22 hours ago

Axios Vitals

Good morning, Vitals readers. Today's newsletter is 880 words, a 3.5-minute read.

Situational awareness: CDC’s Advisory Committee on Immunization Practices is planning to meet Sept. 22 and 23 and expects to discuss COVID-19 vaccine boosters.

1 big thing: Pharma still isn't in the clear

Illustration: Aïda Amer/Axios

A key congressional committee rejected Democrats' signature drug pricing bill yesterday, but that doesn't mean the party's push to lower drug prices is anywhere near over, Axios' Caitlin Owens writes.

Why it matters: Hundreds of billions of dollars are on the line — and Democrats need that money to pay for the rest of their giant legislative agenda.

Driving the news: Three moderate Democrats on the House Energy and Commerce Committee voted against a measure to let Medicare negotiate the price of some drugs. Their opposition sunk the measure in that committee.

  • The House Ways & Means Committee later passed the same provision. But three Democrats is all it takes to kill the entire reconciliation bill on the House floor, meaning it's dead on arrival in its current form.

Between the lines: The House version of the bill could never have passed the Senate anyway, and there was always going to have to be a compromise between the two chambers.

  • But yesterday expedited the watering-down process.
  • The House bill was projected to free up some $700 billion in federal spending, which could then be used to fund Democrats' other priorities like expanding Medicare benefits or extending Affordable Care Act subsidies.

What we're watching: Proponents of drug price reform have been in an increasingly intense messaging battle with the pharmaceutical industry for months now over the merits of Medicare negotiations.

  • "This should be a strong signal to the House leadership that there is broad support for lowering costs for patients without sacrificing access to new cures and treatments," PhRMA said in a statement yesterday.
2. FDA raises skepticism about boosters

FDA scientists took a cautious stance about boosters for the Pfizer vaccine, ahead of a Friday advisory board meeting.

Driving the news: In documents posted on the FDA's website on Wednesday, agency staff said if Pfizer's vaccine is "still effective at preventing important COVID-19-related outcomes, then the benefit of booster vaccination is likely to be more limited."

Between the lines: The assessment "sets up a high-stakes debate over who will need an additional booster dose — and when they will need it," STAT reports.

Where it stands: The Biden administration hopes to soon start offering booster shots to everyone eight months after their second dose.

  • Pfizer told the FDA Wednesday that data from its clinical trials suggest a third shot may be necessary six months after the second dose because of waning efficacy.
3. COVID cases are falling, but deaths are rising
Data: N.Y. Times; Chart: Kavya Beheraj/Axios

The pace of new coronavirus infections in the U.S. is beginning to slow — a potential sign that the states hit hardest by the Delta wave may be starting to turn things around, Axios' Sam Baker writes.

Yes, but: Deaths are still rising, and it’s still too early to know whether schools might drive cases back up again.

By the numbers: On average, about 150,000 Americans are contracting COVID-19 infections every day. That number has fallen by 8% over the past two weeks.

  • Many of the states that experienced the biggest surges in cases and hospitalizations this summer are now beginning to improve.

The virus is now killing 1,888 Americans per day, on average — a 33% jump over the past two weeks.

Between the lines: When a new wave hits, cases go up first, followed by hospitalizations, and then deaths. Today’s rising death toll is the result of the increase in cases and severe illnesses that swept across the U.S. earlier this summer.

  • Vaccinated people can get infected, but are still protected almost entirely from severe illness and death. This summer’s crush of hospitalizations, and now the rising death toll, were preventable.
4. Gottlieb: CDC hampered U.S. response to COVID

Illustration: Shoshana Gordon/Axios

Many criticisms of the U.S. COVID-19 pandemic response have focused on political leaders. But there's a bigger conversation needed about major systemic failures of America's public health infrastructure, including the CDC, former FDA commissioner Scott Gottlieb writes in his forthcoming book "Uncontrolled Spread."

The big picture: Gottlieb argues the nation needs to reform pandemic-preparedness and start treating it like the national security threat it is.

What he's saying: "There's been an aversion that typically security agencies have viewed the CDC as 'having this mission' or 'having the ball on this.' Clearly, they don't," Gottlieb told Axios.

The intrigue: Gottlieb's account, at turns, critiqued both the Trump and Biden administrations. But he argues tackling America's biggest vulnerabilities will require a new focus from our intelligence agencies, as well as a more prospective approach by the CDC.

The bottom line: "People seem content with the narrative that this is just a failure of leadership at the White House, at the Department," Gottlieb said.

  • "It might've been all those things but I think there were clear systemic shortcomings and structural problems that exacerbated the woes that would've left us ill-prepared regardless of who was in power."

Go deeper.

5. Tweet of the day: Vaccine smack talk

Illustration: Shoshana Gordon/Axios

6. New data on stressful life events for kids
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Data: National Center for Health Statistics; Chart: Jared Whalen/Axios

Nearly 10% of children in the U.S. in 2019 lived with someone who was mentally ill or severely depressed, Axios' Marisa Fernandez reports from National Center for Health Statistics data.

The big picture: Stressful life events can have lifelong impacts on a child's physical and mental health, the authors write.

  • 12.5% of white children lived with someone who was mentally ill or severely depressed, compared with about 7% of Black and Hispanic children.
  • Nearly 7% of children were victims of or witnessed violence in their neighborhood. Black children were most exposed at almost 10%.

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7. Chart du jour: A somber number
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Data: CDC and Census Bureau, with Washington Post analysis. Table: Danielle Alberti/Axios

Correction: Yesterday's newsletter misspelled Emory University.