The Weekly Pulse: G7 Pledges Billion Vaccines to Combat Growing Vaccine Gap; SCOTUS Protects Obamacare; N.C. Anti-Abortion Law Blocked

PUBLISHED 6/17/2021 by

For The Weekly Pulse (a revisit of an old Ms. column!), we’ve scoured the most trusted journalistic sources—and, of course, our Twitter feeds—to bring you this week’s most important news stories related to health and wellness.

In this edition: World leaders pledge to donate a billion vaccine doses and recommit to cutting down on carbon emissions; the Supreme Court dismisses the latest challenge to the Affordable Care Act in a 7-2 decision; a federal district court struck down North Carolina’s 20-week abortion ban; and there is a growing vaccination gap between wealthy and poor countries.

The G7 Summit: Solving Policy Issues with BBQ and Jet Planes

+ The G7 Summit is supposed to be a three-day event where seven leaders from the world’s most advanced economies gather to discuss pressing policy issues. The participating countries included the U.K., Canada, France, Germany, Italy, Japan and the U.S. The European Union also sent the presidents of the European Commission and the European Council. Australia, India and South Korea were also invited to attend this year.

The global pandemic and the ongoing climate crisis were prioritized in discussions, but some critics felt the outcome of these discussions fell short. World leaders pledged to donate a billion vaccines over the next 12 months to COVAX—an international vaccine fund—and reaffirmed their commitment to reach net zero greenhouse gas emissions by 2050. The group also approved a U.S. proposal to institute a 15 percent minimum tax on large multinational corporations that seek relocation to tax haven countries.

Environmental activist Greta Thunberg criticized the participating members of the G-7 summit: “The climate and ecological crisis is rapidly escalating … but the G-7 leaders really seem to be having a good time presenting their empty climate commitments and repeating old unfulfilled promises.”

China was notably absent from the summit and not at all pleased by their lack of invitation. A spokesman from the Chinese Embassy in London was quoted in Reuters saying, “The days when global decisions were dictated by a small group of countries are long gone. We always believe that countries, big or small, strong or weak, poor or rich, are equals, and that world affairs should be handled through consultation by all countries.” On Sunday, the G7 leaders admonished China’s blatant disregard for Hong Kong’s autonomy and criticized the state of human rights in the Xinjiang province.

The Supreme Court Protects the Affordable Care Act

The Weekly Pulse: G7 Pledges Billion Vaccines to Combat Growing Vaccine Gap; SCOTUS Protects Obamacare; N.C. Anti-Abortion Law Blocked
Rally in Support of the Affordable Care Act at the White House in February 2017. (Wikimedia Commons)

+ The Supreme Court dismissed the latest challenge to the Affordable Care Act in a 7–2 decision on Thursday. Opponents of the ACA argued that the “individual mandate,” a penalty removed by Congress in 2017, meant that the entire law was unconstitutional. According to Robert Barnes, a writer at the New York Times, the case posed three questions:

“Do the challengers have legal standing to bring the challenge? Did changes made by Congress in 2017 render unconstitutional the ACA’s requirement for individuals to buy insurance? And if so, can the rest of the law be separated out, or must it fall in its entirety?”

Ultimately, the Supreme Court decided the Republican-led states challenging the Affordable Care Act did not have legal standing. Dismantling the entire law would have ended provisions such as keeping young adults on their parents’ health insurance, and ensuring coverage for those with preexisting health conditions.

Repro Run Down: The Medication Abortion Reversal Myth

+ A federal district court struck down a North Carolina anti-abortion law that would ban abortion after 20 weeks of pregnancy. The court cited Roe v. Wade in its decision, stating that pre-viability laws interfere with a woman’s right to an abortion. U.S. District Judge William L. Osteen, Jr. wrote: “State law cannot impose an outright ban that prevents a woman [from] choos[ing] to have an abortion before viability.’” Over the years, North Carolina has imposed numerous medically unnecessary restrictions on abortion such as mandatory counseling and ultrasounds, and abortion clinics must meet “burdensome” standards.

+ California attempts to make abortion cheaper as other states make it harder to access abortion. California lawmakers are currently debating a bill that would cancel any out-of-pocket costs such as co-pays or payments towards deductibles for abortion procedures and counseling. The bill would apply to most private health insurance plans. For low-income individuals the cost of an abortion can be burdensome and the cost only rises as a pregnancy progresses. “The moment that a person finds out that they’re pregnant, the clock is ticking, as well as the meter,” said Fabiola Carrión, a senior attorney with the National Health Law Program.

+ A recent report by NARAL details how anti-abortion laws not only threaten a woman’s reproductive freedom, but also threaten a woman’s economic stability. Abortion is already expensive, but restrictions on abortions only further discriminate against low-income women. Some states have passed laws that force women to delay their abortion, and some women choose to delay their abortion to save money but the longer a person waits to get an abortion the more expensive it becomes. Nationally, 65.5 percent of people get an abortion within the first eight weeks of pregnancy. The average cost of medication abortion under 10 weeks of pregnancy is $550. But the cost of a surgical abortion or an abortion at the hospital is significantly more expensive. And this cost does not cover transportation, hotel stay, child care or missed work.

However, the cost of getting an abortion and all that comes with it does not compare to the expense pregnant people pay when they give birth or raise a child until the age of 17. In Missouri, for example, the cost of having an uncomplicated vaginal birth with insurance is $6,327.80 and $10,871.98 without insurance. In a two-child family with before-tax incomes below $59,000, the average annual expenditure for each child is between $9,330 and $9,980. Sometimes the decision to start a family is less about individual beliefs and more about financial capability. In the United States, some people cannot afford to give birth or raise a child every time they become pregnant. At its center, abortion rights have always been a class issue.

NARAL quotes 33-year-old Jamie from Central Missouri:

“I would not have the life I have today were it not for being able to access an abortion. After having my abortion I was able to graduate nursing school, get off welfare, buy a home, pay my own bills, and spend more time with my kids. I don’t have to rely on anyone else now. Being able to have an abortion when I needed it helped me get here.”

+ Combating attacks from anti-abortion lawmakers, pro-abortion advocates have re-introduced the Women’s Health Protection Act (WHPA) to Congress. WHPA has gained ample support in the House and Senate with a list of 176 original co-signers that is still growing. The bill would codify abortion rights into law regardless of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, and because federal law trumps state law, WHPA would counteract the wave of anti-abortion legislation sweeping through the United States.

On Wednesday, the Senate Judiciary Committee Subcommittee on the Constitution led by Senator Richard Blumenthal (D-Conn.) and Ranking Member Senator Ted Cruz (R-Texas) held a hearing on the Women’s Health Protection Act. The hearing featured testimony from abortion advocates Michele Goodwin, professor of law at UC Irvine and host of the Ms. podcast; Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health and abortion provider; and Tohan, a storyteller from Texas.

Clockwise from top: Dr. Michele Goodwin, Sen. Richard Blumenthal and Dr. Jamila Perritt.

At the hearing, Tohan shared her experience getting abortion as a domestic abuse survivor and an immigrant woman:

“My name is Tohan, I am a mom, a daughter, an immigrant and a preacher’s kid and I have had an abortion… I realized that I was pregnant, and I felt it in my bones that I could not continue with this pregnancy. … Like most people with a child, I know what pregnancy feels like and I know what it is like to raise a child… We need a law to protect us against medically inaccurate laws. I am thankful for my abortion because it allowed me to leave my abuser, care for my son and move on with my life.”

+ Connecticut passed a new state parentage act, to legally recognize parent-child relationships outside of “traditional” heterosexual families—including unmarried couples, LGBTQ+ and those using reproductive technology to conceive. Under the previous parentage act, the non-birthing parent would sometimes not be listed on the child’s birth certificate and would have to go through a lengthy and expensive adoption process to be recognized as a parent. Connecticut is one of many states that has updated its parentage code, but there are still states that discriminate against non-traditional heterosexual families.

+ Courts block laws in North Dakota, Tennessee and Oklahoma that would require physicians to inform patients about a medication abortion reversal procedure that does not exist. There is no evidence to suggest that doctors have a safe method of reversing a medication abortion. The intention of these laws are not to provide abortion patients with medically sound advice, but to spark doubt in their decision.

In Oklahoma, physicians could be charged with a felony if this misleading information is not relayed to the patient and Tennessee health clinics could be fined up to $10,000 if they do not broadcast this information with signs in the office. In the North Dakota case, Judge Daniel Howland wrote,

“State legislatures should not be mandating unproven medical treatments or requiring physicians to provide patients with misleading and inaccurate information. The provisions of [this law] violate a physician’s right not to speak and go far beyond any informed consent laws addressed by the United States Supreme Court, the Eighth Circuit Court of Appeals, or other courts to date.”

+ Chinese birth control policies will cut up to 4.5 million births of Muslim minorities living in the country’s Xinjiang province. China has been criticized by the international community for blatantly disregarding the human rights and fundamental freedoms of the Uyghur community. China has defended its use detention centers, and says they are a part of, “anti-terrorism and de-radicalization efforts in Xinjiang in accordance with the law to protect people’s lives.” But many countries, including the United States, have called the detention centers and birth control policies an ongoing attempt at genocide.

In a study on birth control usage throughout the province, researchers concluded that “a smaller ethnic minority population will also be easier to police, control and assimilate.” Though China denies imposing forced sterilization on women, new research by Adrian Zenz, a researcher at the Victims of Communism Memorial Foundation, concludes that Xinjiang authorities subjected 80 percent of women of reproductive age to invasive birth control surgeries like IUDs or sterilization.

+ Jacqui Palumbo, a writer from CNN, released an article detailing new, innovative designs that help tackle women’s health issues. The designs are finalists for the 2021 Index Award, a project that celebrates innovative thinkers who “design to improve life.” The Hegenberger Speculum is a tool used by midwives to easily stitch premium tears. The premium is the space between the vulva and the anus, and it often tears during childbirth.

Another invention, called Oui, could revolutionize the field of birth control. Oui is less invasive method birth control that can be inserted before sex and lasts up to five hours.

Finally, Antya Waegemann designed a rape test kit that is easier to use and includes an app that outlines step by step instructions on how to use it. “The designs I have created of course consider the entire system … but they are really about taking an entire process that is designed to exclude victims from taking control and seeking justice, and re-designing the aftermath,” said Waegemann.

COVID-19: The Growing Vaccine Gap

+ Time to log out of Zoom and ditch the sweatpants because the Biden administration is scaling back COVID-19 workplace protections. Last Wednesday, the administration updated its optional guidance policies for general industry and only employees in health care settings will be required to wear masks. Although the administration feels this guidance is in accordance with CDC recommendations, unions are pushing for more expansive workplace protections. Sonia Singh, co-director of the Food Chain Workers Alliance, a coalition of organizations fighting for better wages and working conditions in the food industry, said,

“We’re still hearing from many food workers that their jobs are not safe…We’re still seeing big percentages of essential worker populations for various reasons not able to access the vaccination that we know is so critical.”

+ On Tuesday, California rescinded most mask rules for vaccinated people and ended capacity restrictions for businesses. Vaccinated people will still be required to wear masks on public transit like at airports, or on buses, trains and subways.

A person is considered to be “vaccinated” after receiving both doses of the COVID-19 vaccine. Unvaccinated people will still need to wear masks indoors as required by the California Department of Public Health, but unvaccinated employees might be provided with additional N95 masks for work. Most businesses aren’t required to check vaccination status of mask-less customers, but they do have the option to implement a vaccine verification system. If businesses are still wary about potentially having mask-less unvaccinated patrons in the store, they can require patrons to wear masks.

On Monday, Newsom announced the state was working on an electronic version of the vaccination records. “A lot of people have vaccination cards- you got to a big concert, you’re doing a large indoor event with thousands of people. The event may say: ‘We just want to make sure you’re verified as vaccinated,’” said Newsom, “This will just simply be a digitized version. It’s not a passport. It’s not a mandate.”

+ COVID cases spike in China as the deadly Delta variant continues to spread. Doctors suggest the Delta variant is more contagious than other variants and patients are more likely to become severely ill. This is not new news to the international community as Britain and Brazil reported similar trends. The Delta variant first emerged in India and has quickly become the dominant variant in Britain. China has not indicated how many vaccinated people have become infected, but this surge of COVID cases will likely test the efficacy of China’s new vaccine.

+ As vaccination rates slow in the U.S., top health experts are concerned the U.S. will not have a sufficiently vaccinated population to combat the spread of the Delta variant. Dr. Fauci said, “In the U.K., the Delta variant is rapidly emerging as the dominant variant…It is replacing the B.1.1.7,” Fauci said. “We cannot let that happen in the United States.” Originally, President Biden wanted 70 percent of the U.S. population vaccinated before July 4, but that goal is a bit out of reach. Only 63.4 percent of the adult population has received one dose of the vaccine, and 53 percent of all U.S. adults are fully vaccinated. 

+ African countries are in desperate need of more vaccines. South Africa, the continent’s most robust economy, has only vaccinated 0.8 percent of its population and is facing the highest number of COVID cases in the continent. Nigeria is Africa’s biggest country with a growing population of 200 million people, but only 0.1 percent of people are vaccinated. The World Health Organization estimates that the continent needs 700 million vaccine doses, but vaccine shipments have stopped. Poorer countries are struggling to vaccinate their populations because countries with richer economies, like the United States and Britain have hogged a significant portion of the vaccine supply. As previously mentioned, world leaders at the G-7 summit have committed to donating one billion vaccines to COVAX but this “unified” effort to share vaccines with the rest of the world should have happened much earlier. Frenda Shamam, a South African woman who is in charge of elderly homes, perfectly summarized this issue when she said, “It really highlights the biggest problem…the haves and the have-nots.”

+ There is a significant wealth gap between countries that have a surplus of vaccines, and countries experiencing shortages. The United States funneled billions of dollars towards the research and development of COVID-19 vaccines on the condition that Americans would receive the vaccine first. Wealthy nations had funds necessary to pre-order the vaccines for their respective populations, but this created a backlog of orders that prevented poorer countries from accessing vaccine doses. Local vaccine manufacturers may be the solution to vaccine shortages in poorer countries. For example, The Serum Institute of India has contracts for large quantities of AstraZeneca and Novavax vaccines. “India gets priority because it’s my home country,” Adar Poonawalla, the company’s chief executive, said in an interview. Even some wealthier countries are experiencing delays in vaccine supply due to high demand and manufacturing issues.

+ 60 million doses of the Johnson & Johnson vaccine cannot be used because of possible contamination. The FDA will allow 10 million doses of this batch to be distributed to the United States and other countries with a warning that regulators cannot guarantee that the manufacturers at Emergent BioSolutions followed proper manufacturing policies. Emergent has since been closed and is currently awaiting a directive from regulators as to whether they can reopen. 100 million doses of Johnson & Johnson and at least 70 million doses of AstraZeneca were put on hold after it was discovered that workers contaminated a Johnson & Johnson batch with ingredients used in AstraZeneca.

+ The latest COVID-19 vaccine, Novavax, has demonstrated an overall efficacy rate of 90.4 percent in the last of a three-phase trial. The efficacy rate is comparable to both the Pfizer and Moderna vaccines. But the vaccine is not expected to drop any time soon because the company plans to apply for an emergency authorization from the Food and Drug Administration (FDA) at the end of September. Pfizer, Moderna and Johnson & Johnson all elected to get emergency authorizations for their vaccine—a process that would circumvent the FDA’s full authorization process—but it is possible the agency may require new vaccine companies like Novavax to apply via the traditional route. With three different vaccines already in use and high vaccination rates amongst the U.S. population, it is likely Novavax will be used in other countries or used in the U.S. for booster shots. 

+ Children as young as six months old may be eligible to receive a COVID-19 vaccine in the fall. Pfizer and Moderna are now testing vaccine efficacy in children under the age of 12. Children are less likely than adults to develop severe illness following COVID-19 infection, but doctors are seeing rare cases of multi-system inflammatory syndrome in children. Multi-system inflammatory syndrome has been linked to COVID-19 and can affect multiple organs including the heart. Dr. Bill Gruber, a senior vice president at Pfizer said, “We take a deliberate and careful approach to help us understand the safety and how well the vaccine can be tolerated in younger children.”

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About

Kristen Batstone is a senior at American University studying women, gender, sex and sexuality studies with a specialization in social sciences. She is currently the health policy intern for the National Women's Health Network in Washington, D.C.

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