131: ASTHO Reacts to New COVID-19 Plan

Mike Fraser, ASTHO’s CEO, issues a statement offering early reaction to the Biden Administration’s new National COVID-19 Preparedness Plan; Dr. Elisha Hall, Clinical Guidelines Lead for the CDC’s Vaccine Task Force, explains the latest...

Mike Fraser, ASTHO’s CEO, issues a statement offering early reaction to the Biden Administration’s new National COVID-19 Preparedness Plan; Dr. Elisha Hall, Clinical Guidelines Lead for the CDC’s Vaccine Task Force, explains the latest recommendations regarding suggested intervals for first and second doses of COVID-19 mRNA vaccines for some people; and Dr. Marcus Plescia, ASTHO’s Chief Medical Officer, says the pandemic has everyone thinking about the social determinants of health and how to address health inequities.

ASTHO News Release: State and Territorial Health Leaders Look to Next Phase of COVID-19 Pandemic

White House: National COVID-19 Preparedness Plan

CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States

CDC: Interim COVID-19 Immunization Schedule for Ages 5 Years and Older

CDC: U.S. COVID-19 Vaccine Product Information

ASTHO YouTube: Heart Month Q&A with Marcus Plescia


ASTHO logo



This is Public Health Review Morning Edition for Friday, March 4th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


ASTHO is reviewing the Biden administration's National COVID-19 Preparedness Plan released this week in Washington. According to a statement from ASTHO CEO Mike Fraser, many elements in the plan reflect current state and territorial priorities, including work to increase vaccination rates, improve access to testing and therapeutics, and develop approaches that would avoid future business and school shutdowns.

Read what he says about the long-term outlook for the COVID-19 virus by clicking the link to the statement in the show notes.


Also today, the CDC recently offered new guidance regarding the time some people should wait between their first and second doses of a COVID-19 mRNA vaccine. Dr. Elisha Hall is the clinical guidelines lead for the CDC's Vaccine Task Force. She explains the new guidance in today's morning conversation.

What's the process for making a decision like this?


So, when we do this, CDC thoroughly reviews the evidence to date before making changes to vaccine guidance. In this case, we reviewed data on myocarditis and pericarditis, vaccine effectiveness, immunogenicity—or the antibody response to vaccines, and policies from other countries for an extended interval.

Then, we weighed the potential benefits and the potential risks. Specifically, the potential benefits were that an extended interval appears to reduce the risk of myocarditis and increase vaccine effectiveness of the primary series. On the other hand, the potential risk is that a longer interval means a longer duration of time where individuals only benefit from a single dose of an mRNA vaccine.

Additionally, we factor in the discussion from the Advisory Committee on Immunization Practices. Members reviewed the evidence and strongly supported an extension of the intervals between dose one and dose two of the mRNA COVID-19 vaccines.

And finally, we also collaborated closely with the Food and Drug Administration and other partners on this guidance.


Do states and territories need to adjust their vaccine messaging based on this update?


Many of the messages about COVID-19 vaccination are still the same. So, COVID-19 primary series vaccination is still recommended for everyone ages five years and older in the U.S. for prevention of COVID-19.

Getting up to date with COVID-19 vaccination remains critical to preventing illness and hospitalizations and deaths from COVID-19 and COVID-19 vaccines are safe and effective. COVID-19 has undergone—and will continue to undergo—the most intensive safety monitoring in U.S. history. Evidence from the hundreds of millions of COVID-19 vaccines already administered in the U.S. and the billions of vaccines administered globally demonstrate that they are safe and effective.

The only difference in the messaging is that unvaccinated people can now consider a longer interval of eight weeks between their first and second doses of an mRNA COVID-19 vaccine instead of three to four weeks. The interval between COVID-19 mRNA vaccine doses is best determined by considering the balance of risks and benefits based on the individual's age and health conditions.

And we'd also emphasize that, regardless of the interval between the first and second dose, data show mRNA vaccines remain highly effective at reducing the risk of hospitalization or serious complications from COVID-19 infection. It's also important to note that the millions of people who have already received their primary mRNA series at the three or four week interval remain well-protected, especially if they have gotten that booster dose.


What impact could this decision have on vaccine uptake?


Allowing more flexibility with the interval between the first and second dose may help increase uptake for the COVID-19 vaccine primary series—we believe especially for individuals and parents who, for instance, may have concerns about that small risk of myocarditis after vaccination.


You can read about the new CDC guidance using the link in the show notes.


Finally today, awareness is growing about the impact housing, good food, education, and transportation have on public health. That's according to ASTHO's chief medical officer Dr. Marcus Plescia. In comments made during a recent video to recognize Heart Month, Plescia said the pandemic is a big reason why there's so much attention on these and other social determinants.


I think our experience with the COVID pandemic and the profound inequities we've seen with that have really gotten everybody thinking about the fact that we can't continue to live together this way.

And so, I'm hoping we'll continue to see some improvements in those kinds of things, and that will ultimately make the difference in the disparities we're seeing.


You can watch the full video on ASTHO's YouTube channel. There's a link in the show notes.


That'll do it for today's newscast. We're back Monday morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great weekend.

Marcus Plescia MD MPH

Chief Medical Officer, ASTHO

Elisha Hall PhD

Health Education Specialist, CDC