Nirav Shah is pushing for more certainty on the Johnson & Johnson vaccine pause

Apr. 15—Good morning from Augusta. After a week that felt like spring, much of Maine could see rain and snow beginning tonight. Here's your soundtrack.

QUOTE OF THE DAY: "It's bigger than all of us as individuals, for the good of keeping myself and my loved ones safe," said Megan Sinclair, 20, a University of Maine student motivated to get the coronavirus vaccine quickly amid rising cases among young people.

What we're watching today

A top state health official is pushing for certainty around a recent pause over the one-shot vaccine that Maine has used more than other places. Maine Center for Disease Control and Prevention Director Nirav Shah made notable comments during an emergency meeting of a federal advisory panel on Wednesday. Officials agreed that more evidence was needed to determine the cause of exceedingly rare blood clots developed by six women among the millions to get the Johnson & Johnson vaccine so far before lifting a pause put into place this week. Two other similar cases, in a woman and a man, may have occurred during the vaccine's clinical trial.

It means the vaccine that was being relied upon at Maine's newly opened mobile clinic, at certain retail pharmacies and more rural vaccine sites is likely to be in limbo until at least next week. Shah, also the president of the Association of State and Territorial Health Officials, worried about such a move at the meeting in comments reported by the national media.

"We are in a situation where not making a decision is tantamount to making a decision," he said. "Any extension of the pause will invariably result in the fact that the most vulnerable individuals in the United States, who were prime candidates for the Johnson & Johnson vaccine, will remain vulnerable."

In a follow-up tweet, Shah said the federal panel should give "a concept of the conditions" under which the pause would be lifted. Public health officials have been trying to delicately balance their messaging around the vaccine, assuring people that it has been deemed widely safe while citing a need to learn more about the cause of the severe clots. Similar events have not been linked to the Pfizer and Moderna vaccines.

There is a reason why things are slightly more urgent in Maine. Prior to the pause, nearly 54,000 Mainers had received the Johnson & Johnson vaccine, accounting for 9 percent of adults here who have received at least one dose of any COVID-19 vaccine. That is a greater share than nationally, where the one-shot vaccine accounts for less than 6 percent of adults who have received at least one dose, according to federal data.

Shah has said the pause will not slow the state's vaccine effort down and has sought to shift doses from other locations to replace appointments made for these vaccines. But the longer the pause goes on, that effort will remain harder to maintain.

The Maine politics top 3

— "Small Maine towns take brunt of recent rise in COVID-19 cases," Caitlin Andrews and Jessica Piper, Bangor Daily News: "The top 20 zip codes with the highest infection rate in the last month are concentrated in York, Androscoggin, Kennebec and Oxford counties. Only three — Lewiston, Waterville and Sanford — are major urban areas. The highest case rates are occuring in relatively small towns. Health experts pegged the increases to possible fatigue from social distancing measures as the pandemic stretches into its 14th month in Maine, community transmission, more cases in younger adults and lower vaccination rates in those counties."

— "In debate over foreign influence on Maine politics, echoes of Citizens United's corporate speech decision," Steve Mistler, Maine Public: "The legislation centers on whether a company wholly owned by the Quebec provincial government should be allowed to spend money to influence Maine voters in the campaign. But the debate is actually bigger than that, and it has drawn the attention of national groups seeking to beat back the tidal wave of corporate election spending that was unleashed by the U.S. Supreme Court's decade-old Citizens United decision."

— "Former Maine judge and US attorney Thomas E. Delahanty II dies at 75," Judy Harrison, BDN: "One of the things Delahanty said he was most proud of during his most recent stint as U.S. attorney was the record amount of money, $3.7 million, collected in criminal and civil actions in the fiscal year that ended Sept. 30, 2016. That total included the $1.6 million Haynes Timberland Inc. paid to retain ownership of Township 37, where an illegal pot plantation was located."

Measure would restore Medicaid coverage to Maine immigrants

The bill before the Legislature's insurance committee would restore a benefit cut in 2011. Advocates say the bill, which would allow noncitizens and children to access MaineCare, is critical to closing racial disparities exacerbated by the pandemic. Federal law allows immigrants seeking permanent residence to access Medicaid after a five-year waiting period. States can also use federal matching funds to cover them without the wait. Maine used to offer this benefit, but stopped doing so in 2011 under former Gov. Paul LePage.

Opponents are likely to be skeptical of costs associated with expanding MaineCare further. Enrollment is at a high, with more than 340,000 people enrolled in the traditional program as of February and more than 76,000 enrolled in expansion. Those numbers are likely due to unemployment remaining at 4.8 percent in Maine and federal policies not allowing states to unenroll Medicaid recipients during a federal emergency. The state's program has been buoyed by a temporary federal funding matching rate increase.

Assistant Maine House Majority Leader Rachel Talbot Ross, D-Portland, will speak about the bill during a virtual 9 a.m. press conference before a 10 a.m. public hearing, which you can follow here.

Today's Daily Brief was written by Jessica Piper, Caitlin Andrews and Michael Shepherd. If you're reading this on the BDN's website or were forwarded it, you can sign up to have it delivered to your inbox every weekday morning here.

To reach us, do not reply directly to this newsletter, but contact the political team at mshepherd@bangordailynews.com, candrews@bangordailynews.com or jpiper@bangordailynews.com.