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An advisory panel to the Food and Drug Administration voted in favor of authorizing the Covid-19 vaccine made by Pfizer and BioNTech for children ages 5 to 11. After sometimes tense deliberations that weighed the benefits of vaccination against potential risks, the Vaccines and Related Biological Products Advisory Committee voted 17-to-0 with one abstention on Tuesday that two 10-microgram doses of the vaccine should be granted emergency use authorization, a clearance that will remain in effect only as long as the pandemic is considered a public health emergency. (Herper and Branswell, 10/26)

Despite the vote in favor, deciding whether the benefits of vaccination for young kids outweigh potential risks appeared to weigh heavily on the advisers. "This is a much tougher one, I think, than we had expected coming into it," said committee member Dr. Eric Rubin, editor-in-chief of the New England Journal of Medicine. "The data show that the vaccine works and it’s pretty safe ... we’re worried about a side effect that we can’t measure yet," he said, referring to a heart condition called myocarditis. (Miller, 10/26)

Children are far less likely than adults to be hospitalized with COVID-19 or suffer long-term consequences from the disease – putting a higher burden on the vaccine to prove safe and effective to justify its risk. The committee of vaccine experts and pediatricians said that although they are concerned about the unknowns, they felt the data is sufficient to support using Pfizer-BioNTech's vaccine in that age group because it is likely to benefit far more children than it will harm. (Weintraub and Weise, 10/26)

Pfizer Inc.’s lower-dose Covid-19 vaccine for kids under 12 appears to offer protection across the board, company officials said, and the drug giant may look into offering lower doses for teens who now get the adult dose. A scientific advisory panel to the Food and Drug Administration is deliberating Tuesday on whether to recommend the vaccine, which Pfizer makes with partner BioNTech SE, for 5- to 11-year-olds. If cleared by regulators, it would make a Covid-19 vaccine available to all school-age children for the first time. (Baumann, 10/26)

Children ages 5 to 11 may be eligible for the Pfizer-BioNTech Covid vaccine by early next month: two shots spaced three weeks apart. But unlike kids 12 and older, who get the same dosage as adults, the kids in the younger age group will receive 10 micrograms of vaccine per dose, or one-third the amount that a 12-year-old would get. This has created some confusion for parents of 11-year-olds on the cusp of turning 12. Is it best to hold out for the larger dose? Or is it better to get the smaller dose right away? Does the weight or height of the child make any difference? (Caron, 10/26)

A US Food and Drug Administration advisory committee recommended Tuesday that the agency grant emergency use authorization for the Pfizer-BioNTech Covid-19 vaccine for children ages 5 to 11. Next, the FDA decides whether to authorize the vaccine, and then the US Centers for Disease Control and Prevention's vaccine advisory committee will meet to consider whether it should be recommended for that age group. If CDC Director Dr. Rochelle Walensky signs off on that recommendation, younger children could be getting vaccinated next week. (Hetter, 10/27)

The imminent arrival of a COVID-19 vaccine for younger children promises to suppress the spread of the virus, making schools safer and offering a glimmer of hope for parents looking to restore some normalcy into their children’s lives. It remains to be seen, though, how many Georgia parents will get their children vaccinated, a decision they will make without requirements from their schools. While vaccination against diseases such as measles, mumps and rubella have been mandatory in public schools for years, the state has no immediate plans to add a COVID-19 vaccine to the list. (Tagami, 10/26)

A long-awaited moment for some Louisiana families may soon arrive: The authorization for a COVID-19 vaccine for children ages 5 to 11 is a step closer after an advisory committee to the Food & Drug Administration voted to recommend it for that age group on Tuesday. "We could be offering vaccine to children within one to two weeks," Dr. Joe Kanter, Louisiana's state health officer, said at a Tuesday press conference. "That's very, very exciting." Louisiana has ordered 148,000 initial doses for the 421,000 kids in that age group in the state, Kanter said. (Woodruff, 10/26)

The firing of Tennessee's former vaccination director caught the state's top health leaders off guard and sent them scrambling for answers as the health commissioner fumed over the praise coworkers heaped on the ousted employee, documents show. Earlier this year, Tennessee's Department of Health sparked national attention after Dr. Michelle “Shelley” Fiscus was fired under pressure from Republican legislators incensed over the department's efforts to get children vaccinated against COVID-19. Fiscus accused Health Commissioner Lisa Piercey of terminating her “to appease a handful of outraged and uninformed legislators.” (Kruesi and Mattise, 10/26)

The Centers for Disease Control and Prevention said in updated guidelines Tuesday that some immunocompromised people who have received either Pfizer or Moderna's COVID-19 vaccines will be able to get a fourth shot. People over 18 who are "moderately to severely immunocompromised" and have received three doses of an mRNA vaccine may get a fourth shot (of either the Pfizer, Moderna, or Johnson & Johnson vaccines) at least six months after getting their third Pfizer or Moderna dose, per the CDC. (Saric, 10/26)

A study from Johns Hopkins University this summer showed that vaccinated immunocompromised people were 485 times more likely to end up in the hospital or die from Covid-19 compared to most vaccinated people. In small studies, the CDC said, fully vaccinated immunocompromised people accounted for about 44% of the breakthrough cases that required hospitalization. People who are immunocompromised are also more likely to transmit the virus to people who had close contact with them. The US Food and Drug Administration has also authorized booster shots of all three available vaccines for certain people and that would include the immune compromised, the CDC says. (Christensen, 10/26)

The criteria for a booster shot can depend on your age, job, where you live and your underlying health. In most cases, you have to wait until six months after your first two shots. What's more, booster shots don't have to match the first vaccine you had. As you sort through the maze of information (ideally in coordination with your doctor), remember that even without a booster, the vaccines available in the U.S are very effective. (Stone, 10/26)

Scientists and federal health agencies debated COVID-19 boosters for weeks, and are now recommending them for all three approved vaccines, for some — but not all — Americans. Feeling a little lost in all the details about who is currently supposed to get a booster? Take our quiz to understand what's advised in your situation. (Huang, Hurt, Torchinsky and Wroth, 10/26)

The city of Detroit and its neighboring suburban health departments have begun giving Moderna and Johnson & Johnson COVID-19 booster shots. The city said it began offering the boosters Tuesday, in addition to Pfizer boosters, at all city-run vaccination sites, including 10 walk-in centers and home visits. Oakland County Health Division also began administering booster doses of Moderna and J&J vaccines at sites in Pontiac and Holly, with more clinics scheduled throughout the week in Rochester, Pontiac and Southfield. Pfizer booster doses also will be available. (Hall, 10/26)

More Pennsylvanians are showing up for coronavirus booster shots than are getting newly vaccinated, following a national trend in the first days that boosters of all three vaccines have been available to millions of Americans. Last week, more than 100,000 Pennsylvanians and 80,000 New Jerseyans got boosters, according to state data, including some who became eligible after the FDA and CDC endorsed Moderna and Johnson & Johnson boosters midweek. Vaccine providers and health officials across the Philadelphia region said they have seen modest increases in vaccinations since the approval and expected demand to rise further. (McCarthy and McDaniel, 10/27)

Being a parent is hard enough with difficult decisions to make each day. Now add a choice that could make a difference between life or death – even before the bundle of joy is born. Pregnant women must decide whether to take a COVID-19 vaccine, without knowing the long-term effects of the new inoculation, or risk catching the virus. However, one factor that may tip the scales toward taking the vaccine are recent studies, such as one from out of the University of Florida from late this summer. It strongly suggests the vaccine could protect not only the mother, but also nursing infants. (Brownstone, 10/26)

A guaranteed $25 cash card for both vaccine recipients and drivers of vaccine recipients lessened slowing COVID-19 vaccine uptake at participating sites in North Carolina, according to a research letter in JAMA Internal Medicine yesterday. This contrasts with a JAMA study in July that showed no increased vaccine uptake from Ohio's million-dollar lottery. (10/26)

New coronavirus infections are down 56.8% nationwide since the delta variant surge peaked in the first week of September, a USA TODAY analysis of Johns Hopkins University data shows. Cases are down in every region – the South, Mid-Atlantic, most of New England, the Midwest, the West. Some of the states hit hardest in the delta wave – Florida, Georgia, Hawaii, South Carolina and Tennessee – are reporting cases at a rate about one-sixth of where they were less than two months ago. Arkansas and Louisiana cases have fallen by more than three-quarters since then, too. (Bacon, Schnell and Ortiz, 10/26)

New coronavirus infections in the United States have dropped nearly 60 percent since a September spike brought on by the more contagious delta variant, according to data compiled by The Washington Post. The seven-day average of infections stood at about 69,000 this week, figures show, reflecting a 58 percent drop from the latest surge’s peak around Sept. 13, when the average for that week was 164,475. (Jeong and Suliman, 10/27)

Hospital admissions are declining sharply among U.S. children with Covid-19, even more than adults, quieting concerns for now that the return to school could trigger a major uptick in viral transmission. Daily pediatric admissions with confirmed Covid have fallen 56% since the end of August to an average of about 0.2 per 100,000, according to Department of Health and Human Services data. Among adults, new admissions fell 54% to 2.1 per 100,000 in the same period, the data show. (Levin, 10/26)

A research letter yesterday in JAMA Network Open ties large gatherings of unvaccinated students and nonstudents at US universities during last spring's National Collegiate Athletic Association (NCAA) March Madness basketball tournament to COVID-19 outbreaks in the surrounding community. (Van Beusekom, 10/26)

Ten more Utahns died of COVID-19 in the past day, according to the Utah Department of Health. One of them was between the ages of 25 and 44, and four were 45-64. In the past week, 54 Utahns have died of the coronavirus. Since the beginning of October, the number of deaths totals 216 — 6.8% of the 3,159 COVID-19 deaths in the Beehive State since the pandemic began. And there are still five more days in the month. (Pierce, 10/26)

Dallas Mayor Eric Johnson says he tested positive for COVID-19 on Tuesday even though he was fully vaccinated. Johnson, 46, said in a statement that he experienced mild symptoms and wouldn’t attend any events he had scheduled for the rest of the week, including a City Council meeting Wednesday. He has repeatedly urged the public to get vaccinated against the virus and wear masks. He again asked the public to get inoculated and receive booster shots, if eligible. Being fully vaccinated against COVID-19 can largely reduce a person’s risk of hospitalization and death from the virus, doctors say, but infections can still happen. (Bailey Jr., 10/26)

Financial assistance is available for COVID-19-related funeral expenses incurred after Jan. 20, 2020, Gov. Andy Beshear said. The funds are available through the Federal Emergency Management Agency. So far, 2,500 Kentuckians have received assistance for a total of more than $18 million, Beshear said Monday. (10/27)

Santa Clara County may establish a specialized clinic at Valley Medical Center that would help treat those with long term COVID-19 symptoms and is waiting on the recommendations of physicians at the hospital before it forges ahead. Long COVID, also known as long hauler syndrome, is a phenomenon where symptoms of the virus last more than a couple of months after initial infection and include fatigue, shortness of breath and memory problems. It’s estimated that around 15 to 25 million people in the United States may have long COVID, according to Brian Block, a UCSF doctor who joined supervisors for a special meeting on Tuesday to discuss the issue. (Greschler, 10/26)

Yet another version of the coronavirus is getting global attention, this one dubbed AY.4.2. It appears that it could be slightly more transmissible than the Delta variant — a marginal difference that experts say is more of a headache than a devastating gamechanger in the scope of the pandemic. Still, the emergence of AY.4.2 offers lessons about the ongoing evolution of the pathogen. (Joseph, 10/27)

As Covid-19 surged last winter, the Trump White House was torn between competing factions on how to manage the pandemic, including whether to let the virus spread unchecked to reach herd immunity, former coronavirus response coordinator Deborah Birx told congressional investigators. Birx and other doctors pressed the Trump administration to intensify efforts to control disease spread, according to portions of testimony released Tuesday by the Coronavirus Crisis Select Subcommittee. But then-President Donald Trump’s hand-picked coronavirus adviser, Scott Atlas, had rapidly consolidated power on a platform that downplayed the seriousness of Covid to most Americans, squeezing out Birx and other top government health officials. (Cancryn, 10/26)

The Trump administration was “distracted” by last year’s election and ignored recommendations to curb the pandemic, the White House’s former coronavirus response coordinator told congressional investigators this month. “I felt like the White House had gotten somewhat complacent through the campaign season,” said Deborah Birx, whom President Donald Trump chose to steer his government’s virus response, according to interview excerpts released by the House select subcommittee on the pandemic. (10/26)

The Trump administration's former coronavirus advisor, Dr. Deborah Birx, estimated that 30 to 40 percent of the 738,000 COVID-19 deaths in the U.S. could have been prevented had the White House taken necessary steps to curb the spread of the virus .In a closed-door testimony conducted by the House Select Coronavirus Subcommittee on October 12 and 13, Birx testified that more than 130,000 American lives could have been saved if the administration promoted mask-wearing and social distancing in the early days of the pandemic. (Fung, 10/26)

Former Trump COVID special advisor Dr. Scott Atlas slammed Dr. Deborah Birx for her reported testimony to congressional investigators as "an Orwellian attempt to rewrite history," defending his work on the Trump COVID-19 task force, and telling Fox News that history's "biggest failure of public health policy lies directly at the hands of" officials who recommended lockdowns during the early months of the coronavirus pandemic.  (Singman, 10/26)

A federal judge in Texas denied Southwest Airlines pilots union’s request to temporarily block a vaccine mandate for employees, which is a requirement under new government rules. Dallas-based Southwest Airlines must require staff to be fully vaccinated against Covid-19 by Dec. 8 unless they receive a religious or medical exemption, according to rules for federal contractors that the Biden administration issued last month. (Josephs, 10/26)

Meatpacking giant Tyson Foods says more than 96% of its workers have been vaccinated ahead of the company’s Nov. 1 deadline for them to do so. The company based in Springdale, Arkansas, said the number of its 120,000 workers who have been vaccinated has nearly doubled since it announced its mandate on Aug. 3. At that point, only 50% of Tyson workers had been vaccinated. (Funk, 10/26)

Top Republicans in Florida are considering a new approach in their opposition to the federal vaccine mandate imposed by President Joe Biden: throwing the baby out with the bathwater. The state’s GOP leadership proposed late last week to completely end oversight of the Occupational Safety and Health Administration (OSHA), the agency tasked with enforcing a federal rule that would require all private businesses with 100 or more employees to be vaccinated against COVID-19 or to undergo testing for the virus each week, in Florida. (Goodkind, 10/26)

More than 200 City of Boston workers were placed on unpaid leave Tuesday for their noncompliance with COVID-19 requirements, meaning they failed to either verify their vaccination status or show proof of a weekly, negative test for the virus. The total number of city workers on unpaid leave for violating the policy remains north of 800. Acting Mayor Kim Janey announced a vaccine mandate for the city workforce, which includes more than 18,000 employees, in August. At the time, she emphasized that vaccinations were key to the city’s battle against the pandemic. The new requirement took effect in phases, with different groups of workers having to comply by different dates. (McDonald, 10/26)

Los Angeles city employees who have not been vaccinated will have to fork over $130 each week to cover COVID-19 testing but will have a longer deadline to get the shots or lose their jobs, according to a plan passed by lawmakers Tuesday. City workers originally had until Oct. 20 to get fully vaccinated but now they have until Dec. 18. During the extended period, unvaccinated workers will have $65 deducted from their paychecks twice a week to cover the cost of weekly testing, or $260 per pay period. (Casiano, 10/26)

Another California county closed down an In-N-Out restaurant on Tuesday because the popular burger chain refuses to enforce COVID-19 vaccination rules. Contra Costa County health officials indefinitely shut the Pleasant Hill restaurant after it ignored repeated warnings to verify that customers who wanted to dine indoors had vaccination cards or proof they had tested negative for the virus in the past 72 hours. (10/27)

Two lawsuits — one of which seeks $200 million in restitution — are asking different courts overturn a COVID-19 pandemic face mask requirement for Clark County School District students. On Friday, parents Jason Ruiz, Robert Parker and Erin Gomez filed a civil rights complaint in Clark County District Court on behalf of five children against the school district, Gov. Steve Sisolak and Nevada Attorney General Aaron Ford. That followed a previous lawsuit filed Sept. 20 in U.S. District Court by 14 plaintiffs on behalf of 18 children seeking to overturn the face mask mandate. It named district Superintendent Jesus Jara and the Clark County School Board as defendants. (Wooton-Greener, 10/26)

Florida Surgeon General Joseph Ladapo on Tuesday wrote on Twitter about his refusal to wear a mask while meeting with state Sen. Tina Polsky, who has breast cancer, saying he can’t “communicate clearly and effectively” with his face covered. “Having a conversation with someone while wearing a mask is not something I find productive, especially when other options exist,” Ladapo said in his first public remarks about the incident. “It is important to me to communicate clearly and effectively with people. I can’t do that when half of my face is covered.” (Rohrer, 10/26)

Many progressives have started lining up behind an emerging social and environment bill that’s neither as big nor as bold as they wanted, thanks to an outnumbered but potent band of party moderates who’ve enjoyed a disproportionate say in shaping the measure. Democrats rolled past unanimous Republican opposition in August and pushed a 10-year, $3.5 trillion fiscal blueprint of the plan through Congress. With talks continuing, the actual package — it reflects President Joe Biden’s hopes for bolstering health care, family services and climate change efforts — seems likely to be around half that size. Prized initiatives like free community college and fines against utilities using carbon-spewing fuels are being jettisoned, and others are being curtailed. (Fram, 10/27)

Democrats are considering payment reductions for private Medicare Advantage plans to help offset the cost of a multitrillion-dollar budget bill, according to three sources with knowledge of the talks, triggering a lobbying fight from the insurers. The insurance industry is closely watching lawmakers’ search to pay for a sweeping jobs and social spending bill expected to cost around $2 trillion over a decade. The House version of the bill didn’t include any changes to the Medicare Advantage program, and the Senate has not yet introduced its own text, but lobbyists are concerned about the threat of payment cuts. (Clason, 10/26)

Democrats are coalescing around a plan to offer a few years of subsidized private insurance to uninsured people with lower incomes in states that refused to expand Medicaid. The latest idea is an attempt to save a pillar of the party’s health care agenda as members rush to broker final agreements on their sweeping social spending package. The plan is more amenable to the private insurance industry and comes days after Sen. Joe Manchin (D-W.Va.) expressed opposition to the party’s preferred proposal: to create a new federal program that mirrors Obamacare’s Medicaid expansion. (Ollstein, 10/26)

One Senate Democrat could block an effort by his colleagues to extend health care to millions of poor people in a dozen states. For West Virginia Sen. Joe Manchin, his opposition is a matter of fairness. Taxpayers in his state – and in the 37 other states that have expanded Medicaid eligibility under the 2010 Affordable Care Act – pick up 10% of the cost to cover low-income residents who are covered by the law. Why then, he argues, should the federal government now pay for 100% of the cost in the states that have refused the 90-10 split – as Democrats are proposing to do in the massive social spending bill pending in Congress. (Groppe, 10/26)

Democratic leaders scrambling for an infrastructure vote this week to boost two Democratic gubernatorial candidates hit a brick wall Tuesday, when the head of the Congressional Progressive Caucus said liberals will oppose the popular public works bill until a larger benefits package is finalized. Rep. Pramila Jayapal (D-Wash.) emerged from an hourlong meeting with Speaker Nancy Pelosi (D-Calif.) amplifying her long-held position: Progressives won’t support the bipartisan infrastructure bill, known as the BIF, before there’s agreement on every detail of the social spending package at the heart of President Biden’s domestic policy agenda. (Lillis and Wong, 10/26)

KHN: Medicare Plans’ ‘Free’ Dental, Vision, Hearing Benefits Come At A Cost 

When Teresa Nolan Barensfeld turned 65 last year, she quickly decided on a private Medicare Advantage plan to cover her health expenses. Barensfeld, a freelance editor from Chatham, New York, liked that it covered her medications, while her local hospitals and her primary care doctor were in the plan’s network. It also had a modest $31 monthly premium. She said it was a bonus that the plan included dental, hearing and vision benefits, which traditional Medicare does not. (Galewitz, 10/27)

As a diabetes doctor in Baltimore, Sally Pinkstaff saw her patients struggle to pay for insulin. They told her they would take half the normal amount, delay doses, even skip entire months. She would try to help them by adjusting their prescriptions — and sometimes by giving them cash. Then, after she received a diagnosis of smoldering multiple myeloma, she began to see firsthand what it meant to depend on a costly drug. Her disease, a type of blood cancer, is often treated with an oral medication, Revlimid, that can keep the disease at bay for years. At first, the insurance from her medical practice charged her a $50 co-payment a month. But when she retired and went on Medicare, the first bill was nearly $4,000, and she became the patient who stopped taking her medicine for a month. (Sanger-Katz, 10/27)

KHN: KHN Campaign Contributions Tracker: Pharma Cash To Congress

Every year, pharmaceutical companies contribute millions of dollars to U.S. senators and representatives as part of a multipronged effort to influence health care lawmaking and spending priorities. Use this tool to explore the sizable role drugmakers play in the campaign finance system, where many industries seek to influence Congress. Discover which lawmakers rake in the most money (or the least) and which pharma companies are the biggest contributors. Or use our search tool to look up members of Congress by name or home state, as well as dozens of drugmakers that KHN tracks. (Lucas and KHN staff, 10/26)

KHN: Pharma Campaign Cash Delivered To Key Lawmakers With Surgical Precision 

The Biden administration and Congress are embroiled in high-stakes haggling over what urgent priorities will make it into the ever-shrinking social spending bill. But for the pharmaceutical industry there is one agenda: Heading off Medicare drug price negotiation, which it considers an existential threat to its business model. The siren call to contain rising drug costs helped catapult Democrats to power, and the idea is popular among voters regardless of their politics. Yet granting Medicare broad authority to intervene in setting prices has nonetheless divided the party. (Knight, Pradhan and Lucas, 10/27)

TikTok, Snapchat and YouTube, all social media sites popular with teens and young adults, faced a barrage of questions and accusations Tuesday from lawmakers who want the companies to do more to protect children online. Executives from all three companies committed to sharing internal research on how their products affect kids — an issue that has come to the forefront in the past several weeks as tens of thousands of pages of Facebook’s internal documents have been revealed by a whistleblower. (Lerman and Lima, 10/26)

The hearing, held by the Senate Subcommittee on Consumer Protection, Product Safety, and Data Security, managed to stay on topic about half of the time. The committee’s Republican members were keen to steer their rare time with a TikTok executive toward questions about privacy concerns over the company’s relationship with the Chinese government. Diversions notwithstanding, a few of the hearing’s more useful moments saw the three policy leads pressed to answer yes/no questions about specific policy proposals crawling through Congress. The hearing featured testimony from Snap VP of Global Public Policy Jennifer Stout, TikTok’s VP and Head of Public Policy Michael Beckerman and Leslie Miller, who leads government affairs and public policy at YouTube. (Hatmaker, 10/26)

Lawmakers in the Senate hammered representatives from Snapchat, TikTok and YouTube on Tuesday, in a combative hearing about whether the tech giants do enough to keep children safe online. It marked the first time Snapchat and TikTok have landed in the hot seat in Washington, D.C., and for nearly four hours lawmakers pressed the officials about how the apps have been misused to promote bullying, worsen eating disorders and help teens buy dangerous drugs or engage in reckless behavior. (Allyn, 10/26)

Leaked Facebook documents provide a first-hand look at how Trump’s social media posts ignited more anger in an already deeply divided country that was eventually lit “on fire” with reports of hate speech and violence across the platform. Facebook’s own internal, automated controls, meant to catch posts that violate rules, predicted with almost 90% certainty that Trump’s message broke the tech company’s rules against inciting violence. Yet, the tech giant didn’t take any action on Trump’s message. (Seitz, 10/27)

Five years ago, Facebook gave its users five new ways to react to a post in their news feed beyond the iconic “like” thumbs-up: “love,” “haha,” “wow,” “sad” and “angry.” Behind the scenes, Facebook programmed the algorithm that decides what people see in their news feeds to use the reaction emoji as signals to push more emotional and provocative content — including content likely to make them angry. Starting in 2017, Facebook’s ranking algorithm treated emoji reactions as five times more valuable than “likes,” internal documents reveal. The theory was simple: Posts that prompted lots of reaction emoji tended to keep users more engaged, and keeping users engaged was the key to Facebook’s business. (Merrill and Oremus, 10/26)

Kaiser Permanente allegedly coerced employees to upcode claims for Medicare Advantage beneficiaries, resulting in an estimated 75% error rate, according to a new complaint from the U.S. Justice Department. The federal government intervened in six related lawsuits in July and filed a complaint Monday, outlining how Kaiser physicians allegedly changed medical records often months after care was provided to boost the Oakland, California-based integrated health system's Medicare Advantage reimbursement. More than half of Kaiser physicians said they were forced to add diagnoses they did not consider, evaluate or treat, according to one of the whistleblowers and former Kaiser medical coder, Randi Osinek. (Kacik, 10/26)

A state appeals panel has given Northside Hospital its blessing to build an outpatient surgery center in Braselton. The Georgia Certificate of Need Appeal Panel decision is being hailed by the hospital system — which has hospital campuses in Lawrenceville and Duluth — as a win for patients in northeast Georgia. The Department of Community Health denied Northside’s Certificate of Need request to build the center in 2018 and the hospital system had been appealing the decision since then. (Yeomans, 10/25)

Cigna launched a virtual-first plan for select employers on Tuesday, with its new offering following the recent announcements of other major insurers and coming just in time for open enrollment. Like UnitedHealth Group, Aetna and Centene, Cigna's new virtual-first plan offers a $0 copay, and will start in January 2022. Cigna will offer virtual-first primary, dermatology, behavioral and urgent care services for employers, and digital dermatology to its exchange members. Although the new virtual-first plan will only be available for certain employers, all business customers will have access to MDLive's network of more than 2,500 virtual clinicians for wellness and behavioral health checks, prescription refills and emergency care. (Tepper, 10/26)

April Anthony, founder of leading home health care company Encompass, is being accused of breaching her employment contract by secretly meeting with employees after leaving the firm earlier this year, resulting in five high-ranking executives joining her new competing venture. Dallas-based Encompass Health, founded by Anthony in 1998, and Birmingham-based Encompass Health Corp., which trades on the NYSE and acquired Encompass Health in 2014, sued Anthony Tuesday in state court in Dallas. The lawsuit accuses Anthony, 54, of Highland Park, of violating an employment agreement she signed in October 2019 that prohibited her, once she left Encompass, from recruiting away employees for two years or engaging in a competing business for a year. (Walters, 10/26)

KHN: How Billing Turns A Routine Birth Into A High-Cost Emergency

Caitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son. Wells Salerno went into labor on the eve of her due date, in the early weeks of coronavirus lockdowns in April 2020. She and her husband, Jon Salerno, were instructed to go through the emergency room doors at Poudre Valley Hospital in Fort Collins, Colorado, because it was the only entrance open. (Bichell, 10/27)

A representative for Betsy DeVos’s family office told jurors in the Elizabeth Holmes criminal trial that the former Theranos CEO provided misleading financials and details about the company’s technology in soliciting an investment. DeVos, the former education secretary in the Trump administration, invested $100 million in Theranos in 2014. Lisa Peterson, who oversees private equity investments at RDV Corp. and handled the Theranos deal, testified on behalf of the family on Tuesday. (Khorram, 10/26)

Infectious mononucleosis – also known as "mono" or "the kissing disease" – in childhood or adolescence is associated with an increased risk of developing multiple sclerosis (MS) as an adult, according to a new study. In order to reach these conclusions, researchers from Sweden and the United Kingdom used data from nearly 2.5 million Swedish people. In the population-based cohort study, published earlier this month in the journal JAMA Network Open. the authors wrote that they had used the Swedish Total Population Register to identify Swedish-born individuals from Jan. 1, 1958, to Dec. 31, 1994, who reached 25 years of age from Jan. 1, 1990, to Dec. 31, 2019, with both parents alive in 1990, in order to aid in the identification of all first-degree relatives as well as MS diagnoses in parents. (Musto, 10/26)

Young adults with colon cancer are just as likely to die from the disease as older people — in some cases, maybe even less likely — according to a study to be published today in the Journal of the National Cancer Institute. Colorectal cancer is among the fastest-growing cancers among people younger than 50, and researchers aren't sure why. (Reed, 10/27)

Researchers at the Cleveland Clinic have launched a first-of-its-kind study for a vaccine aimed at preventing lethal breast cancer. Triple-negative breast cancer is considered one of the most aggressive types of breast cancer because it does not typically respond to hormonal or targeted therapies, researchers say. (Chen, 10/26)

The number of annual cigarette sales increased in 2020 for the first time in two decades, according to data from the Federal Trade Commission. The number of cigarettes sold by the largest cigarette companies in the U.S. increased from 202.9 billion in 2019 to 203.7 billion in 2020, according to the most recent FTC Cigarette Report. (Doherty, 10/26)

The Republican-controlled Wisconsin Assembly was poised to give final approval Wednesday to a package of anti-abortion bills that Democratic Gov. Tony Evers is all-but certain to veto. Final approval of the bills designed the reduce the number of abortions in the state comes after the state Senate, also controlled by Republicans, passed the measures over Democratic objections last week. Republicans do not have enough votes in the Legislature to override an Evers veto. Democrats have accused Republicans of only taking up the bills to energize conservatives ahead of the 2022 midterm election. (Bauer, 10/27)

The Illinois Senate voted Tuesday to repeal a law requiring that parents or guardians be notified when girls younger than 18 are seeking an abortion. Building on momentum among abortion-rights activists after September’s Texas “heartbeat” law banned most abortions, Democrats who control the General Assembly want to dump the 1995 law requiring notification, which both sides of the debate call the last restriction on abortions in Illinois. (O'Connor, 10/27)

Gov. Greg Abbott and other defenders of a new Texas law that bans abortion after about six weeks — even in cases of rape and incest — have vowed to crack down on sexual assault to reduce the need for abortions. Abbott said last month, soon after the law known as SB 8 went into effect, that he would "eliminate all rapists." An NBC News review of state and FBI data, however, indicates that the clearance rate for rapes in Texas has been dropping year to year and that Texas' clearance rate now lags behind the national average by almost a third. (Strickler and Kaplan, 10/27)

Leafly and similar sites will be able to resume contracting with Florida medical marijuana operators to allow patients to order products online, under a ruling issued Monday by an administrative law judge. Florida health officials this year stopped medical marijuana operators from using Leafly and other third-party sites to process patient orders, saying the arrangements violated a state law banning operators from contracting for services “directly related to the cultivation, processing and dispensing” of cannabis. (Kam, 10/26)

This week, advocates from across Pennsylvania are set to rally in Harrisburg in support of legalizing syringe service programs in the commonwealth, where the public health measure is still against the law — though some communities allow them to serve people in addiction. At the same time, in New Jersey, where syringe services have been legal since 2006, harm reductionists are fighting to keep the state’s oldest needle exchange program open in Atlantic City. (Whelan, 10/26)

Dr. David Bishai, health officer at the Harford County Health Department who assumed the position in January at the height of the coronavirus pandemic, was terminated from the position last week, he said late Tuesday evening. Bishai, a Johns Hopkins Bloomberg School of Public Health professor with degrees in medicine and business, said he was not given a reason for his firing. He said he was called into an in-person meeting with officials from the Maryland Department of Health who informed him that the Harford County Council had voted to remove him, and that Maryland Department of Health Secretary Dennis R. Schrader had approved the vote. (Miller, 10/26)

Senegal and Rwanda have signed an agreement with German company BioNTech for the construction of its first start-to-finish factories to make messenger RNA vaccines in Africa. BioNTech, which developed the Pfizer-BioNTech COVID-19 vaccine, said Tuesday that construction will start in mid-2022. It is working with the Institut Pasteur in Dakar, Senegal’s capital, and the Rwandan government, a statement said. (Petesch, 10/26)

Moderna on Tuesday said it will make up to 110 million doses of its COVID-19 vaccine available to African countries, which local officials called a breakthrough on the world’s least vaccinated continent. The announcement said Moderna is prepared to deliver the first 15 million doses by the end of this year, with 35 million in the first quarter of 2022 and up to 60 million in the second quarter. It says “all doses are offered at Moderna’s lowest tiered price.” (Anna, 10/26)

The U.K. reported its highest daily death toll from coronavirus since the beginning of March, adding to fears that tighter restrictions might be needed this winter. The number of people hospitalized is also at the highest since that period. Steadily increasing hospitalization and death rates have put pressure on the government to enact its “Plan B,” which could include mandatory face coverings and a recommendation to work from home. (Capel, 10/26)

Chinese organizers have confirmed participants in next year’s Winter Olympics will be strictly isolated from the general population and could face expulsion for violating COVID-19 restrictions. Vice mayor and Beijing 2022 organizing committee official Zhang Jiandong told reporters Wednesday that those taking part in the games beginning Feb. 4 must remain in a “closed loop” for training, competing, transport, dining and accommodation. (10/27)

Though flu cases are still low in Europe, an unusually early spike in Croatia is a sign that the 2021-22 flu season could be severe for older people, the European Centre for Disease Prevention and Control (ECDC) said today. The ECDC said the main subtype detected in the region over the past month is influenza A H3N2, which is known for disproportionately affecting older people and has been linked to lower vaccine effectiveness. It said the early signals suggest the season could be severe for older people but noted the timing of flu circulation may vary among countries. (10/26)

The World Health Organization approved a cervical cancer vaccine from China’s Beijing Wantai Biological Pharmacy Enterprise Co., broadening access in developing countries to a scarce shot that prevents one of the most common causes of cancer. The inoculation was developed by Wantai’s vaccine subsidiary Xiamen Innovax Biotech Co. and works against the two highest-risk types of human papillomavirus, a sexually-transmitted virus that can cause cervical cancer. It received a stamp of approval from the WHO, known as a prequalification, which is widely recognized by developing nations as proof of a product’s safety and efficacy. (10/26)

Centene Corp. said it will restructure its pharmacy-benefits management business following claims by several states that it had inflated drug costs at taxpayers’ expense. The health insurer recorded a $1.1 billion accounting charge earlier this year in anticipation of resolving disputes with states that alleged that the company overcharged their Medicaid programs for prescription drugs. On Tuesday, Centene said it will seek new proposals from outside companies to help it manage what it expects to be more than $30 billion in annual drug spending in the years to come. The company’s existing contract for pharmacy services runs out at the end of 2023. (Tozzi, 10/27)

The state of Texas has settled with drug manufacturer Johnson & Johnson for its role in the nationwide opioid epidemic, with the company agreeing to pay $290 million to partly fund addiction recovery efforts in cities and counties, Attorney General Ken Paxton announced Tuesday. About $3.9 million will go directly to Harris County if approved by commissioners, according to Harris County Attorney Christian Menefee. (Gill, 10/26)

Pancreatic cancer is hard to detect early and notoriously resistant to treatment, making it the deadliest type of major cancer. Rafael Pharmaceuticals, a small drug maker backed by a telecom billionaire, hopes to deliver better news for patients and investors with the readout of a large clinical trial within the next two months. It’s an inordinately risky challenge for Rafael, but with a giant payoff if successful. Here are six things to know about the company and its drug, devimistat, before Phase 3 pancreatic cancer study results are announced. (Feuerstein, 10/27)

A group of protesters converged Tuesday on the corporate offices of UnitedHealthcare to demonstrate against what they call “unethically high” prescription drug prices. The protesters were from the AIDS Healthcare Foundation, and they say that people with HIV/AIDS are facing expensive drug prices that are impeding them from seeking care. The demonstrators say that OptumRx, the prescription service under UnitedHealthcare, is throwing unethical charges on specialty independent pharmacies where people with HIV or specific pre-existing conditions seek care. (Mohs, 10/26)

Mark Cuban’s drug company is diving into the controversial world of pharmacy benefit management with the launch of a new venture tasked with lowering drug prices for its customers. The company, Mark Cuban Cost Plus PBM, will serve as an intermediary that negotiates with drug manufacturers and pharmacies for rebates and discounts on behalf of employers, health insurers and government health programs. While PBMs play a critical role in drug pricing, they’ve faced scrutiny in recent years over a lack of transparency regarding how much they’re making off rebates and how much of the cost savings actually gets passed onto their customers. It’s a narrative Cuban’s new Dallas-based company says it wants to change. (Wolf, 10/26)

The political organization led by Democratic titan Stacey Abrams is branching out into paying off medical debts. Fair Fight Action on Wednesday told The Associated Press that it has donated $1.34 million from its political action committee to the nonprofit organization RIP Medical Debt to wipe out debt with a face value of $212 million that is owed by 108,000 people in Georgia, Arizona, Louisiana, Mississippi and Alabama. (Amy, 10/27)

Throwing out your old, unused prescription drugs may seem like routine house cleaning –  and leaving them "for an emergency" or until you run out of space may seem like no big deal –  but in reality, getting rid of those medications can play a key role in combating the substance misuse crisis and could help save lives. The substance misuse crisis is ravaging communities in New Hampshire and across the country – and in many communities, drug overdose deaths increased during the pandemic. Substance misuse is complicated, and there is no one path to addiction. Often though, substance misuse starts with taking a prescription drug – sometimes ones that have been prescribed, and sometimes from old, unused pills left in medicine cabinets. (Sen. Maggie Hassan, 10/23)

Do you remember all the uproar about skyrocketing insulin prices and the horrific impact these prices had on those living with diabetes? Well, for Michael Hague, a 62-year-old man from East Tennessee, that problem still exists. He is still forced to ration his insulin because of its exorbitant cost. There hasn’t been much improvement in increasing insulin affordability and accessibility. Today, I am asking you to stand behind the ideals you were elected upon: healthcare being a fundamental human right. (Tiffany Richardson, 10/27)

Articles on where to retire usually focus on things like weather, housing costs and taxes. But these aren’t the only things that wannabe retirees should consider. Another is the cost of prescription drugs. I’ve mentioned before that seniors will need a small fortune to pay for medical costs that Medicare won’t: $300,000 for a couple retiring at age 65 is the latest estimate of this from Fidelity Investments, the Boston-based asset management giant. A big reason for this, says a separate study, is meds. (Paul Brandus, 10/25)

Critics argue that the United States is the only developed country where the federal government doesn’t negotiate prescription drug prices and that a 40 percent cut to the pharmaceutical industry’s size will have limited or no impact on future cures or pandemic preparedness. If it all sounds too good to be true, that’s because it is. Under the guise of Medicare “negotiations,” the US House of Representatives is considering a measure that would mandate the government to set prices on some of the most widely used drugs. These price controls would shrink the sector by 40 percent or $100 billion per year in revenue. Our entire industry invests about $100 billion per year in research and development. (David A. Ricks, 10/25)

The argument that allowing Medicare to negotiate for lower prescription-drug prices will inhibit pharmaceutical manufacturers’ ability to invest in research and development of new lifesaving drugs isn’t based in reality (“Medicare Drug Debate Weighs Price, Innovation,” U.S. News, Oct. 12).A study published in Health Affairs, a peer-reviewed health-research publication, found that the revenue from the top 20 best-selling prescription drugs in the U.S. more than covers all the R&D costs of the 15 pharmaceutical companies that manufacture those drugs. Meanwhile, nine of the 10 largest drug companies spend more on marketing their products than on research. They also pay their executives exorbitant salaries. (10/26)

Congress is shaping up to be one of the scarier places to be this Halloween. The reconciliation bill remains an unsolved riddle and Congressional Democrats and President Biden are pushing for some particularly ill-advised policies. Chief among them are changes to the way we calculate drug prices. Fortunately, wise members like San Diego’s Rep. Scott Peters are pushing back. (Sue Peschin, 10/26)

America is at a crossroads when it comes to paying for prescription drugs. Down one path, pharmaceutical companies will continue hiking drug prices much faster than wages grow for typical Americans. They’ll continue launching headline-grabbing drugs at outrageous list prices, even when there are questions about whether those drugs truly work. In this scenario, the result of drug companies’ unchecked power could be that many more Americans will borrow for life-saving treatments the way they borrow for homes and educations. Taking out a mortgage for survival is a grim prospect. (Ron Wyden, 10/25)

And yet I have, since returning to Germany about a month ago, been struck by how much more rational, efficient, and pragmatic the country’s handling of the late stages of the coronavirus pandemic has been. While the American response to COVID-19 has barely gone beyond the measures that were first adopted in the spring of 2020, Germany has phased in a series of additional policies over the past 18 months. None of them adds serious disruptions to daily life, and yet they collectively put the country in a much better position to contain the virus. (Yascha Mounk, 10/26)

I was waiting in line at the Motor Vehicle Administration (MVA) in Maryland this summer when I noticed two state troopers posted inside. Despite a mask mandate in Prince George's County, neither wore a face covering. Out of curiosity, I called the Maryland State Police headquarters and asked a sergeant if their troopers are required to follow the Covid-19 protocols of the counties in which they work. The sergeant replied the troopers were state employees, and there was not a statewide mask mandate in place. (Sonia Pruitt, 10/26)

At a time when the United States and Soviet Union were amassing stockpiles of nuclear weapons that could decimate each other thousands of times over, Albert Sabin, an American scientist, traveled to Russia in 1956 to share his groundbreaking research on an oral polio vaccine with his Soviet colleagues. Sabin’s collaboration with virologist Mikhail Chumakov was a critical milestone in the quest to eradicate polio. Unlike Jonas Salk’s vaccine, which saw wide use in the United States beginning in 1955, Sabin’s version used live but weakened virus, was taken orally rather than through a shot, and provided lifetime immunity after one dose. Thanks to the partnership with Chumakov, the Sabin vaccine was tested on millions of people throughout Russia and Eastern Europe in 1958 and 1959, before being fully licensed in the United States in 1962. (10/27)

Advisers to the Food and Drug Administration marked a milestone in the covid-19 pandemic on Tuesday, as they recommended authorization of the Pfizer/BioNTech vaccine for children ages 5 to 11. Having millions more Americans eligible for vaccination could influence the trajectory of the pandemic and reduce community infection rates, though I believe the more significant outcome will be that young kids will finally be protected from illness, disability and death. (Leana S. Wen, 10/26)

On May 14, I went for a jog, amazed at my newfound freedom. The Centers for Disease Control and Prevention had just signed off on the vaccinated shedding their masks outdoors. In Brooklyn’s Prospect Park, on a cloudless spring day, I pondered what seemed like a miraculous paradigm shift: Apparently, I no longer had to fear that my fellow joggers would kill me, or I them. (Katherine Eban, 10/27)

Tennessee is trying to recover from the deadly delta COVID surge which brought the state’s death toll to more than 16,000 citizens. But state lawmakers are back in Nashville Wednesday to curb COVID protocols and tie the hands of local and state officials and businesses from protecting people from the virus. Some legislators have taken particular delight in politicizing the coronavirus even as their own colleagues have suffered from it, as neighbors have died and health care systems are taxed. (10/26)

DeSantis' latest move, announced last week, is to call a special legislative session to undermine federal requirements announced by President Joe Biden that some workers be vaccinated against the coronavirus. Among the laws he wants lawmakers to pass is making businesses liable for medical harm that results from mandatory vaccinations, even though millions of vaccines have safely been administered in the United States. DeSantis has for months tried to walk the tight rope between pleasing anti-vaxxers and not undermining the vaccines his own administration has distributed. If there was any doubt of which side he favors, last week's announcement put the nail in the coffin. (10/26)

Fourteen years ago, I sat face-to-face with my doctor, weighing my odds of survival. Was it a flip of a coin? I had breast cancer that had traveled to my lymph nodes, and on a bone scan it appeared to have spread to my skull. For two weeks, I had been reading the dismal, nauseating survival statistics for younger women with metastatic breast cancer. "If I were in Vegas, I'd put money on you being alive in five years," my doctor said. (Susannah Hills, 10/26)

“I finally build up the courage to tell the doctor I need help. Staring at the floor, I tell him the truth about how much I am drinking and how many pills I am taking. As I look up, our eyes meet. His face is aghast. He quickly looks away. With his back turned to me, he mumbles something to the effect, ‘We don’t treat those issues here.' ”That is a story from Chad Fahlberg — a person in long-term recovery recounting his experience facing stigma due to his substance use disorder. (Matthew Stefanko, Brea Perry and Anne Krendl, 10/27)