Emergency Absentee Voting for Hospitalized Patients and Voting During COVID-19: A 50-State Study.

INTRODUCTION: Voters facing illness or disability are disproportionately under-represented in terms of voter turnout. Earlier research has indicated that enfranchisement of these populations may reinforce the implementation of policies improving health outcomes and equity. Due to the confluence of the coronavirus 2019 (COVID-19) pandemic and the 2020 election, we aimed to assess emergency absentee voting processes, which allow voters hospitalized after regular absentee deadlines to still obtain an absentee ballot, and election changes due to COVID-19 in all 50 states. METHODS: We performed a cross-sectional study collecting 34 variables pertaining to emergency voting processes and COVID-19-related election changes, including deadlines, methods of submission for applications and ballots, and specialized services for patients. Data were obtained from, in order of priority, state boards of elections websites, poll worker manuals, application forms, and state legislation. We verified all data through direct correspondence with state boards of elections. RESULTS: Emergency absentee voting processes are in place in 39 states, with the remaining states having universal vote-by-mail (n = 5) or extended regular absentee voting deadlines (n = 6). The emergency absentee period most commonly began within 24 hours following the normal absentee application deadline, which was often seven days before an election (n = 11). Unique aspects of emergency voting processes included patients designating an "authorized agent" to deliver their applications and ballots (n = 38), electronic ballot delivery (n = 5), and in-person teams that deliver ballots directly to patients (n = 18). Documented barriers in these processes nationwide include unavailable online information (n = 11), restrictions mandating agents to be family members (n = 7), physician affidavits or signatures (n = 9), and notary or witness signature requirements (n = 15). For the November 2020 presidential election, 12 states expanded absentee eligibility to allow COVID-19 as a reason to request an absentee ballot, and 18 states mailed absentee ballot applications or absentee ballots to all registered voters. CONCLUSION: While 39 states operate emergency absentee voting processes for hospitalized voters, there are considerable areas for improvement and heterogeneity in guidelines for these protocols. For future election cycles, information on emergency voting and broader election reforms due to COVID-19 may be useful for emergency providers and patients alike to improve the democratic participation of voters experiencing illness.

Emergency Mail-in Voting in Rhode Island: Protecting Civic Participation During COVID-19 and Beyond.

The COVID-19 pandemic challenges safe and equitable voting in the United States' 2020 elections, and in response, several states including Rhode Island (RI) have made significant changes to election policy. In addition to increasing accessibility of mail-in voting by mailing applications to all registered voters, RI has suspended their notary/witness requirement for both the primary and general election. However, RI's "emergency" voting process still plays a crucial role in allowing voters who missed the mail-in ballot application deadline, such as those unexpectedly hospitalized in the days leading up to the election, to still cast their ballot. COVID-19 has also forced RI to modify its emergency voting procedures, most notably allowing healthcare workers to serve on bipartisan ballot delivery teams. This commentary highlights these salient updates to voting procedures and serves as a primer as to how interested health care workers may navigate this process alongside patients and lead in the arena of patient voting rights.

Comparison of CaptiaTM Measles IgG Assay with Vidas® Measles IgG Assay for determination of immune protection status against measles virus.

BACKGROUND: Correlation of the assay cut-off values for CaptiaTM Measles IgG and the Vidas® Measles IgG assays with the World Health Organization recommended immunoprotective level of ≥120 mIU/mL is not stated by the manufacturers. Lack of such information may affect interpretation of immune protection (IP) for measles. OBJECTIVE: The aim of this study was to compare the relative performance of the CaptiaTM Measles IgG assay and the Vidas® Measles IgG assay for determination of IP against measles virus. STUDY DESIGN: Correlation of the cut-off value of both assays with the immunoprotective level was determined with the 3rd WHO Measles IgG International Standard. One hundred clinical samples including frozen and fresh were tested with both assays. The positive percentage agreement (PPA) based on the manufacturers' interpretation and the WHO recommended immunoprotective level was compared. RESULTS: Samples tested positive by the CaptiaTM assay were at or above the immunoprotective level while those tested equivocal and positive by the Vidas® assay were immune protective. The overall PPA between both assays was 78.31 % (95 % CI = 67.91-86.61%). When Vidas® equivocal results were regarded as immunoprotective, the overall IP agreement was 96.39 % (95 % CI = 89.80-99.25 %). CONCLUSIONS: CaptiaTM assay was more sensitive than the Vidas® assay in determination of IP against measles virus. Testing of measles immunity with the Vidas® Measles IgG assay might underestimate the IP unless equivocal results were regarded as immunoprotective.