| Welcome to Wednesday's Health 202 — since March Madness will soon come to a close, we want to know: Duke or UNC? Send tips and who you're rooting for to rachel.roubein@washpost.com. Today's edition: BA.2 is now the dominant version of the coronavirus, the virus inches closer to President Biden and the latest on the effort to get more covid-19 aid. But first … | A second booster shot is getting less fanfare |  Federal health officials have signed off on a second booster for people 50 and over. (Scott Olson/Getty Images) | | | Older adults are now eligible for a second booster shot. But don't expect a massive surge of people rushing to secure an appointment. To strengthen waning protection, the Food and Drug Administration greenlit another dose of the Pfizer-BioNTech and Moderna vaccines for people 50 and older at least four months after their first booster. The Centers for Disease Control and Prevention quickly updated its guidance yesterday to allow for the second booster, but didn't explicitly say all eligible individuals should go out and get the shot. CDC Director Rochelle Walensky pinpointed people 65 and over — as well as those 50 and older with underlying medical conditions — as "most likely to benefit from receiving an additional booster dose at this time." The big question: How many people will run out and get another shot? | - "I will offer it to people," said Sterling Ransone, the president of the American Academy of Family Physicians who practices in Deltaville, Va. "I think some will jump on it. Some will wish to wait and see where the [coronavirus case] numbers are going nationally."
| | Robert Califf, FDA commissioner: |  | | | | | Uptake of the first booster shot has been slower than desired, with a top FDA official yesterday urging Americans to get the extra dose, our colleagues Carolyn Y. Johnson and Lena H. Sun note. | - About 15 million people 65 and older — about one-third of the age group — are fully vaccinated but haven't gotten a booster.
- Only about 40 percent of people between 50 and 64 have received their first booster.
| | And when it comes to another shot … multiple doctors described a relatively newer phenomenon, where some patients say they may wait for cases to begin surging again or for a life event — such as traveling — before getting an extra dose. | - "It's not vaccine hesitancy, it's vaccine strategy," Janis Orlowski, the chief health care officer for the Association of American Medical Colleges, told The Health 202.
| | There's a debate among outside experts about who should get a second booster. Many scientists who support a fourth dose for some older adults see little proof that those under 60 or even 65 would clearly benefit. The evidence is based largely on data from Israel — and it's limited and mixed. | - "The primary benefit of a fourth shot is thought to be protection against severe illness, and that risk can vary dramatically among people 50 and older. Not all experts are convinced the benefits are clear," Carolyn and Lena write.
| | The argument for the first booster dose was "more compelling," said Robert Wachter, the chair of the medicine department at the University of California at San Francisco, who believes federal officials made the right decision. The omicron surge presented a "clear and present danger" — and even then, broad swaths of the population didn't get the extra dose. The confusion around the second booster means doctors will likely be tasked with helping their patients decide what to do. For George M. Abraham — the president of the American College of Physicians — that means encouraging some patients with health conditions to go ahead with the second booster. For those who are hesitant, he would tell them it's fair to wait. But if coronavirus cases go up, or if a patient becomes increasingly at risk due to travel or a change in their health, then the decision can be revisited. | | White House officials have said the country has exhausted funds to buy a potential fourth vaccine dose for all Americans. But on whether there's enough vaccine supply for those 50 and older to get a second booster? Federal health officials say yes. | - "We anticipate having enough current doses on hand right now," Dawn O'Connell, the federal health department's assistant secretary for preparedness and response, said at a news conference earlier this week. She added: The government doesn't have enough funds to buy new variant-specific doses if one is needed in a few months.
| | |  | Chart check | | BA.2 is now the dominant coronavirus variant in the U.S. | | The omicron subvariant BA.2 has emerged as the dominant coronavirus strain circulating in the country, accounting for roughly 55 percent of new cases, according to CDC data released yesterday. | | Here's a snapshot of where we are now: Daily reported cases fell 6 percent nationwide in the past week and declined to last summer's lower levels. However, that's likely an undercount, since many results of rapid tests aren't reported. | | Meanwhile, the seven-day average of coronavirus deaths across the United States — fewer than 750 each day — is back to levels virtually not seen since last summer. But yet … It's still too early to say what the impact of BA.2 will be. Disease experts can't say for sure whether or when another wave could come. | | |  | White House prescriptions | | The coronavirus inches closer to Biden as restrictions fall |  President Biden meets with Ukrainian refugees during a visit to Poland last weekend. (Evan Vucci/AP) | | | After years of modeling strict precautions, President Biden is now at a higher risk of contracting the virus, experts say. Over the last two weeks, the coronavirus has crept closer to Biden, disrupting the White House even as the administration has begun relaxing strict pandemic measures, The Post's Annie Linskey reports. For instance: Two high profile White House officials, second gentleman Doug Emhoff and one foreign leader have all tested positive for the virus over the past two weeks. Experts say that because the 79-year-old president is vaccinated against the coronavirus, has received a booster dose and is not immunocompromised, an infection would be less severe. In upcoming weeks, Biden is expected to amp up his domestic travel, which could put him in contact with more people. Some infectious-disease specialists, like Céline Gounder, who served on Biden's coronavirus advisory board during the presidential transition, said boosting the president more frequently might be advisable — even if it isn't recommended for the general public. | | |  | From our notebook | | | The latest on more coronavirus aid: Negotiations are ensuing between Senate Majority Leader Chuck Schumer and Sen. Mitt Romney (R-Utah). Last night, Schumer filed cloture — a procedural move — on legislation that could be used as a potential vehicle for the Senate to be able to quickly consider more funds if a deal is reached. Yesterday morning, Schumer said on negotiations with Republicans: "We are not there yet on reaching an agreement but we are going to keep working in good faith to get there." Republicans, such as Romney, have demanded that any new dollars be fully paid by repurposing unused funds from prior covid-19 packages. Asked yesterday about negotiations, Romney said "we're making good progress." | - "We're asking for the [Congressional Budget Office] to provide scoring on various categories of money that are unspent because we want to make sure that we have actual savings," Romney said.
| | |  | Coronavirus | | The Biden administration will start vaccinating some migrants at the border |  Migrant children along the U.S.-Mexico border are seen with adults as they wait in line to get a coronavirus test. (Julio Cortez/AP) | | | The Biden administration will begin requiring coronavirus vaccines for undocumented migrants from seven areas along southwest border, the New York Times reports. The policy shift comes days before the administration's next review of a Trump-era pandemic order that allowed authorities to turn away migrants seeking to enter the country. | - The decision to begin vaccinating some undocumented migrants seems to suggest there are other measures that can be done to curb the spread of the coronavirus across borders.
| | The details: The Department of Homeland Security will initially provide up to 2,700 coronavirus vaccines per day, with the goal of increasing the amount to 6,000 daily by the end of May, CNN reports. | - If single adults refuse the shot, they will be detained and deportation proceedings will commence, according to directions given to senior security officials Sunday, per NYT.
- If they request asylum and can't remain in detention, they'll be released with a monitoring device "with stringent conditions." Same goes for migrant families who decline the shot.
| Last military medical coronavirus deployment ends | | Since the early days of the pandemic, medical military personnel have been deployed to assist overwhelmed health facilities across the country. Yesterday, the final Department of Defense medical team ended its mission, CNN reports. Nearly 5,000 personnel have been deployed across 49 states and territories to help since 2020, according to the White House. They were charged with everything from administering vaccinations to helping with the pandemic response in communities hit hard by delta and omicron. "At this point, we don't have requests coming in for our teams, so we're able to draw down the last team," Natalie Quillian, the White House's deputy coordinator of the covid-19 response, told CNN's Jacqueline Howard. But "we stand ready if we see another surge." | | |  | In other health news | | - Americans who received the one-shot Johnson & Johnson coronavirus vaccine should get a booster dose of either Pfizer-BioNTech or Moderna's vaccine to be better protected against serious illness, Lena reports, citing CDC data released Tuesday.
- A cohort of 21 mostly Republican-led states sued the Biden administration to end the federal mask mandate on transportation, per The Post's Lori Aratani.
- Our colleague Katie Shepherd has a deep dive out on the experience of disabled Americans and the 6 in 10 people living with a chronic illness in the United States who have struggled to get medical supplies amid global shortages and supply chain disruptions caused by the pandemic.
- Kentucky lawmakers sent a 15-week abortion ban to the state's Democratic governor, as the Supreme Court considers whether to allow a similar Mississippi law to go into effect, the Associated Press reports.
| | |  | Sugar rush | | | Thanks for reading! See y'all tomorrow. | |
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