With Dan Goldberg

PROGRAMMING NOTE: We'll be off for Thanksgiving this Thursday and Friday but back to our normal schedule on Monday, Nov. 29.

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Quick Fix

— Most Americans can now get booster vaccines, though federal officials aren’t pushing young people just yet.

— New Covid surges signal a bleak winter with cases averaging close to last years’ rate.

— FDA says releasing thousands of Pfizer documents could take decades, pressing for a solution with transparency advocates.

WELCOME TO MONDAY PULSE and a short week ahead of the Thanksgiving holiday. Send tips and favorite recipes to [email protected] and [email protected].

Driving the Day

YOU SHOULD GET YOUR BOOSTER, IF YOU WANT — Federal regulators on Friday green-lit booster shots for American adults, opening the door to millions of new vaccine rounds — and the potential to clear up some booster confusion.

The CDC’s independent vaccine advisers voted unanimously to allow all adults to get an additional Pfizer or Moderna shot, hours after the FDA authorized broad booster dosage. The panel said all American adults “may” opt for a booster depending on their individual benefits and risks, while those 50 and older “should” get boosted.

The wording walks a line between making age-based recommendations and acknowledging scarce data on the benefits of boosting young and otherwise healthy adults, POLITICO’s Lauren Gardner writes.

… But a fresh round of questions have emerged. The new recommendations are intended to address what many states have said when leapfrogging the federal government on booster access: Earlier criteria were so confusing that even eligible individuals weren’t scheduling their shots.

“The pursuit of precision creates confusion,” said Nirav Shah, the head of Maine’s CDC and a committee member. Several panel members acknowledged criticism from outside experts and even governors — like Colorado Democrat Jared Polis — of the government’s pace on making booster calls.

And yet another question looms: When will they revise the recommendation to strongly urge all adults down to age 18 to get boosted?

“I feel like we’ve had a moving goal post here,” said committee member Lynn Bahta of the Minnesota Department of Health.

COVID CASES CLIMBCoronavirus cases are rising once again, disrupting classrooms, overwhelming hospitals and alarming public health officials — even in areas with high vaccination rates — who warn the country is headed for a holiday surge that could leave thousands dead.

Over the last two weeks, cases across the country are up nearly 30 percent. Though nearly 70 percent of the country has had at least one shot and hospitalizations have fallen from their September highs, the news in many states remains grim, and the trend lines portend a fresh wave in the coming weeks.

The latest Covid surge is particularly concerning to health officials because holiday travel is expected to exacerbate the problem as it did last year when Thanksgiving and Christmas gatherings fueled a record number of new infections and led to more than 100,000 deaths in January.

The hope was that this year would be different. In addition to vaccines, effective treatments, such as monoclonal antibodies, can significantly reduce the chance of hospitalization and death.

Yet, the country is averaging more than 1,100 deaths a day — almost the same tally as last year at this time before the vaccines had been authorized.

SCOTUS WATCH: ABORTION CALL LOOMING — The Supreme Court could release opinions today, setting up for a move on the controversial Texas abortion ban. While it would be earlier than expected for the court to weigh in on Texas’ six-week abortion ban, an opinion today could help lawyers laying out arguments for a Dec. 1 hearing on Mississippi’s ban.

The high court could refuse to halt Texas’ limit or rule against it and block enforcement of the measure that would effectively block abortions in the state.

FDA: WE NEED 55 YEARS TO FILL THIS FOIA — The Food and Drug Administration told a court last week it could meet advocates’ demands for Pfizer coronavirus vaccine documents — in five decades or so.

The agency laid out the timeline in a document filed with the U.S. District Court for the Northern District of Texas roughly a month after the plaintiffs — dozens of scientists calling themselves Public Health and Medical Professionals for Transparency, filed suit to expedite their Freedom of Information Act request centered on the vaccine’s approval.

The FDA hasn’t yet provided any of the more than 320,000 pages it estimates are linked to the request and argues the plaintiff’s March deadline request is simply unworkable.

“Reviewing and redacting records for exempt information is a time-consuming process that often requires government information specialists to review each page line-by-line,” DOJ lawyers argued.

Add that to a small staff and significant FOIA backlog, and the FDA says it needs to work on a rolling basis. The agency is pushing to issue 500-page portions of the request a month instead.

Coronavirus

BIDEN’s VACCINE COORDINATOR DEPARTS — President Joe Biden’s coronavirus vaccine coordinator is leaving the administration, in the highest-profile departure yet from the White House’s Covid-19 response team.

Bechara Choucair, who was among the administration’s first Covid-19 appointees, is stepping down today after more than 10 months spent managing the nation’s vaccine rollout, three people with knowledge of the matter told Adam and Alex Thompson.

“Dr. Choucair is returning to the West Coast after staying longer than originally planned to help lead our country’s COVID-19 response,” Jeff Zients, the White House’s Covid-19 response coordinator, said in a statement confirming the exit, touting Choucair’s “work to help state and local health officials across the country vaccinate their communities.

Choucair, who was previously an executive at Kaiser Permanente, will return to the private sector. The departure is the second in the last month for the Covid-19 response team; Clark Humphrey, the team’s digital director, left the administration in late October.

Choucair is not likely to be replaced, with the rest of the White House team picking up his responsibilities instead.

Biden’s Covid-19 testing coordinator also planning an exit. Carole Johnson is in line to become the director of HHS’ Health Resources and Services Administration, two people with knowledge of the matter told PULSE.

The appointment is not yet final, and Johnson does not have a set date for leaving the White House and joining HHS. But her selection would fill one of several senior positions at the department that have lacked a permanent appointee since Biden took office.

Johnson was named to Biden’s Covid-19 team last December alongside Choucair, Humphrey and a slew of others. She has since managed the administration’s efforts to ramp up testing and a series of other initiatives, including the surge response teams deployed this summer to help tamp down Delta outbreaks.

HHS did not respond to a request for comment.

On the Hill

ANTI-BBB AD CAMPAIGN AGAINST AT-RISK DEMS — The Koch-backed Americans for Prosperity is launching a seven-figure ad blitz targeting vulnerable House Democrats who voted for the reconciliation bill late last week.

The group’s ad buys will target more than a dozen House Democrats facing tight reelection races next year, hammering the lawmakers over rising inflation, POLITICO Influence reported last week. That includes representatives in Florida, New Jersey, Iowa, Texas, New Hampshire, Virginia, Arizona and Pennsylvania.

“Prices have skyrocketed,” says one ad targeting Rep. Stephanie Murphy (D-Fla.). “Families feel it every day. Congresswoman Murphy just voted for the Biden-Sanders plan that will make things worse. Trillions in government waste. Tell Congresswoman Murphy their vote will make life harder and more expensive.”

Veterans

VA STATS SHOW DEVASTATING COVID TOLL — Veterans Affairs reports that roughly 1,498 nursing home residents and 54 staff died of complications related to the virus since late May 2020, a number likely to rise as missing data comes in from hard-hit states.

The first batch of sobering numbers comes almost a year after Congress passed a law requiring disclosure of Covid-19 deaths in veterans’ homes, POLITICO’s Joanne Kenen, Darius Tahir and Allan James Vestal report. That partial toll is even higher than the 1,394 resident deaths and 40 staff deaths POLITICO had been able to tally based on the more limited figures available last summer.

For months, the VA has insisted it had no legal obligation to give a home-by-home breakdown on death and infection — although nothing had stopped the agency from doing so voluntarily, as some states have done. It changed that policy Thursday.

Citing pressure from Congress, the VA said that state homes will have to report “COVID-19 related information” to both the VA and the CDC, and the veterans agency will in turn start making it publicly available week by week.

Around the Nation

WHY CALIFORNIA KEEPS VOTING ON KIDNEY DIALYSIS — For the third straight election cycle, California voters are being asked to make complex decisions about kidney dialysis.

The last two dialysis initiatives failed resoundingly. But for the union behind the bids, victory at the ballot box may not be the point, POLITICO California’s Victoria Colliver writes.

What’s happening: Dave Regan, who leads SEIU-United Healthcare Workers West, acknowledges he’d like the union to represent the kidney dialysis workers at the companies that own the bulk of the state’s clinics, DaVita and Fresenius Medical Care. But he insists that isn’t why his group has backed the series of measures, which have cost those companies at least $216 million to fight.

“We obviously are a health care union. Would we like to represent dialysis workers? Sure. Is that why we’re doing this? No,” he said in an interview this month.

Kidney dialysis is big business. The state’s 600 clinics serve about 80,000 patients a month, and they employ thousands of workers. The road to organization is challenging, with corporate-run clinics scattered throughout the state, each employing fewer than 30 workers at each site.

What We're Reading

A divisive British scientist was central to the AstraZeneca vaccine development but earned ire from peers questioning its data, Gregory Zuckerman writes in an upcoming book excerpted in The Daily Beast.

Anthony Fauci received thousands of angry messages after a media campaign led by animal health advocates who falsely accused his institute of inhumane experiments on beagles, The Washington Post’s Yasmeen Abutaleb and Beth Reinhard.

Cities around the world are grappling with piles of new kinds of waste — discarded personal protective gear like thousands of masks, Jessica Leigh Hester writes in The New York Times.

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