The COVID-19 vaccine from the Cambridge-based company, Moderna, received emergency use authorization (EUA) from the Food and Drug Administration on Friday and began to be shipped across the country yesterday. It joins the vaccine from Pfizer/BioNTech that began to be administered to healthcare workers last week. The two vaccines are similar in that they employ messenger RNA (mRNA) technology as opposed to injecting live virus into recipients. Both vaccines have effectiveness rates of over 94% and both require two doses spaced 21 days (Pfizer) or 28 days (Moderna) apart to be effective. The differences between the two are mainly logistic. The Pfizer vaccine requires ultracold storage and is shipped in cartons of 975 doses. Therefore, it is generally less practical for physician practices and others without ultracold storage. Moderna’s vaccine requires normal refrigeration and is shipped in 100-dose packages, making it easier to store and disperse. While, the EUA issued for the Pfizer vaccine authorizes five doses per vial, it became apparent last week that hospitals could get six or seven doses out of vials. Last Wednesday, DPH began informing hospitals that they should not waste any useable doses of the Pfizer vaccine.

The Pfizer/BioNTech and Moderna COVID-19 vaccines can be administered to pregnant and lactating women, and the serious allergic reactions to them are not statistically significant, according to two Massachusetts infectious disease experts who presented during an MHA webinar last Thursday.
  
The 30-minute webinar is available for viewing here.
  
In a discussion moderated by MHA’s SVP and Chief Innovation Officer Valerie Fleishman, Dr. Tamar Barlam of Boston Medical Center and Dr. Paul Biddinger of Mass General Brigham both indicated that their facilities are offering the vaccine to pregnant and lactating caregivers, and are encouraging those individuals to engage with their doctors to make the personal decisions that are best for them. Women make up 75% of the healthcare workforce.
  
Barlam is chief of the section of infectious diseases and the director of antimicrobial stewardship for Boston Medical Center. Biddinger is the medical director for emergency preparedness at Mass General Brigham and chairs the state’s vaccine task force.
  
All vaccines may trigger an allergic reaction in recipients. People who have had serious allergic reactions in the past to components of the vaccine – such as polyethylene glycol or sorbitol, but not to the main mRNA component – should not get the vaccine. But people who have had anaphylaxis for unknown reasons can still get the vaccine if they tell their doctor, consult with an allergist, or submit to prolonged observation after getting the shot. That is, having a peanut or penicillin allergy, for example, should not prevent people from getting the COVID-19 vaccine. Those administering the vaccine should have epi pens or Benadryl on hand – as is the normal course of action when giving inoculations.
  
More than 1,500 people registered for the MHA webinar entitled COVID-19 Vaccine Q&A: What You Need to Know as a Healthcare Worker – exceeding viewership of other popular MHA webinars. 

Last Wednesday, Massachusetts Department of Public Health (DPH), recognizing the fact that COVID-19 vaccines have been reported to cause discomfort to some receiving dosages, issued guidance to hospitals about how to handle those experiencing side effects.
  
“Because a small percentage of individuals may experience side effects after being vaccinated against COVID-19 and many health care personnel will be vaccinated in a short period of time, DPH is providing guidance about how health care personnel may continue to work in the safest manner possible while mildly symptomatic in the three days following COVID-19 vaccine administration,” DPH wrote.
  
Those with rashes or itching after receiving the shot can continue working, DPH said. Those who have mild reactions (mild headaches, aches, etc.) for less than three days post vaccination should get tested for COVID-19 but can continue working. Those who have severe headaches, fever, aches within three days should get tested and not return to work.
  

It may be the “most wonderful time of the year” as Andy Williams famously sang in 1963, but during the pandemic this holiday season is also the most dangerous.
  
The state and the Massachusetts hospital community are urging people to limit in-person celebrations to household members only, and to postpone or cancel travel this holiday season. Stay away from Santas, deliver carols virtually, and maintain social distancing if out and about looking at holiday light displays. View this page from the state for more holiday ideas.

This morning, MHA released a joint video statement in partnership with leaders from the Massachusetts Medical Society, Massachusetts League of Community Health Centers, Organization of Nurse Leaders, and American Nurses Association – Massachusetts. “We know how hard this is. We understand the sacrifices you are making,” they state. “Please stay home this holiday season, to ensure that next year is joyous and bright.”

 While some may consider the warnings Scrooge-like in their severity, they’re grounded in hard science. The Thanksgiving holiday – in which similar warnings were issued and often ignored – has resulted in a frightening spike of COVID-19 cases. According to the DPH Daily COVID-19 Dashboard, COVID hospitalizations are almost double what they were before Thanksgiving. Non-ICU bed availability has decreased from 28% on November 21 to 15% on December 16, and ICU bed availability decreased from 47% on November 21 to 27% on December 16. While hospitals still remain open and safe places to seek most care services, they are relying on their community members to help them from being strained further.
  

The Moderna vaccine was the second piece of important news to come out of Cambridge last week – on Tuesday Cambridge Health Alliance (CHA) announced it will add 42 new child, adolescent and specialized autism spectrum/neurodevelopmental beds at its Somerville campus, bringing CHA’s capacity to 69 youth beds. CHA will also convert two units at CHA Cambridge Hospital into adult units with 22 beds, increasing the total adult bed capacity to 62. Eight of these beds will be designed to treat high-acuity adult patients who often face challenges getting placed at facilities across the region. CHA currently operates a 22-bed geriatric unit and a 22-bed adult unit at CHA Everett Hospital.
 
The additional beds could not come at a better time as emergency department boarding rates have increased dramatically during the pandemic. CHA has consistently been recognized as a leading behavioral healthcare resource and its expansion will assist the entire healthcare community in finding placements for patients.
 
"The COVID-19 pandemic has exacerbated the need and urgency to increase psychiatric inpatient capacity across the state," said Marylou Sudders, Secretary of Health and Human Services and COVID-19 Command Center Director. "Once again, Cambridge Health Alliance has stepped up to meet the health needs of the community, and in particular children with complex behavioral health needs."
 

The Centers for Medicare & Medicaid Services has announced that it is extending the third quarter 2020 data submission deadlines for several of its quality reporting and value programs for hospitals, post-acute care facilities, and other providers. CMS indicates the extension is intended “to help providers focus on patient care during the COVID-19 public health emergency.” A list of affected programs and new deadlines is available by following this link.

Fourteen mental health advocacy groups last week announced a coordinated effort to address the mental health crisis facing states that existed before the pandemic, but has been exacerbated by it.
  
The groups said they would engage with the federal government, governors, and key policy makers across the U.S. to introduce a roadmap for accelerating effective mental healthcare. The effort calls for increased resources at all levels of government to improve access to mental health information, treatment, and support. 
  
The leadership coalition is made up of CEOs from the Massachusetts Association for Mental Health, the American Psychiatric Association, the American Psychological Association, Meadows Mental Health Policy Institute, Mental Health America, the National Association for Behavioral Healthcare, the National Alliance on Mental Illness, the National Council for Behavioral Health, One Mind, Peg’s Foundation, the Steinberg Institute, The Kennedy Forum, the Treatment Advocacy Center, and Well Being Trust. 
  
The leadership coalition’s plan – titled A Unified Vision for Transforming Mental Health and Substance Use Care – calls for policy, programs, and standards that prioritize mental healthcare and address the social and economic conditions, including racism and discrimination, that result in inequitable access to effective treatment. 
  

Ransomware Threats to Hospitals: Key Facts and Strategies for Protection

Wednesday, January 13, 2021; 12 - 1:15 p.m. 

Ransomware is a cybersecurity threat that is on the rise. The threats are constantly evolving, and every organization is vulnerable to ransomware attack, data theft, and privacy breaches. These incidents are time-consuming to address, costly, and take a toll on public confidence in healthcare institutions at a time when you can least afford them.
  
As we rely on technology in every aspect of healthcare delivery, it is crucial to be vigilant, know the facts and understand strategies for how to protect your organization’s information technology infrastructure and how to be resilient if you are subject to ransomware. 
  
Learn from industry experts, including Colin Zick and Chris Hart from Foley Hoag, about the current cybersecurity landscape, where ransomware fits in that landscape, how to ensure that your organization – and sensitive patient and employee information – is protected. Click here to register.