage, date, and other information pertinent to providers and patients to ensure the completion of a series. Similar to contact tracing, massive follow up will be required via text messages, along with other interventions to remind patients of their upcoming second dose.

Source: CNN

The Food and Drug Administration (FDA) has issued a statement on the importance of properly adhering to FDA-issued vaccine guidelines. The vaccines have been issued with specified dosages and are scheduled at timed intervals. Individuals are instructed against reducing the number of doses (only taking one shot), extending the length of time between their booster vaccines, or changing guidance that is not rooted in evidence-based science, as it will directly impact the efficacy of the vaccine. Until new data is released by scientists and manufacturers of the COVID-19 vaccine regarding changes in dosage or schedules, FDA encourages continued adherence to its current issued guidance.

Vaccine hesitancy will surely further complicate matters. A study conducted by the Kaiser Family Foundation revealed that African Americans are increasingly skeptical of a COVID-19 vaccine. The findings allude to generational distrust of government and medical institutions by people of color, specifically, African Americans, where vaccine hesitancy has been influenced by lived experiences with discrimination and systemic racism. A successful vaccination plan will not only consider the herculean task of distribution and administration but should provide credible outreach within communities of color to foster confidence in the COVID-19 vaccine.

The National Consumers League continues to educate consumers on the importance of vaccine safety and compliance through our advocacy and engagement with the FDA. Our best line of defense against the pandemic is vaccine confidence and adherence. We encourage all who are able to get vaccinated for their own health and the health of their loved ones and community.

NCL testified before CDC committee on COVID-19 vaccine recommendations

For immediate release: December 22, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League (NCL) testified before the Centers for Disease Control and Disease Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) this weekend on the equitable distribution of the Moderna vaccine and recommendations for consumer education on vaccine safety. In its testimony, NCL applauds the transparency and access afforded to the public throughout the COVID-19 vaccine approval process.

Equitable distribution:

NCL is encouraged that the Food and Drug Administration (FDA) has approved the Moderna vaccine and that the U.S. government will lead distribution efforts. Due to its ease of transport and storage, the Moderna vaccine stands to readily ship to rural and hard to reach communities. NCL calls on federal health officials at the helm of distribution to facilitate access to the Moderna vaccine to medically underserved areas.

Safety and efficacy:

NCL expressed its trust in the FDA and CDC’s robust inter-agency collaboration to continue ongoing, post-market surveillance of adverse events among recipients of the COVID-19 vaccine and to inform consumers of any additional safety recommendations. NCL urged the CDC to educate consumers about potential reactions and side effects, as this transparency will further encourage the compliance necessary to achieve herd immunity. The vaccine is expected to induce flu-like symptoms after the initial dose and this may deter some patients from getting their second dose if they aren’t warned about what to anticipate.

Vaccine adherence:

NCL encouraged the CDC to conduct culturally competent and inclusive public messaging about vaccine safety to ensure that communities of color and persons with limited English proficiency are informed and feel empowered in their decisions to vaccinate. Adding to the complexity of administering the vaccine, public health officials will need to ensure the completion of two doses in a series. This stands to create additional challenges because evidence has shown that when a vaccine involves multiple doses, nearly 50 percent of patients fail to return for a second dose.

Equitable allocation:

NCL applauds ACIP’s recommendations to prioritize vaccinations for health care workers and long-term care facility residents in Phase 1a. Now that there are two approved vaccines, NCL calls on ACIP to prioritize recommendations to vaccinate the approximately 87 million non-healthcare essential workers unable to work from home—such as bus drivers and grocery workers—who are at higher risk of exposure. Racial and ethnic minorities make up more than 40 percent of the essential workforce and are the backbone of many essential industries. The pandemic has illustrated that low-income minority communities experience more severe COVID-related illness requiring hospitalization and are at higher risk for death.

Persons who recovered from COVID-19:

Lastly, over 18 million individuals in the U.S. have been infected with the coronavirus. It is expected that individuals who recover will acquire some natural immunity to COVID-19. Individuals who recover from the coronavirus want to know if they are protected from reinfection and for how long. We call on the CDC to expedite developing vaccine recommendations for persons who’ve recovered from COVID-19.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL statement on White House pressure to approve COVID-19 vaccine

For immediate release: December 11, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – In just a matter of days, we could potentially have an FDA-approved COVID-19 vaccine ready for rollout. Now more than ever, the public needs to see the evidence of a transparent and deliberate process to ensure the safety of a vaccine. NCL has actively participated in the vaccine approval process, testifying before the Centers for Disease Control and Prevention and the Food and Drug Administration’s (FDA) vaccine advisory committees to ensure that the nation’s most vulnerable consumers are considered at each step of the approval process. The race to a vaccine is a critical one, consumers should not be discouraged by the careful deliberation of the States’ vaccine approval process, but should instead be encouraged that the U.S. is following deliberate, well-established protocol to vet and review the data. 

NCL is amongst the stakeholder groups advocating for increased scrutiny of the data, particularly citing reports from the U.K. about adverse reactions to the Pfizer vaccine among people with severe allergies. We expect that the FDA will be aware of these concerns and call on the agency to perform ongoing post-market surveillance to ensure public safety. Consumers should rely on continuous guidance regarding potential adverse events, as this will be critical to ensuring vaccine confidence. 

NCL has continually recognized the integrity of the career-scientists at the FDA who are entrusted with ensuring the safety of the U.S. drug supply and applaud their demonstrated commitment to fostering public trust throughout the COVID-19 vaccine development, evaluation, and approval processWe have great confidence in the FDA’s rigorous approval methods and trust that the agency will issue an Emergency Use Authorization only after careful consideration of the available safety and efficacy data.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL testified before FDA committee meeting on Pfizer-BioNTech COVID-19 vaccine

For immediate release: December 11, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League (NCL) testified before the Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) this week regarding the Pfizer-BioNTech COVID-19 Vaccine.

“As the nation’s oldest consumer advocacy organization, NCL has been encouraged by the honesty, transparency, and access afforded to the public during this critical time.” NCL commended the Food and Drug Administration, Centers for Disease Control and Prevention, and other public health entities for their commitment to fostering public trust throughout the COVID-19 vaccine development and approval process and thanked the committee for the opportunity to speak.

In its testimony, NCL noted that there has never been a more critical time for consumers to have confidence in the FDA.

Emergency Use Authorization (EUA):

The FDA has undergone scrutiny from the scientific community for prematurely issuing EUAs for COVID-19 therapeutics. NCL is aware that developing a vaccine for COVID-19 is a time-sensitive priority and appreciates that the FDA recognizes that an EUA is not intended to replace long-term randomized clinical trials data associated with full FDA approval. We are encouraged by data reporting a consistent vaccine efficacy rate of 95 percent across age, gender, race, and ethnicity demographics and look forward to seeing more guidance around the vaccine, as the trial continues to collect safety and efficacy data.

Safety and Effectiveness:

NCL noted the public’s growing trust in the FDA’s rigorous vaccine approval process and called on the agency to perform ongoing post-market surveillance. Such surveillance performed in the United Kingdom found that the vaccine may be unsafe for individuals with severe allergies. Consumers will rely on ongoing guidance from public health agencies regarding any potential adverse events from the vaccine and expect that the FDA will be aware of these concerns.

Innovative Vaccine Delivery Systems:

Additionally, ensuring innovative vaccine delivery methods, such as including oral or nasal options, could address geographical access issues, diverse health needs, and increase uptake overall.

Diversity in Clinical Trials:

We applaud Pfizer’s efforts to ensure diversity in their COVID-19 vaccine clinical trials. NCL requests that the FDA continue to prioritize vaccine clinical trial data that reflects diversity, as people of color will need to have confidence in the vaccine’s efficacy. This will affect the overall uptake of the vaccine.

The development of a COVID-19 vaccine in such a short time frame is a huge scientific feat, made possible through robust collaboration between private and public entities. NCL will continue to support the FDA and CDC in efforts to release a COVID-19 vaccine safely and expeditiously.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Throwing COVID-19-related cautions to the wind

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

Over the past nine months, we’ve lived in a state of hypervigilance. The meticulous precautions we’ve observed throughout the pandemic have taken a toll on us. At worse, we’ve lost a loved one, friend, or coworker to this incessant virus. At best, we’ve been forced to recalibrate our routines and our lives. This collective weariness, to which experts have coined “COVID-19 Caution Fatigue is a prevailing factor in the current spike in cases.

When we are subjected to high levels of stress (e.g., high alert related to COVID-19), it can activate the stress hormone, cortisol. High levels of this hormone can cause us to become desensitized to the stimuli that triggered the stress hormone in the first place. Meaning, we start to ease up on our vigilance because the threat feels less real. These factors compounded—by feelings of isolation due to limited social contact‑—may have caused us to lose the motivation to maintain safe practices.

We see evidence of this as people are increasingly dining indoors, gathering for weddings, going to rallies, and are boarding flights nationwide. These behaviors are considered responsible for “superspreader events,” where COVID positive people expose multiple others. On average, every person with COVID-19 can potentially transmit the virus to two to three additional people. This has a multiplier effect with people spreading it, in turn, to another two to three people, and, well, you get the picture.

Dr. Fauci has warned that large gatherings during the holiday season could lead to “a surge superimposed upon that surge that we’re already in.” The pandemic demands personal sacrifices—which in turn leads to COVID induced malaise. I’ve personally RSVP’d “No” to a couple of family weddings—because the health and safety of my family matters more than joining them for a round of the “Cha Cha Slide.”

We must listen to public health experts. As I write this, the United States has more than 14.2 million COVID-19 cases and 275,000 deaths. These sad statistics will increase throughout the holiday season. Here are some ways you can combat COVID-19 Caution Fatigue:

  • Build a new routine. Find new and safe ways to move, interact with people, and entertain.
  • Healthy behaviors: focus on nutrient dense food, get adequate sleep, and limit alcohol use.
  • Journal: reflect on all that you’ve endured this year. A lot of us have been pushed to grow, expand, and adjust in unexpected ways. Focus on how far you’ve come, how resilient you are, and keep pushing.
  • Limit sreen time: For those of us working from home, it’s become increasingly tricky to maintain a work-life balance. Try to log off at a set time every day and take a break from screens in general (phone, TV, computer) and find ways to decompress from your day.
  • Personal improvement: Use time that would’ve been spent socializing on cultivating a new hobby. Take a free online course to learn a new concept. I personally like Coursera. Or learn a new language through mobile apps like Duolingo.
  • Prioritize self-care. Practice guided meditations via mobile apps like Headspace, read, or even start virtual therapy to process your emotions, through services like Talkspace.

In recognition of the emotional toll of social distancing, the CDC has issued guidelines on how to cope during the holidays. There’s light at the end of the tunnel. Perhaps several COVID-19 vaccines will be available in the coming months. That said, we have a long way to go, as the demand for the vaccine will far exceed its supply for many months. Remain vigilant and continue to adhere to pandemic-related safety guidelines. Our collective efforts will keep us safe while the vaccines become available across many demographics. Let’s continue to keep ourselves, our loved ones, and our communities safe through care and precautions against COVID-19. Mask up, stay 6 feet apart, wash your hands frequently, and avoid large gatherings. Happy and safe holidays to all!

Jeanette Contreras portrait

Low-income essential workers lack adequate COVID-19 testing

By NCL Director of Health Policy Jeanette Contreras

As the United States enters the third wave of COVID-19, low-income and minority communities hit hardest by the virus continue to disproportionately lack access to testing. The pandemic is shining a spotlight on the underlying health disparities that have long persisted within these medically underserved communities. Racial and ethnic minorities experience more severe COVID-related illness requiring hospitalization and are at higher risk for death from COVID-19. This is due largely to the prevalence of chronic conditions such as diabetes, asthma, heart disease, and chronic obstructive pulmonary disease (COPD).

In addition, racial and ethnic minorities make up a significant portion of the low-wage essential workers on farms, in grocery stores and warehouses, and in truck shipping. The essential workforce is composed of  64 percent women and 41.2 percent people of color. This translates to a higher risk of exposure to the virus among minorities because their employment involves interacting with the general public or co-workers in an unsafe environment. According to an August 2020 report from the U.S. Department of Health and Human Services (HHS), Hispanic/Latino persons were the largest demographic living in counties identified as coronavirus hotspots (3.5 million persons), followed by Black/African American persons (2 million).

HHS released a comprehensive strategy to address the lack of access to COVID-19 testing in vulnerable communities, which included expanded testing at federally qualified health centers (FQHCs) and partnerships with retail pharmacies. However, the very social determinants of health that these communities face, such as lack of transportation, child care, and paid sick leave, create significant barriers to getting to a community health clinic or a drive-through testing site. Despite higher demand in minority communities, there are fewer testing sites available to them when compared to access in predominantly white, more affluent areas. Researchers of the COVID Tracking Project found that zip codes with white populations of 75 percent had significantly more testing sites per capita than zip codes that were 75 percent minority.

Though adequate testing is only one of the prongs in confronting the pandemic, followed by contact tracing and isolation, it provides critical data needed to provide resources in the communities hardest hit by this pandemic. The World Health Organization (WHO) recommends conducting around 10–30 tests per confirmed case as a general benchmark–less than 5 percent positivity rate suggests the pandemic is under control. The U.S. currently has a positivity rate of 6 percent, and many states are not testing at a rate needed to contain the spread. Further adding to the disproportionate burden, there is no federal guidance for routine testing of essential workers. To provide adequate testing in low-income and minority communities, we need to address the underlying social determinants of health that place them at greater risk.

Equitable allocation of a COVID-19 vaccine

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

As the world waits with bated breath for the release of a safe and effective COVID-19 vaccine, one concern that is paramount is the proper distribution of the vaccine. According to leaders of Operation Warp Speed (OWS)—a coordinated partnership between the Department of Health and Human Services (HHS) and the Department of Defense (DoD)—detailed planning is ongoing to realize OWS’s lofty goal of delivering 300 million doses of a COVID-19 vaccine, with the initial doses available by January 2021.

Implementing a vaccine program of this magnitude is contingent upon precise coordination that traverses federal, state, local, tribal, and territorial governments. The prodigious task ahead is determining who would get the first initial doses of the vaccine upon release. The pandemic has further illustrated that communities most vulnerable to COVID-19 are often rife with systemic racism and socioeconomic factors conducive to higher infection rates. An initial limited supply of a vaccine will only intensify these inequities.

Multiple analyses conducted on the federal, state, and local levels confirm that people of color have experienced a disproportionate burden of COVID-19 cases and deaths. Hispanic or Latinx, and American Indian and Alaskan Native (AI/AN) communities have experienced three times the rate of infection, and Black communities two times the rate of infection, compared to White populations. The CDC warns that this imbalance in morbidity and mortality is begotten by deep-seated disparities that stem from generations of racism and unaddressed social determinants of health.

To mitigate these inequities, the National Academies of Science, Engineering, and Medicine (NASEM) have formed a committee to establish an overarching framework addressing key considerations for the equitable allocation of a COVID-19 vaccine, including at-risk communities, priority populations, geographic distribution, scalable measures, and vaccine hesitancy.

The framework proposes four phases of vaccine distribution and their corresponding priority populations, as follows:

[Source: NASEM]

The above proposal will inform CDC’s Advisory Committee on Immunization Practices’ (ACIP) recommendations in advance of a COVID-19 vaccine release; and it was developed through careful consideration of CDC’s Social Vulnerability Index (CDC SVI), and the apropos, COVID-19 Community Vulnerability Index (CCVI). To elucidate, these phases were designed with people of color in mind, as they experience heightened risk of exposure working in essential roles in society, and therefore succumb to higher rates of infection.

Another key component of the vaccine plan is addressing vaccine hesitancy. People of Color are significantly underrepresented in clinical trials and undertreated in medical settings. This phenomenon, compounded by a general mistrust of medical establishments by minorities, will prove to be a challenge when encouraging vaccine uptake. Community engagement will be essential in building trust among the vaccine hesitant and messaging should be delivered by community leaders, or healthcare providers that resemble the population they treat. Culturally competent care has proven to have favorable effects on health outcomes and it is critical in encouraging vaccine confidence.

Once a vaccine becomes available, health officials across the country will need to deploy resources and personnel to ensure access to the vaccine among our most vulnerable. As affirmed by U.S. Army Lt. Gen. Paul Ostrowski (OWS), “We have to be able to go beyond the pharmacies, the hospitals and so forth to get after nursing homes; to get after meatpacking facilities; to get after those that are sheltered [at home]. We have to get this out to all four corners of this nation.” Getting to a vaccine is a challenge in itself, but once its released, it’s all hands-on deck.