And we'll begin this afternoon with
remarks from Dr. Westergaard.
Good afternoon, I'm Ryan
Westergaard, I am the Chief Medical
Officer and the State Epidemiologist
for Communicable Diseases here at
the Wisconsin Department of Health
Services.
Thank you for joining us today and
happy to give an update on the
status of COVID-19 vaccine
availability in Wisconsin.
Today, the Wisconsin department
of health services or DHS has
issued recommendations related to
who should get the updated COVID-
19 vaccine.
Recommendations that are based on
our review of and our agreement with
science-based recommendations of
the American Academy of Pediatrics,
the American academy of Family
Physicians, and the American College
of Obstetricians and Gynecologists.
Evidence continues to show that
COVID-19 vaccines lower the
chance of severe illness across
age groups, which is especially
important for people who might be at
higher risk and the people who could
spread illness to them, such as
close family members and friends.
Because of the benefits of COVID-19
vaccination outweigh the
risks for almost all people,
DHS supports the recommendations of
our leading, of our nation's
leading medical associations who
recommend the vaccine be
available for individuals six
months and older during this fall
respiratory virus season.
In addition to these
recommendations, we've issued a
statewide standing medical order.
That allows pharmacists to
provide the COVID-19 vaccine to
those who want it without requiring
a prescription from a clinical
provider.
In the past, our nation's
medical associations and our
nation federal health agencies
who review the same data
have issued recommendations that
align with one another.
Today, that's not the case.
In the past several months, leaders
at federal agencies have
made policy decisions and
issued recommendations that aren't
supported by or directly contradict
scientific consensus.
These decisions may result in
limited access to the COVID-19
vaccine, which scientific
studies have continuously showed
lower the risk of illness,
hospitalization, and death for
people who choose to get them.
Our goal here in Wisconsin is
to ensure that healthcare providers
can use their expertise and their
compassion to talk with their
patients and help them make the best
recommendations that they can to
protect every person's individual
health needs.
We also want to ensure that
Wisconsin residents are aware of
the vaccine recommendations that are
based on broad scientific consensus
and to ensure families across
Wisconsin can access the
vaccines that for them.
The guidelines that we're discussing
today around the COVID-19 vaccines.
We will continue to monitor federal
actions around vaccine
recommendations and vaccine access
for other vaccines
and we will provide Wisconsin health
care providers and residents with
transparency on what we recommend.
I'll be happy to now take questions
from the group. Thank you.
And thank you and a reminder to
please stay on mute until it is
time to ask your question and
we'll begin this afternoon with Tony
Lang fellow from Fox 11 Tony.
Hi, this is Brian Burke with WLUK.
I'm filling in for Tony.
He's out and getting some other
parts of the story.
Hey, what are your thoughts on the
governor's executive order?
Can you explain the importance of
vaccines right now and their
availability?
Yeah, from my perspective as
a physician and someone who receives
a lot of questions about
availability of COVID-19
vaccines, the governor's executive
order did something that was very
helpful, which was to
direct our department, the
Department of Health Services, to
increase access for
vaccines at pharmacies through
issuing a standing order.
We've done standing orders standing
medical orders as a health
department in the past when we
wanted things to be accessible
without people having to go through
the process of making an appointment
with their clinician, which could
sometimes involve waiting period.
And in general, I mean, the policy
in Wisconsin and past has been that
that pharmacists can
can widely prescribe vaccines
if they're approved by the federal
government because there's been some
uncertainty around what the federal
Government has been has been.
Is going to recommend and has been
recommending.
We wanted to make sure that people
know that the science about
vaccines hasn't changed, that they
still are beneficial, and
if there's barriers put in place
by the lack of
consistency at the federal
government, that people in Wisconsin
can know they can go to a pharmacy
and get their vaccine.
So it made it hopefully clearer
for us to communicate.
Maybe not right this afternoon
because pharmacies need some time to
get things, to get organized and get
procedures in place.
But the issuance of the standing
order allows for pharmacists
to give COVID-19 vaccines
without concern that it hasn't been
explicitly recommended by
the CDC, which has been
a source of uncertainty recently.
Thank you. Now to Nick Boar
from WISN in Milwaukee,
Nick.
W-I-S-N in Milwaukee.
Okay, let's move on to Jason Colby
from Fox six Jason.
Yes, thank you for your time.
Um, have Wisconsin pharmacists,
I guess they've been, they've had
the vaccine now for about 10 days
or a week or so.
Have they been turning people
away that were under 65?
What has been going on for
the last week?
Did you say.
Yeah, thanks for the question.
We've heard that there's been
inconsistency across pharmacies.
As you know, there's multiple
commercial or retail pharmacy
chains.
There's also smaller pharmacies
that can
administer vaccines in
smaller communities.
And when we've informally polled
people in our professional networks,
family and friends, we have heard
people say that the vaccine is not
yet available for them and that
they're waiting for clarification.
So, our hope
is that with clarification here
at the state level.
The pharmacies will all be able to
move together to resemble
the practice of last respiratory
virus season, was that nearly
anyone could go get
a flu vaccine and a COVID
vaccine at their local pharmacy.
And so that is the goal of the
standing order, is to get to that
point. As for what has been the
practice, what we've heard in the
past 10 days, I
can't say that we can describe one
common practice. I think there's
been a lot of variability, and
that's one of things that we're
trying to help with with the
guidance and the standing order.
Thank you.
I forgot to mention at the onset
that we're taking one question to
start. And if we have time, we'll
come back around for additional
questions.
Our next question belongs to Sarah
Volpenheim from the Milwaukee
Journal Sentinel, Sarah.
Hi, thanks for taking my question.
So under the
ACA, whether or not
a health insurer is required to
fully cover a vaccine is
tied to the recommendations by the
ACIP and by CDC.
Do these actions by the state
do anything to require
that health insurers cover?
Annual COVID-19 vaccine and
has the state received any
assurances from insurance companies
that they will cover the vaccine
going forward?
Those are great questions.
Thank you for bringing them up.
They are not directly addressed by
the standing order that we're
talking about here from our DHS
agency, but there was
information, there was a directive
in Governor Evers executive
order yesterday that directed the
office of the commissioner on
insurance to issue a bulletin
about
requiring certain health insurance
companies to cover COVID-19
vaccines.
So I wish I could speak in a lot
more detail about that, but I'll
have to refer you to that department
or that office for the details on
exactly how that's going to be
implemented.
But that was part of the executive
action yesterday was to
acknowledge that there's also
uncertainty about which insurance
companies can and will
uh pay for COVID-19
vaccines. So this executive action
was an additional effort to
try to um to try,
to create consistency out of that.
So I would stay tuned um
for additional communication from
that office um
and hopefully things will become
clearer in the coming days.
I looked at the bulletin
that they issued, and it looked like
it was termed as guidance,
not a requirement.
Is that am I understanding that
right?
Or can you speak to that at all?
I think for the technical
answers
to those questions we have to follow
up with the Office of the
Commissioner.
Thank you. And let's move on to
Abigail Wandersee from the Badger
Herald. Abigail.
Hi, thank you so much for your time
today. I was just wondering
if you guys have any insight
into the likelihood of this
executive order facing
backlash in the medical field.
I know that there are some
scientists who are maybe
not so on board with some of the
peer-reviewed studies about the
COVID-19 vaccine, but I'm
just interested to see how DHS will
maybe tend with some of those
medical professionals.
Yeah, yeah, thanks Abigail for
that question.
So the
lack of consistency among
how public
health leaders and scientists are
interpreting the evidence on COVID
has been a major
issue for this year.
You know, respectfully, you
know, can disagree with
people who have different
interpretations of medical
literature.
So at the state level here
in our, our discussions that
led toward discussions around
doing the standing order and issuing
this guidance.
We felt it was important to not say
this is us as a health department
going alone and making
recommendations.
So we invoked
several activities of
professional organizations that
for many years have been in the
practice of issuing guidance
to groups of patients,
for example. And I mentioned at the
beginning that American Academy of
Pediatrics has for many years
issued a recommendation
schedule of children for whom
these vaccines or vaccines that are
recommended for the children.
There's a similar
professional organization called
American College of Physicians for
Adult Internal Medicine, the
American Academy of Family
Physicians, the American College of
Obstetricians and Gynecologists.
So how these professional
organizations work is that they are
comprised of experts and leaders in
their field. They review the
evidence and they make consensus
recommendations.
And unanimously, at least
all four that I've mentioned,
are giving the recommendations that
we're promoting through our
media messaging and reflected in
our standing order.
One step further is
that as the
disruption or the
changes that
were made to the ACIP,
the Advisory Committee on
Immunization Practices over the past
year, a private
initiative
of of
scientists and physicians have
reviewed the literature in the
same manner that the ACIP
has been accustomed to doing,
doing a systematic literature
review, synthesizing it at a
high level and searching
around the world for relevant
studies.
This was called the Vaccine
Integrity Project and is led at
the Center at the University of
Minnesota.
And that review also
was consistent with
what the professional
recommendations are.
So we feel comfortable that
what the recommendations that we are
uplifting and with our.
Are in our understanding
order are highly supported by
the medical literature and
we're happy you know we're have to
we want to be very transparent about
that when people to read the
studies.
Themselves and the vaccine integrity
project which has done this in a
transparent way has really enabled
the field and added another voice
for.
Sort of objective evaluation of
the published literature so we've
relied on that a lot and we have a
lot of confidence in it.
Thank you, Abigail.
Now to Sarah Lear from Wisconsin
Public Radio.
Sarah?
Hi, so some listeners might
wonder why it's important for them
to get the COVID vaccine again this
year. You know, let's say they
already got it last year, for
example, what's your message to them
about why it is important to get the
updated vaccine?
Yeah, the best example that people
may be familiar with is how we
recommend influenza vaccines.
So influenza vaccine like COVID
or the influenza virus like
the virus that causes COVID-19
are respiratory viruses that
infect the upper respiratory tree
and they spread around the
world, sometimes in
a seasonal pattern.
So we talk about respiratory virus
season in the fall and winter and
early spring when COVID
and flu and RSV are
circulating.
The other thing that these viruses
have in common is that they change
over time, they undergo slight
mutations.
If you recall back during
the emergency phase of the pandemic,
we were always discussing the new
variants, which had
nicknames with letters like B113
or the Delta variant or the Omicron
variant. So those are all the same
virus, but they were variations
of the virus because virus like
also organisms evolve over
time.
So what can happen with both
influenza and with COVID-19
is that over the course of a year,
enough evolution can happen that
the shape of the proteins on the
virus may not match the
antibodies that are simulated
by the vaccine, and therefore the
effectiveness might wane.
There are some vaccines that
we give that confer lifelong
immunity, but as a
rule, vaccines for respiratory
viruses need boosting every year,
both because the effectiveness
wears off and because these
viruses can change over
time.
So I would think about it in that
way, in the same way that we
recommend getting your flu shot
booster every year because the
flu that's coming around this year
might be slightly different than the
flu going around last year, we
recommend a COVID booster.
COVID hasn't been around nearly as
long as influenza, but so far
the evidence suggests that annual
updates to better match the.
The vaccine to the virus
boosts its effectiveness a bit,
so that's why we're recommending
those two reasons.
The protection can wane so much and
the virus has evolved in
slight ways, but the
experience from past
seasons says that they should
continue to work to prevent severe
disease, even if it's not a perfect
match.
Thank you. Now to J.R.
Ross from WISPolitics, J.
R.
I'm good so far, thanks.
Okay, thank you.
Now to Jennifer Kalfus from
the Wall Street Journal.
Jennifer?
Jennifer from the Wall Street
Journal.
Okay, we'll move on to Celia.
From the Sawyer County records,
Celia.
Hi there, thank you for taking my
question.
I was just wondering because given
sort of changes and recommendations
year to year from the federal
government as well as discrepancies
between the state and federal
guidance now, I'm wondering
what you think about how confusion
surrounding these eligibility
requirements might impact vaccine
uptake.
Thanks, Celia.
It's a great question, and
we're very concerned
that confusion around recommendation
will result in fewer
people getting vaccinated.
I think that's what most
people are confused about.
But in that environment,
we at the state level don't
have control over what
the policies are, the
recommendations at the federal
level. We, just
as I committed to doing what
I think is right for my patients, we
as a health department have to
continue to do what we think is in
the best interest of the
health of our state.
And our review of
the science suggests that
people should have access to
the updated vaccine,
and because changing policies
might make it more difficult for
people to get, we took this action
to try to enhance
access.
The key message that I want to
get out is that, and that our agency
wants to get out is, that vaccines
lower your risk, no matter who
you are.
They're most important for people
who are older and people who have
chronic health conditions.
But the science suggests that even
people who are younger and healthier
can expect to have a lower risk
if they take the vaccine.
So for that reason, our goal
is to encourage people to both
understand this and make
the decision.
We're not mandating anyone get a
COVID vaccine.
What we wanna do is make people
aware that it's beneficial and
they are available.
And that's what the goal of our
public messaging in our standing
order is to say that anyone
who decides that they
want to get a vaccine, anyone who's
talked to their physician and
says, I know I'm in a low-risk
group, but I want to one.
We want them to be able to get one
without a lot of difficulty.
But the short answer to your
question is we think
confusion around recommendations
is a challenge for public
health. And we're trying to do our
best by saying what we think.
Is best supported by the science,
but it's a challenging
environment to try to
communicate that right now.
Thank you. Now to Kimberly Weffel
from the Wisconsin State Journal.
Kimberly?
Hey, you know, if vaccinations
are not covered by insurance,
you know, what is the what is the
cost for some people?
Do you? And this may not be a
necessarily a question for you.
But if you have an estimate of what
the cost might be for people to get
the injections, that'd be helpful to
know.
Okay, probably more efficient is
to get back to you on that.
I could ballpark it, but then
it wouldn't be exactly right.
But it'd be also easy for us to look
it up and help you find
what the retail cost is for the
different for the, the
different products that are
available at retail pharmacies right
now. So why don't we do that?
Sounds good. Now we'll move on to
Todd Richmond from the Associated
Press. Todd.
I don't have anything, I'm good,
thanks.
Okay, thank you.
And to Shelly Nelson from
the Superior Telegram, Shelly.
You're very difficult to hear,
Shelly.
It's definitely, yes, I can.
What advice would you...
You said, what is my advice for
people who have learned that
their insurance will not cover the
vaccine?
Okay, thank you.
Well, I think the first
recommendation is to be patient.
We recommend that everyone get
the COVID-19 vaccine, but it's not
an emergency, right?
The virus will be here.
Circulating for the next
several months. In fact, it kind of
never goes away, but we expect
surges in the fall and
the action that we are taking
with the office of the commissioner
of insurance. We are hoping.
In fact, insurance companies that
maybe have not covered it will
eventually cover the insurance.
So I think that's the first lesson
is, or the first suggestion
is just to be patient
and not give up because
there are people at different levels
and agencies in the government who
are working to try to improve
access.
So if you are frustrated
the first time, we encourage
people to try again,
try to get more information.
At the end of the day, if...
It's not covered by insurance
and the out-of-pocket price
is
too high.
I think we're going to have to wait
and see if there are
programs where free vaccines
are available.
Traditionally, we've had programs
for adults and programs for
children from the federal government
to make vaccines available
for people
without insurance.
The availability of vaccines
to be covered in those programs is
in question right now.
We don't know the answers
for sure.
And there may be, we could be in a
situation where people have to make
the choice of spending out of pocket
or not getting the vaccine.
And we hope we can avoid that,
but we just have to, you know, folks
will just have be patient as we
work through the policy challenges
of making sure it gets covered.
Thank you and we do have time
for some additional questions.
We'll start at the top of the list
again with Fox 11 in Green
Bay Fox 11 another question.
I'm good, thanks.
Okay, WISN in Milwaukee.
Moving on then to Jason Kelby at
Fox 6.
The standing order refers
to this being
an off label usage.
Can you explain what that means off
label? Usage?
Yeah, I'd be happy to.
So the way that medic that
medicines and vaccines are
approved in in
this country is that the,
the FDA will
review the data from the
manufacturer.
Make and then make a decision, make
a decisions, whether to
approve it broadly
for large groups of patients or
approve it for people with limited.
With limited eligibility.
For example,
the vaccines that come with vaccines
that were in use just one year ago,
the FDA had approved them for
as appropriate to use
ages six months and older,
essentially for everybody.
So if the FDA
explicitly says this is approved for
this population, that's
considered an unlabeled.
Prescription or non-label
indication.
The way medicine is practiced in
this country though, is if the
FDA recommends
a medication for anyone,
if it's approved for a
limited number of people, that
means it's appropriate to use
by a prescriber.
For people outside of that as long
as they have a discussion about the
risks and benefits and make a
decision about using
this off label.
So even if it's not explicitly
included as an
indication as part of the approval
by FDA, it's allowable
for it to be used as long as
people understand that it's off
label So off-label
indication in this sense is
that language is in there because
earlier in the summer,
when the FDA approved the updated
COVID-19 vaccines,
they didn't Do
the approval that was for the
previous season, which has always
been the case for that flu vaccine.
For example, if it's if
they approve it one
year, the new the updated
formulation comes in.
They review the data. It's still
safe. It still shows effect.
And they've still review it.
They'll, they'll prove it again, the
updated one.
So this essentially everyone I've
talked to said this has never
happened before the FDA took the
updated formation and they limited.
The indications that they approved
it for to people over.
To people over 65 and
people under 65, if they have
a medical condition on
a list of conditions that increase
the risk.
That's the key, that's the
piece that was at odds or in
conflict with the recommendations
of the organizations that I
had mentioned before, American
Academy of Pediatrics,
the College of Obstetrics and
Gynecologists, that approval of
not approving yet for this
population.
Was at odds with what
these groups and, you know, the
consensus among medical experts
was for everyone to
get it.
We thought it was important to
acknowledge that these are the
on-label indications.
These are the off-lable indications.
But through the longer text
of the standing order, we tried to
explain why people should
consider getting the vaccine even if
they are in this group for
whom it is considered off- label.
That's not something that we had
done before that I'd ever been aware
of statewide standing orders
being done.
We felt it was important in this
case because the review
of the science suggested that
the risks and benefits of
COVID-19 vaccination haven't
changed, that the data still
support use among all
ages.
Even though admittedly the degree
of risk of severity is highest
in certain groups, and therefore the
incremental benefit is lower among
other groups.
But we still think that it's
beneficial and people should have
the option to take it if they
understand that
there are
benefits, understand that they are
risks, and understand that it is
an off-label indication.
I hope that clears it up.
It's a bit of a complicated.
Thank you.
Well, thank you.
Now to Sarah Volpenheim from the
Milwaukee.
Dr. Fentanyl,
Sarah. Hi, thanks again.
I came on a little late, so I
might've missed this.
I'm sorry if I did.
Does the standing medical order
allow people under 65
without an underlying condition
to get the vaccine without a
prescription?
Yes, that is the that is the purpose
of the standing order.
Thank you.
And one last question.
This one belongs to Abigail
Wanderseed from the Badger Herald.
Abigail?
Hi, thank you again.
I'm just curious if you have seen
a change in receptiveness to
getting the COVID-19 vaccine
initially versus the
booster in Wisconsin tonight over
time. We've seen boosters in
years past, but then now we, again,
have a new booster.
How has that receptiveness changed
over time and with potentially
different presidents in
office?
Oh, great question.
So I would say that the uptake
of COVID-19 vaccine has decreased
from a peak in 2021-2022
than when we started doing boosters.
The number of people who signed to
got a booster was quite a bit lower
than people who got the primary
series and it's gone down similar
before we have we have access
to good data.
We've we've at least previously had
it on dashboards.
I have to check to see whether our
dashboard goes back multiple years
because we resolved it.
So I don't wanna quote you figures,
but we can help you get
data about showing how many people
in Wisconsin have gotten
a booster because the administration
of those vaccines is
tends to be something that we
track.
So I think it's a minority
of people who are eligible for the
boosters have gotten the boasters,
but that doesn't change the fact
that we recommend and we acknowledge
that anyone who chooses to it can
expect to have their risk
of severe illness hospitalization
reduced somewhat.
So we really feel it's an individual
choice, and people shouldn't go
without access to the vaccine if
they've decided that it's what they
want to do to protect their heads.
Thank you for that.
And with that, we will conclude
today's media call.
Our thanks to Dr. Westergaard and
for all of you for participating.
Any additional questions you have
can be sent to DHS media.
Thank you and have a great
afternoon.