Red states putting their stamp on vaccine ‘passports'

By Ben Leonard

VACCINE PASSPORT TECH GOES RED: Several Republican-leaning states that had rejected so-called vaccine passports over fears they limited freedom are now embracing the technology behind them.

At least five states with bans on “passports” or governor opposition to them — Arizona, Mississippi, South Carolina, Oklahoma and Utah — are developing or have already rolled out the technology. But they’re largely doing it quietly and for slightly different reasons.

The benefits they see: With some places in the U.S. like New York City requiring proof of vaccination for indoor dining and events, and countries mandating the information for entry, residents in these states might need it to travel. Plus, adopting the technology allows for access to health records in a digital format, state officials say.

“ 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.

These states aren’t all taking the same approaches to deploying the credentials.

When Utah implemented the technology last fall, it did not heavily advertise the move. State lawmakers had passed legislation prohibiting state-enforced vaccine mandates, making a marketing push politically unpalatable to some officials.

“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.

But South Carolina plans to advertise the credentials via press release and social media when it launches its program by the end of March, said Stephen White, director of the immunization division at the state’s health department.

“I'm more fearful….of us getting a whole bunch of calls from a whole bunch of people that don't have their information in the registry,” White said, adding there hasn’t been any pushback from within the state government. “This isn't a passport. This is essentially a Covid card that people get at their convenience because it’s their record.”

He expects residents to need them in South Carolina mainly for traveling, as well as to “kee[p] up with the times.”

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 despite close to two-fifths of states barring vaccine "passports" or proof of vaccination requirements.

A number of states banning "vaccine passports" are working to offer digital vaccine credentials. | POLITICO

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FISSURES OVER RESEARCH AGENCY: Democrats and Republicans are at odds over ARPA-H, President Joe Biden’s proposed multibillion-dollar research agency to tackle health care’s most daunting challenges, POLITICO’s Sarah Owermohle reports.

Funding medical research has become more divisive, with Republicans critical of scientists, including Anthony Fauci. The recent resignation of Cabinet official Eric Lander, who was a key supporter of ARPA-H, has complicated the push. And Democrats are divided over where the agency would live.

Ex-National Institutes of Health director Francis Collins — who supports the agency being part of the NIH — was recently named a temporary science adviser to Biden. But a growing number of lawmakers oppose housing it there.

Democrats speaking with POLITICO downplayed divisions over where the agency would be located.

“I don’t think it matters so much where it’s housed as it matters how it’s structured, to both give it the independence but also the ability to cross pollinate,” said Rep. Diana DeGette (D-Colo.), who proposed in a bill with Republican cosponsor Fred Upton (Mich.) that the agency reside at NIH.

Research on conditions like cancer or Alzheimer’s has rarely been controversial, but Republican skepticism of the agency reflects a broader cultural fight ahead of the November midterm elections.

“The majority of Republicans in the House worry ARPA-H will become another slush fund for Fauci-minded scientists — unchecked scientists who will use more government money just to curate their public image rather than get results,” a Republican leadership aide close to ARPA-H discussions said.

STUDY: AI BEATS RADIOLOGISTS:  Machine-learning beat radiologists in classifying hip fractures, a recent study in Scientific Reports found.

Artificial intelligence was used to classify thousands of hip radiographs and checked against classifications from at least two experts. The technology was 19 percent more accurate than hospitals — for an overall accuracy rate of 92 percent in identifying the type of fracture. Hospitals accurately diagnosed the fracture 77.5 percent of the time.

Because misclassifying a fracture can have significant ramifications, researchers opted to take a “more conservative approach,” with AI only diagnosing images if its confidence rating for classifying the fracture was above a certain mark. This would leave an expert to diagnose the remaining images.

“While this led to some radiographs not being classified, it also increased the accuracy on the classified images,” the researchers wrote.

But still, the findings, coupled with previous research, suggest that AI could play a role in diagnosing hip fractures.

Artificial intelligence has long been touted as a potential game-changer in health care, with radiology among the areas where it has shown the most promise. Amid the buzz, the FDA has approved many more devices using AI in recent years.

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BILL GATES WANT THE WORLD TO THINK OUTSIDE THE NEEDLE: Billionaire philanthropist Bill Gates says there’s a better way to beat Covid-19 than the World Health Organization’s target of immunizing 70 percent of the world by mid-2022, POLITICO’s Erin Banco reports from Munich.

For Gates, the goal is unattainable and misses reality, reflecting a top-down mindset that has to change ahead of the next pandemic.

“We live in a world where you have countries that spend $12,000 per person per year on medicine and countries that spend $200 per person per year,” said Gates, whose foundation has been one of the largest spenders in the fight against Covid-19. “If you’re playing the $200-per-person game, you can only do things that have huge impact.”

Some of the things Gates called for: 

— Strengthening health systems in low-income countries to bolster vaccine distribution

— Funding global surveillance efforts to detect diseases earlier

— More funding for research and development of diagnostics and therapeutics

— More efficient vaccine production and administration

“In the future, we don’t want to use a needle. It may turn out that you take your first dose as a micro-patch and your second dose as an inhalation because to get infection blocking you actually want secretory antibodies in the nose. And we’ve never been good at that,” Gates said.

VAX GROUPS PUSH BIDEN ON WAIVERS: Vaccine advocacy groups are pushing President Joe Biden to break an impasse at the World Trade Organization by following along with South Africa and India’s calls to waive broad intellectual property rights to tackle Covid-19, POLITICO’s Doug Palmer reports.

Public Citizen and Oxfam America were among a coalition of dozens of groups writing to Biden ahead of the WTO General Council meeting this week. The groups pushed Biden to dial up the pressure on the European Union by calling for a special emergency meeting within 30 days to approve a proposal waiving protections on vaccines, therapeutics and diagnostics.

The council is expected to talk through the issue and once again not come to a conclusion.

Biden endorsed waiving intellectual property rights for vaccines last May, but the European Union has resisted the proposal, saying logistical issues are the true barriers to vaccine distribution. Pharmaceutical companies also have lined up against the calls, saying it would hurt incentives for innovation.

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