COVID Booster Shot Meets Health Care Monopoly

This post is part of an occasional series on health care. Here’s the prologue to the series, which originally preceded the post below.

Here’s a fairly straightforward story from The New York Times from a few days back, reminding us of the fact that immunity from some of the COVID vaccinations is limited in time, and may well require a booster shot.

 WASHINGTON — Biden administration health officials increasingly think that vulnerable populations will need booster shots even as research continues into how long the coronavirus vaccines remain effective.

Senior officials now say they expect that people who are 65 and older or who have  compromised immune systems will most likely need a third shot from Pfizer-BioNTech or Moderna, two vaccines based on the same technology that have been used to inoculate the vast majority of Americans thus far. That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.

On Thursday, a key official at the Centers for Disease Control and Prevention said  the agency is exploring options to give patients with compromised immune   systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for the Pfizer    vaccine.

Skipping a bit:

Pfizer’s continuing global study of its clinical trial participants shows that four to six months after the second dose, the vaccine’s effectiveness against symptomatic infection drops from a high of 95 percent to 84 percent, according to the company.

As a (then) full-time hospital worker actively exposed to high concentrations of COVID, I got my second dose of the Pfizer-BioNTech shot on January 6. If the vaccine’s effectiveness definitely drops from 95% to 84% in four to six months, then I’m well past my due date for a booster. Though I’m no longer a full-time hospital worker, I’ve been waiting for twelve weeks now for the paperwork to go through on my bid to work per diem for Hunterdon Medical Center’s OR. Assuming it goes through, I’ll be back in the COVID-intensive environment I previously inhabited. And if it doesn’t go through, I intend to apply to do the same work at a different hospital. So one way or another, I intend to make my way back to hospital work, and (by implication) to re-immerse myself in COVID.

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Too Much Time on Their Hands: The Underemployment of Our Managerial Class

I keep hearing hand-waving stories from right-leaning members of our managerial class about how unemployment benefits are dampening the desire to work among rank-and-file workers. Let me give you a small glimpse into the work ethic of this same managerial class in my own case. I’ll leave you to decide, at least in this case, whose work ethic could use some improvement.

I’ve been writing here since October about the eight month gig I recently did working full time for Operating Room Environmental Services (OR EVS) at Hunterdon Medical Center in Flemington, New Jersey. About seven weeks ago, I gave notice at the hospital, telling both Surgical Services and HR that I would continue to work at HMC’s OR once a month as a per diem worker at the same rate as I’d earned before. They were delighted to hear it; OR EVS has been decimated by turnover, and was practically dying for weekend coverage. I could easily have insisted on a raise, but didn’t. This, by the way, for an institution that failed to give me bereavement leave after the unexpected death of my wife in March.

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Hospitals Are Not Safe: Infection, PR, and EVS

I get the need (I suppose) to see the bright side of things as expressed in this article on LinkedIn, especially after the misery of the COVID-19 pandemic. Hospital workers did great things during the pandemic, and can be justifiably proud about the good they did. But I wish I had thirty minutes with a hospital executive at the level of Mikelle Moore below, to give them a small dose of some realities with which they seem oddly unacquainted.

Adapting to Uncertainty, Learning on the Front Lines and Creating a Purposeful New Normal | AHA News

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Code Blue to Code Green: EVS, RCM, and Health Care

As many readers will know, I just spent the last eight months working full time for OR EVS at Hunterdon Medical Center in Flemington, New Jersey. About a week ago, I started a new job as a junior analyst in hospital revenue cycle management (RCM) with Aergo Solutions in Iselin, New Jersey. People have asked how I like my new job. Get back to me on that when I know what the hell I’m doing, since for now, I obviously don’t.

For now, I can only comment on the transition between the one job and the other. And the only comment I can muster is that I’m having trouble putting things in words. The difference between working for OR EVS and working for hospital RCM is so stark and abrupt that I’m inclined to think that you really have to experience it first-hand to know what it’s like. One day you’re working with fracture tables; the next day, you’re working with pivot tables. The two things have about as much in common as the two jobs themselves.

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EVS Journal (3): Mr Clean and the Politics of Disinfection

From an article in yesterday’s New York Times, “U.S. Regulators Find More Flaws at Plant Where Doses Were Ruined”:

WASHINGTON — Federal regulators have found serious flaws at the Baltimore plant that had to throw out up to 15 million possibly contaminated doses of Johnson & Johnson’s coronavirus vaccine, casting doubt on further production in the United States of a vaccine that the government once viewed as essential in fighting the pandemic.

The regulators for the Food and Drug Administration said that the company manufacturing the vaccine, Emergent BioSolutions, may have contaminated additional doses at the plant. They said the company failed to fully investigate the contamination, while also finding fault with the plant’s disinfection practices, size and design, handling of raw materials and training of workers.

The F.D.A. has not yet certified the plant, in Baltimore’s Bayview neighborhood, and no doses made there have gone to the public. All the Johnson & Johnson shots that have been administered in the United States have come from overseas.

The report amounted to a harsh rebuke of Emergent, which had long played down setbacks at the factory, and added to problems for Johnson & Johnson, whose vaccine had been seen as a game changer because it requires only one shot, can be produced in mass volume and is easily stored.

Right, “harsh rebuke.” As someone who works in the field–health-care environmental services (EVS), tasked with cleaning and disinfecting health care-related spaces–let me let you in on a little trade secret. If every health-care related facility were put under fine-grained regulatory scrutiny of the kind described in this article, the shortcomings ascribed to this one plant would suddenly become forthcoming just about everywhere you looked.

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