GOP debates a post-Roe world

Feb 23, 2022

With Megan Messerly, Alice Miranda Ollstein and Ben Leonard

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QUICK FIX

— With Roe v. Wade hanging in the balance, red states are taking different tactics to limit abortions … and not on the same page.

— Speaking of red states: The once hot-button issue of vaccine passports is evolving as governments find use for digital records.

— African officials say vaccination donations need to be paused because supply isn't the issue anymore; it's willing recipients.

WELCOME TO WEDNESDAY PULSE, Where I'm excited to catch "Augmented" on PBS tonight. Send show recommendations, news and tips to sowermohle@politico.com.

On Tap

RIGHT ARGUES OVER POST-ROE STRATEGY — Several red states are poised to pass 15-week abortion bans as soon as this week, mirroring a Mississippi law the Supreme Court could soon deem constitutional.

That's to say they aren't taking the Texas tack and banning all abortions after six weeks, Megan Messerly and Alice Miranda Ollstein write.

Advocates of the 15-week approach, which is advancing in Arizona, Florida and West Virginia, see it as politically and legally safer. Conservatives feel confident the Supreme Court will either eliminate or limit Roe v. Wade later this year and are concerned the Texas law could be undone by ongoing legal challenges.

Arizona state Sen. Nancy Barto on the Senate floor last week said that while she believes "every life should be protected," 15 weeks is a "common sense limit" and a "step in the right direction."

Everyone isn't on the same page, though. Some anti-abortion-rights advocates believe states should be going further.

"Some national and state groups believe we should proceed cautiously and strategically," said Kristi Hamrick, the spokesperson for Students for Life of America, which is pushing bills in dozens of states that mirror Texas', and outlaw the use of abortion pills early in pregnancy. "We respectfully disagree."

Meanwhile, abortion-rights advocates likely don't have the votes to stop 15-week bans from moving forward and are struggling to convince a distracted and exhausted public to mobilize against the policies.

VAX PASSPORT TECH TAKES OFF IN RED STATES — Many Republican-leaning states that had eschewed vaccine passports over fears that they would infringe on people's freedom are now turning to the technology behind them to allow their residents to travel and get digital immunization and health records, POLITICO's Ben Leonard reports.

The tech is gaining steam in at least five states — Arizona, Mississippi, South Carolina, Oklahoma and Utah — despite bans against "passports" or governor opposition, in the case of Mississippi.

These states aren't planning on requiring them for indoor dining or entertainment venues a'la New York City or Los Angeles, and they're not labeling them "passports," a now-politically charged term.

"We're starting to see some jurisdictions that had a very strict stance, 'We're not going to put any QR codes on anything,' look at this again with fresh eyes and say, 'Okay, this really isn't a passport. This is really just an evolution of a record moving into the digital age,'" said Rebecca Coyle, executive director of the American Immunization Registry Association.

PR moves: Many are rolling them out with little to no fanfare. Some states like Utah aren't heavily advertising the technology, with some officials deeming a marketing push politically unpalatable.

"They were hesitant because it looked like the state was pushing a vaccine passport," said Jon Reid, the manager of Utah's immunization information system.

On the other hand, South Carolina won't be shy about its digital credentials when they are expected to launch by the end of the March, said Stephen White, director of the immunization division at the state's health department, with plans to advertise on social media and via press release.

The shifting attitude in the once-hesitant states highlights the draw of digital records for states and the growing desire for patients to have access to their health information.

De facto standard: The Biden administration said last spring it would issue standards for vaccine credentials, but has not, leaving states to work in a patchwork manner on the technology. But the Vaccination Credential Initiative's SMART Health Cards have emerged as a de facto standard, with 20-plus states developing the technology or already launching it.

Around the World

AFRICA CDC WANTS VAX DONATIONS PAUSED — The Africa CDC will ask that all Covid-19 vaccine donations be paused until the third or fourth quarter of this year, the director of the agency told POLITICO's Daniel Payne.

Why? John Nkengasong, director of the Africa Centres for Disease Control and Prevention, said the primary challenge for vaccinating the continent is no longer supply shortages but logistics challenges and vaccine hesitancy — leading the agency and the African Vaccine Acquisition Trust to seek the delay.

"It makes sense to say, 'Look, let's pause and avoid the risk of sending so much that it gets expired, and then clear this and put our efforts in taking these ones up so we can now see how many people have actually been immunized — and then maybe now you can look at the next wave of donations,'" he said.

This marks a shift in the challenges Africa faces — from not having enough doses to not being able to quickly get those shots into arms.

"It's not to say that donations are not important," he said. "It's just to say let's not just do it at once."

Nkengasong said the available dose supply is no longer the main barrier to immunizing the continent. As the supply of doses has become more predictable, African leaders have been able to better plan distributions and make sense of how many they need for a certain period of time.

GLOBAL FUND ASKS FOR $18B ON NONCOVID BATTLES — The Global Fund to Fight AIDS, Tuberculosis and Malaria released its case for its upcoming funding cycle, saying it needs at least $18 billion to get back on track after the Covid-19 pandemic.

The Fund estimates that investment would save 20 million lives between 2024 and 2026, reducing HIV, TB and malaria deaths by 65 percent, Erin Banco and Daniel write. In that same timeline, the fund says 450 million infections could be avoided. For every dollar spent in these efforts, the Global Fund said, $31 in health and economic gains — like fewer infections and more productive economies — would be made.

Making up for lost progress : In 2020, for the first time in almost two decades, the Global Fund saw declining results in its efforts to stop HIV, TB and malaria.

"We've seen a huge impact from Covid on public health activities that require a high level of contact," Harley Feldbaum, head of strategy and policy at the Global Fund, told POLITICO. HIV and malaria treatments were better maintained than tuberculosis, though HIV prevention saw setbacks because of the pandemic, Feldbaum said.

Around the Agencies

STUDY: FDA'S SODIUM DELAY COST LIVES — The FDA's several-year delay finalizing voluntary sodium reduction goals for the food industry may have cost more than 250,000 lives, according to a new study in the journal Hypertension.

Unnecessary deaths: Using modeling, researchers projected that the FDA's new finalized sodium targets — which span two and a half years — could save up to 445,979 lives across a decade. The delay in finalizing the targets is projected to have led to as many as 266,644 unnecessary deaths, POLITICO's Helena Bottemiller Evich reports.

The backstory: The agency in October finalized short-term voluntary reduction targets, more than five years after first proposing both short- and long-term goals during the Obama administration. During the Trump administration, then-FDA Commissioner Scott Gottlieb surprised some by sticking to the Obama administration's push to limit salt.

But FDA hasn't laid out a timeline for finalizing long-term targets.

Names in the News

Robert Otto Valdez is the newest director of the Health and Human Services Department's Agency for Healthcare Research and Quality. Valdez comes to AHRQ from the University of New Mexico, where he was a family and community medicine professor. David Meyers , who was acting director since January 2021, will resume his role as deputy director.

It's official: Danielle Carnival is coordinator of the Cancer Moonshot initiative at the White House's Office of Science and Technology Policy. Carnival, a neuroscientist, most recently was senior adviser to the OSTP director, standing up the initiative, Daniel Lippman writes.

What We're Reading

A group of scientists calling themselves the "Urgency of Normal" are pressing to remove child mask mandates and return to an idea of normal — but arecherry picking and misinterpreting data to get there even as their members gain more public notice, Melody Schreiber writes for The New Republic.

The Washington Post editorial board questions how many people have died from Covid-19 due to misinformation and hesitancy, citing sobering CDC figures and polling.

Coronavirus vaccines are unlikely to trigger a rare inflammatory condition in children, according to data published Tuesday that could put parents at ease about a potential side effect of the virus, The Associated Press' Lindsey Tanner reports.

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