Axios Vitals

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April 27, 2022

Good morning, Vitals readers. Today's newsletter is 763 words or a 3-minute read.

Situational awareness: Vice President Kamala Harris was prescribed and is taking Pfizer's antiviral Paxlovid after being diagnosed with COVID, officials say. It comes just a day after the White House promoted expanded availability of the drug.

1 big thing: HIV PrEP is supposed to be covered, but often isn't

Illustration of a red AIDS awareness ribbon shaped like a "no" sign

Illustration: Sarah Grillo/Axios

Medications that prevent HIV — along with the necessary doctor's visits and lab tests — are supposed to be fully covered by most insurance plans under the Affordable Care Act.

  • Patients and advocacy groups tell Axios they're often not.

Why it matters: Studies show HIV pre-exposure prophylaxis, often called PrEP, is more than 90% effective in preventing the transmission of HIV.

  • But the brand-name version of the daily pill costs upward of $20,000 a year, and billing problems that shift costs to patients lead many who would benefit to opt out, advocates say.

"You hear stories all the time," Jeffrey Crowley, director of the Infectious Diseases Initiative at the O'Neill Institute and a former director of the White House Office of National AIDS Policy, told Axios.

  • "They've been on PrEP and then all of a sudden, there's a new obstacle," he said. "They need to get prior authorization or they used to get their meds for 90 days and now they can only get them for 30 days. All of these hassle factors cause people to fall off."
  • Or as in the case of patients like Cambridge, Massachusetts, resident Michael Brazile, they get fully covered PrEP treatments — along with a surprise bill for lab services required to obtain the drug.

What they're saying: "I'm helping six people right now and we have to go to insurance commissioners every time?" Carl Schmid, executive director at HIV + Hepatitis Policy Institute, told Axios. "There really is a problem. With the ACA it's supposed to be seamless and that's not what's happening."

The other side: The other side: Insurers say the problem often is physicians aren't properly coding their visits as preventative. In many cases, insurers are working to educate provides about the issue, said Kristine Grow, a spokeswoman for AHIP, which represents health insurance plans.

Go deeper.

2. Yep, you've probably had COVID

Data: Clarke, et al., 2022, "Seroprevalence of Infection-Induced SARS-CoV-2 Antibodies"; Chart: Kavya Beheraj/Axios

The majority of Americans — nearly 60% of U.S. adults and nearly 75% of adolescents — have antibodies that indicate prior COVID-19 coronavirus infection, according to CDC data released Tuesday.

  • Only one in three seniors 65 and up have the COVID antibodies, the data shows.
  • But three in four kids have them as of February 2022, up from under half in December 2021 at the beginning of the Omicron surge in the U.S.

3. Alarm bells over COVID lockdowns in China

Illustration: Sarah Grillo/Axios

Illustration: Sarah Grillo/Axios

China's strict COVID controls have been successful in tamping down case counts, but their vulnerabilities are being exposed, Axios' Dave Lawler reports.

Driving the news: Amid signs that Beijing may enter a strict Shanghai-style COVID lockdown — which resulted in severe food shortages and difficulties obtaining medical care — alarmed residents in the capital city are panic-buying supplies.

Between the lines: As David writes, China's vaccines are less effective than western mRNA vaccines, 41% of people over 60 have not had the recommended three doses, and exposure to the virus up to this point has been very low. That all makes the prospect of uncontrolled outbreaks all the more dangerous.

  • In comparison, as Axios' Adriel Bettelheim wrote recently, America may have actually "failed upward" with its large amounts of immunity gained through a high infection rate.

Yes, but: Of course, another major difference is the U.S. willingness to tolerate thousands of new daily COVID cases and hundreds of daily deaths.

  • As David writes, while the official report of around two dozen new cases in each of the past three days in China amount to a rounding error in any major U.S. city, China's zero-COVID strategy makes them a bona fide emergency.

4. Quote du jour: Coffee shops vs. pharmacies

Photo: Stephen Brashear/Getty Images

"The learning there is that ... you also have to connect the customer to the physical asset [and] the employee ... It's all about writing the right algorithms and merging that data together and understanding how to put that in the hands of the consumer, but equally in the hands of our employees so that they can be the hero for the day."
— Walgreens CEO Roz Brewer — a former Starbucks exec — on lessons from the success and shortfall of the coffee giant's digital app. She was speaking at Fast Company's 50 Most Innovative Companies event.

5. Catch up quick

🗣 Caught in the abortion debate are a relatively small number of women who terminated their pregnancies for medical reasons and feel isolated from support. They are building a community to help grieve.

🩺 Reversing advice many seniors have followed for years, a federal task force officially advised Tuesday against most adults over 60 taking routine aspirin to prevent their first heart attack or stroke.

💉 Pfizer and BioNTech asked the FDA Tuesday to authorize a COVID vaccine booster dose for children ages 5 through 11.