What FDA approval of the Pfizer vaccine means for a hard-hit state

Transcript

MARGARET TALEV: Good morning! Welcome to Axios Today! It’s Tuesday, August 24th. I’m Margaret Talev, in for Niala Boodhoo. Here’s what we’re watching today: dire conditions in Qatar for evacuees from Afghanistan. Plus: FDA approval of the Pfizer vaccine raises questions about young kids. But first, today’s One Big Thing: what that FDA approval means for vaccination rates in a hard-hit state.

The FDA yesterday granted full approval to the Pfizer BioNTech COVID vaccine. Will it convince more people to get vaccinated though? The answer to that question will be especially important in states with low vaccination rates and surging hospitalizations, like Alabama, that state is currently one of the hardest hit by COVID in the nation. Dr. Scott Harris is the state health officer for the department of public health in Alabama, Dr. Harris, good morning.

DR. SCOTT HARRIS: Good morning.

MARGARET: We last spoke with you in December, just before the public really started getting the vaccine and it's been eight months now. What's the current situation in hospitals in Alabama?

DR. HARRIS: Alabama has really encountered a difficult time, particularly over the last three to four weeks. We've seen our hospital numbers increase at a really rapid rate. We're not quite at the peak that we established back in January in terms of total Covid hospitalizations, but we've especially had problems with our ICU capacity. We have many, many more people needing critical care than we have beds.

MARGARET: The stats — 2,588 Covid cases in the last day or so, 38 of those are pediatric cases.

DR. HARRIS: Yeah, we really, we have seen an increase in pediatric cases that we had not identified before. Total pediatric hospitalizations make up, you know, between one and two percent of all hospitalizations, but that's a lot for kids. Kids don't usually end up in the hospital at that rate with most illnesses.

MARGARET: So big news now, full FDA authorization for the Pfizer vaccine. About a little more than a third of the folks in Alabama are fully vaccinated. That's a huge rate of unvaccinated people. Could that full FDA authorization help actually increase the vaccination rates in your state?

DR. HARRIS: It is a very big deal. It will certainly help with some people's concerns. A lot of people have used that as maybe an excuse to not get vaccinated. Now they don't have that excuse. I hope they don't find a new excuse. We definitely have a lot of vaccine hesitancy and there are a lot of different reasons for that, but I do believe we've got some people who are still just on the fence, that so-called movable middle, that we're hoping to get to now.

MARGARET: Doctor, when we last spoke back in December, we had talked about the concerns of Black Americans, Black residents of Alabama around the vaccine, the historical reasons for that tied to systemic racism, experimentation, Tuskegee. It turned out that the vaccine hesitancy didn't just impact Black Americans, right?

DR. HARRIS: Well, that's exactly right. We actually anticipated what we thought we might see in our African American community. We had a really good plan for that. We worked well on that. And in fact, some of our predominantly African American counties are the most vaccinated counties in our state. We're vaccinating Black Alabamians at a rate a little higher than white Alabamians. It's rural white communities where we really encountered a lot of resistance.

MARGARET: Donald Trump himself was actually booed at a rally in Alabama, right, within the last few days for recommending the vaccine. Are there any lessons that you have learned from the outreach with people who are vaccine hesitant? What have you learned about the approach and how it needs to change?

DR. HARRIS: Yeah, I think you wouldn’t be surprised to hear me say that it really comes down to trust. You know, we kind of naively thought if we just rolled out the science, then people would be compelled to accept it because everybody believes in science. But in fact, we have people that just aren't really interested in hearing a message from state government in general or public health in particular. We really have found that they want to listen to people that they trust. And so that's really been the crux of what we've been trying to do with our communications campaign. We want people to talk to their own doctor. Their own healthcare provider, people in their communities that they believe provide them with good information and you know, it's hard to do that. It's sort of one conversation at a time. It's really labor intensive. It takes a lot of work to do that and you know, sometimes it works and sometimes it doesn't work.

MARGARET: Dr. Scott Harris is the state health officer for the department of public health in Alabama, and has got a heck of a job. Thank you for all your work and we hope to talk to you again soon.

DR. HARRIS: Thank you very much.

MARGARET: In 15 seconds: the Pfizer FDA approval invites new questions about young kids.

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MARGARET: Welcome back to Axios Today. I'm Margaret Talev, in this week for Niala Boodhoo.

After the FDA granted full approval for Pfizer's COVID vaccine for those 16 and older, Axios healthcare editor Tina Reed tells us that one of the immediate questions for many was what that might mean for younger kids — those under 12 who are not yet able to get any of the COVID vaccines.

TINA REED: Multiple doctors I spoke with said they expected that parents would be pushing for what's known as off-label use by pediatricians to administer the vaccines to these kids. Off-label use is common more broadly among drugs that have been approved by the FDA. And it means that the drug that is being used is being used for something other than what, for what it was originally approved for, or for a different group than what it was originally approved for. Acting FDA commissioner, Janet Woodcock was quick to warn on Monday that children are not little adults and that more data was needed. The American Academy of Pediatrics similarly warned pediatricians against off-label use. The final word actually appeared to come from the CDC on Monday when they said off-label use in kids under 12 was not authorized, saying the administration of it might not be covered under the PREP Act and that providers might not have immunity from claims. So for now, kids 11 and under will have to continue to wait until more data comes in.

MARGARET: Axios healthcare editor, Tina Reed.

MARGARET: The Biden administration is holding thousands of evacuees from Afghanistan at an air base in Doha, Qatar, where they're being vetted as potential refugees before they can be brought to the U.S. or another country. And according to emails shared exclusively with Axios, the conditions there are quote “a living hell.” We're here with Axios’ national political correspondent, Jonathan Swan, with more on this story. Hi, Jonathan.

JONATHAN SWAN: Hey Margaret.

MARGARET: Jonathan, tell us: What are things like at the Doha air base? And how do we know this?

JONATHAN: So, shortly before eight o'clock last Friday morning, an official at U.S. Central Command sends this email to some of his colleagues at Central Command, and also some officials at the U.S. State department. Quote, “while not in any way downplaying the conditions in Kabul or the conditions the Afghanis [sic] are escaping from, the current conditions in Doha are of our own doing.” He described it as quote “a life-threatening humanitarian disaster.” He then goes on to quote staff communications about the conditions at the Doha air base quote “a humid day today, where the Afghans are housed is a living hell. Trash, urine, fecal matter, spilled liquids and vomit cover the floors.”

MARGARET: Reading these descriptions, does it seem that the U.S. was actually prepared to house these evacuees?

JONATHAN: No. Uh, I've spoken to sources inside the U.S. government who are literally working on this right now. And ... I can't convey to you the anguish and the anger, frankly, about the lack of foresight that things could fall apart so quickly and that they would need to have these facilities up and running so quickly.

MARGARET: Do we have a sense of whether the Biden administration Is improving, whether these conditions are getting better?

JONATHAN: The-the press officers are saying that they've mobilized to try and improve the conditions at the Doha air base. Make it more sanitary, to make sure that there isn't, what this person warned about, a humanitarian crisis.

MARGARET: Axios' National Political Correspondent Jonathan Swan. Thanks for being with us, Jonathan.

JONATHAN: Thanks for having me.

MARGARET: A few hours after we spoke with Jonathan, the Pentagon told Axios that they are taking steps to improve conditions on the ground including adding more toilets and offering traditional Afghan meals three times a day. The State Department also responded to say quote “we are working quickly to alleviate bottlenecks and are surging consular personnel in Qatar.”

One last thing before we go: the Paralympics kick off today in Tokyo ... with 234 athletes representing the US across eight sports. A record number of 29 publicly-out LGBTQ athletes are also set to compete in this year’s games. You can catch the first event — the women’s 400 meter freestyle — starting at 8 p.m. Eastern tonight.

That’s all we’ve got for you today! I’m Margaret Talev — thanks for listening — stay safe and we’ll see you back here tomorrow morning.