ANA Leads Nursing Community to Strengthen COVID-19 Vaccine Confidence


On December 15, 2020, the American Nurses Association (ANA) joined with the American Hospital Association (AHA) and the American Medical Association (AMA) in an open letter urging health care professionals to take the COVID-19 vaccination when it becomes available to them. Since that time, ANA has been delighted to see the welcome images and stories shared of nurses stepping up to take the COVID-19 vaccine, and prepare themselves to vaccinate the general public when the time comes. In one of our favorite postings on social media, Reuters tweets a video of a nurse in New York receiving their second dose, on January 4. And here is ANA chief nursing officer Debbie Hatmaker cheering on nurse volunteers to go out and get the shots in the arms of the first tiers of vaccine recipients.

More recently, ANA, AHA and AMA released a public service announcement (PSA) calling for the American public to get the COVID-19 vaccination when it is their turn. The PSA emphasizes that COVID-19 vaccines are safe and effective, and will help us all as we work together to defeat COVID-19. 

Many people, including some nurses and other health care providers, are skeptical about taking the vaccine. Some are distrustful of the speed with which the vaccine came to market. Others, including many individuals from Black American, Latinx and other communities of color, legitimately distrust a healthcare system that has a history of discrimination, abuse, and neglect. This history not only points back to unethical and inhumane scientific experimentation such as the Tuskegee project, but is manifest in persistent disparities and systemic injustices in health care access and outcomes, even to this day in the COVID-19 pandemic. ANA along with the American Academy of Nursing has called for broad-based social action to address injustice and racial inequities in health care. Disparities must be addressed if the project to vaccinate the nation is to be successful.

In an effort to lead by example and show certainty of the science in the safe outcomes of COVID-19 vaccines, ANA President Dr. Ernest Grant participated in the Moderna vaccine trial. “It afforded me the opportunity to stand in solidarity with nurses on the frontline, battling the COVID-19 pandemic all across the U.S. Secondly, I recognized the urgent need for Black Americans to participate in vaccine clinical trials,” said Dr. Grant. The trial was unblinded earlier this year and Dr. Grant learned that he did receive the vaccine, as opposed to the placebo. He has elected to remain in the study for the full two years, as Moderna continues to gather data on the effects of the vaccine.

ANA leaders are confident in the capacity of the nursing profession to meet this moment. This confidence comes from knowing that nursing remains the most trusted profession, and that nurses hold themselves to high ethical and practice standards. Following these standards in the broadest sense means that a nurse will have an informed, considered approach to receiving and administering the COVID-19 vaccine. A nurse must consider their duties to optimize patient outcomes and promote the common good, along with the responsibility to safeguard their own well-being. In any situation, there is an ethical obligation to seek and obtain education and information, as well as advocate for answers when there are questions. Nurse leaders have a duty to provide nurses with accurate and accessible information so that individual nurses can make an informed decision for themselves and in turn assist in counseling their patients. 

In a survey of 13,000 nurses conducted last October, four out of ten nurses indicated a need for more information about the COVID-19 vaccine as a major reason for their skepticism at that time.  To meet that need, ANA set about to educate nurses and equip them with the tools they need to make decisions for themselves and for their patients. One key component is a set of Guiding Principles for Nurses, organized around themes of Access, Transparency, Equity, Efficacy, and Safety, approved by the ANA Board of Directors in 2020.

ANA continues to work to gather the most credible, evidence-based information about the vaccines, and share that information widely with members, nursing communities, partners in health, and policymakers.

Nurse-focused materials available now include:

  • FAQs created jointly by ANA and the pharmacist group ASHP, written with the clinician in mind.
  • A webinar and short-form videos featuring perspectives from a public health nurse and presenting the facts about COVID-19 vaccine development and distribution

ANA’s dedicated vaccine webpage also offers links to relevant information from partners such as the Centers for Disease Control and Prevention (CDC).  ANA is using its other distribution channels to share information helpful to nurses in the vaccination effort, such as the Vaccine Handling Toolkit recently released by ANA’s partner US Pharmacopeia. The toolkit informs operational issues on preparation and labeling, storage and transport, and waste and disposal of COVID-19 vaccine material.

Providing vaccine education and resources aligns with ANA’s commitment to immunization as a critical component of public health. In addition to providing information directly to nurses, ANA has advocated for public policies to address specific aspects of the vaccine roll-out that are important for nurses and their patients. In a letter to the transition team for the new Biden administration, ANA emphasized that nurses are central to vaccination efforts and their voices should be considered in distribution planning. ANA also called for federal resources to support mass distribution and administration. Advocacy on vaccines goes hand in hand with continued advocacy for policies to expand access to protective equipment and provide economic relief as strategies that are also key to slowing the spread of COVID-19.

For more information about ANA advocacy on issues that are important to nurses, visit

President Biden Releases $1.9 trillion COVID-19 Relief Plan


On January 14, President Biden’s transition team unveiled the administration’s first COVID-19 relief plan—the American Rescue Plan. The $1.9 trillion plan would roll out in two steps: rescue and recovery.

The President’s plan is broadly aimed at shoring up the economy, but the proposal does address workforce issues of particular interest to nurses and other frontline health care workers, as well as teachers. President Biden is calling on Congress to provide $350 billion in emergency funding for state, local, and territorial governments to ensure their ability to keep front line public workers on the job. A key selling point for this aid is that it would bolster state capacity to effectively distribute COVID-19 vaccines, scale testing, reopen schools, and maintain other vital services.

In order to address health care coverage needs of patients, President Biden is calling on Congress to subsidize continuation health coverage (COBRA) through the end of September. The plan also directs Congress to expand and increase the value of the Premium Tax Credit to lower health insurance premiums and set a cap of no more than 8.5 percent of patient income for coverage.

Tragically, mental health issues and substance use disorders continue to be major consequences of the pandemic for many people, including frontline health care workers and first responders.  President Biden has called on Congress to appropriate $4 billion to enable the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration to expand access to services for more Americans.  ANA supports these broader mental health investments, as well as targeted efforts to address nurses’ mental health.

Acknowledging the economic hardships brought on by the pandemic, the plan includes $1,400 in additional direct aid for those with incomes below $75,000 and $400/week in enhanced unemployment insurance payments. The plan also includes funds for state work-sharing programs and would continue the moratorium on evictions through September 2021 for those struggling to pay their rent or mortgage. The plan would allocate $5 billion for combatting homelessness, provide a 15 percent increase in Supplemental Nutrition Assistance Program benefits, and a $3 billion increase in Special Supplemental Nutrition Program for Women, Infants, and Children. The plan also proposes to raise the federal hourly minimum wage to $15 per hour.

In addition to including benefits for the unemployed and underemployed, the proposed plan would provide hazard pay—going forward and retroactively—to essential workers who have taken on extra risk during the pandemic by working on the front lines. ANA supports recognition of frontline health care workers and continues to advocate for hazard pay for the nurses integral to combatting the COVID-19 pandemic.  Additional support for families includes $25 billion for child care centers, expansion of child care tax credits and the Earned Income Tax Credit, and $1 billion in cash assistance for Temporary Assistance for Needy Families programs.

Last, President Biden is calling on Congress to allocate $3 billion for the Economic Development Administration (EDA). Grants from EDA provide resources directly to state and local government entities, tribal institutions, institutions of higher education, and non-profit organizations to fund initiatives that support localized economic development. This funding—double the amount provided by the CARES Act last year—would support the broad range of financial needs in communities across the country as they continue to respond to and recover from the COVID-19 pandemic.

As Congress and the administration work to see the policies contained in the American Rescue Plan signed into law, ANA continues to work with lawmakers to address the needs of nurses and patients in more targeted ways. ANA’s legislative agenda calls for specific steps to address nurses’ mental health needs, provide hazard pay, institute a moratorium on nurses having to use paid time off when they contract COVID-19, and investing the public health infrastructure and workforce.

Large health care investments cap off eventful 2020 as we look ahead into 2021


What a historic year it has been on so many levels. Leaving behind the first year of a new decade that saw struggles which we could not have foreseen in January 2020, and going into a holiday season that looks vastly different from years passed and a future that is still unclear – it’s easy to focus on the negative. However, despite the trials and tribulations of this year, it is important and inspiring to recognize all of the ground-breaking work that ANA and nurses have done in the policy, government affairs and advocacy spaces, as we look towards what is on the horizon in 2021.

At the time of publication, Congress is in the process of passing a year-end package that will avert a government shutdown, include money for vaccines and COVID-19 aid to frontline workers, boost the economy, and include language to protect patients from surprise billing for health care. ANA has been working with our allies in Congress, and advocating to get these items addressed. Please be on the lookout for further details on the year-end package by visiting ANA’s new advocacy page. In the meantime, let’s acknowledge the progress made throughout 2020, which was necessitated by the COVID-19 public health emergency (PHE).

Earlier this year, the U.S. Congress and the President signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Included in the law is language that reauthorizes Title VIII Nursing Workforce Development Programs and authorizes Nurse Practitioners (NPs) and Clinical Nurse Specialists (CNSs) to order home health care for their patients. These are longtime ANA federal legislative priorities, and we applaud Congress and the administration on their passage in the early stages of the pandemic. Advanced Practice Registered Nurses (APRNs) like NPs and CNSs are key to COVID-19 care and maintaining access to non-COVID-19 care throughout the crisis.

By summer, ANA was becoming a regular voice for nurses as Congress sought additional solutions to PHE challenges in the healthcare system. ANA President Ernest Grant testified at a hearing before the Senate Finance Committee, “Part 2: Protecting the Reliability of the U.S. Medical Supply Chain During the COVID-19 Pandemic.” Dr. Grant was there to answer the many questions Senators had about the impact of COVID-19. Questions ranged from what more the federal government could do to strengthen the supply chain, to the needs of nurses on the ground.

ANA also responded on behalf of nurses to proposals outlined in a white paper released by the Senate Health, Education, Labor, and Pension (HELP) Committee. The Committee requested input on what the U.S. had learned from the past 20 years of public health preparedness and response, and how we can better prepare for future pandemics. ANA’s response focused on how to rebuild and maintain state and federal stockpiles, improving public health capabilities, and increasing medical supply surge capacity and distribution. 

ANA has been consistently present with effective advocacy on personal protective equipment (PPE), which has been in short supply all year. As a result, the enterprise was tapped as leadership of a broad-based the coalition that will be a united voice to Congress and the administration on PPE and supply chain issues, to improve public health.

As we pivot to start working with the incoming administration, ANA has hit the ground running, providing substantive recommendations to transition leaders, and applauding the appointment of a registered nurse to President-elect Biden’s COVID-19 Task Force. We have communicated the many ways in which ANA and nurses can be a resource to the transition and the upcoming administration. We continue to solidify relationships to ensure that ANA will maintain a strong voice in the White House and key agencies in the months ahead.

Like the rest of the Policy and Government Affairs team, the ANA Political Action Committee (ANA-PAC) experienced a very successful year in 2020 despite the multitude of challenges it faced at the start of the pandemic. For starters, the PAC continued its winning streak with a 95 percent win rate in the 2020 general election for the nearly 100 candidates the PAC supported based on their pro-nursing agendas. Members of ANA drove their support unlike in years passed to the tune of over 5,600 contributors to the PAC which was an increase of 34 percent over 2019 and counting! And it doesn’t stop there: the financial strength of the PAC continues to improve as receipts are up 3 percent over last year and this number only continues to grow as we head toward the year end. Policy and GOVA will be spending the early part of 2021 strategizing our support for our existing nursing champions and starting new outreach efforts to those new freshman members of Congress. Stay tuned for updates in the next ANA-PAC quarterly newsletter.

ANA advocacy on federal regulatory policy has also strengthened nurses and demonstrated the power of nurses’ voices. With the COVID-19 PHE extended until March 2021, Medicare payment flexibilities gained in 2020 will continue. A number of these provisions expand access to APRNs for non-COVID-19 care as well as COVID-19 care, which has been a boon to patients and their providers throughout the pandemic, especially in rural areas.

The readiness of the Centers for Medicare and Medicaid Services (CMS) to remove regulatory barriers to practice has come as a result of direct advocacy over the years by ANA and partner organizations. The voices of frontline nurse providers were also heard, as CMS gathered first-hand accounts and created space to share this information on regular conference calls with nurses about the impacts of COVID-19 on their practice.

The pandemic has demonstrated the value of APRNs across the health care system, and CMS’ actions tell us that Medicare leaders are hearing us. The future is indeed bright, as CMS continues to review unnecessary barriers and craft regulatory relief. ANA policy leaders are right there, urging specific changes, and making a powerful case for making permanent changes to expand access to APRNs. We saw some success in the physician payment rule for 2021, which removed federal restrictions on APRN supervision of diagnostic tests.

CMS was not the only agency hearing nurses’ voices as important decisions were made. Early and often, ANA repeatedly called for steps to improve protections for frontline providers, including a return as soon as possible to pre-pandemic standards for PPE.

We made our case to the Occupational Safety and Health Administration, the Office of Minority Health at HHS, the Department of Veterans Affairs, Federal Emergency Management Agency, Government Accountability Office, and the White House Economic Advisors. ANA has become the “go to” organization for agency staff when they hear about events happening on the ground to work together to improve conditions for nurses. 

The pandemic made ANA’s presence even more valuable with the American Medical Association’s (AMA) RUC and CPT committees, which are the driving force for health care reimbursement. ANA CPT advisors were at the table when the CPT codes for both the Pfizer and Moderna vaccines were developed. In a separate process, ANA advisors were consulted to account for increased practice expenses incurred during the pandemic. Throughout, ANA engaged feedback and comment from the nursing community. All of these accomplishments could not be done without the loud impassioned voice of our ANA members and RNAction advocates. This united voice sent nearly 460,000 letters to Congress, responded to public comments and engaged in several surveys where the results were presented to Congressional offices across Capitol Hill. All of the input from nurses, our nation’s most trusted profession for 18 straight years, directly impacted legislation and policy throughout the year. We have you to thank for that – your efforts on the frontlines, your expertise and your advocacy do not go unnoticed. With over 200,000 RNAction advocates, we are poised to improve the profession of nursing and conditions for your patients again in 2021.