With Carmen Paun and Susannah Luthi

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Quick Fix

— Congressional leaders closed in on a long-awaited coronavirus relief deal, haggling deep into Tuesday night.

— The outgoing Trump and incoming Biden administrations aren't aligned on vaccine messaging, a fissure that could create public health risks.

— The president's promised $200 drug-discount cards hit another speed bump, with OMB raising concerns just hours after a key industry panel signed off.

WELCOME TO WEDNESDAY PULSE — Where the joy over the Covid-19 vaccine's arrival is amplified inside the hospitals that have been under siege. “We’re all taking a photo and all sharing it because we’re so excited this is happening,” said Kelly Wong, a Brown emergency medicine resident who got the first dose on Tuesday.

Gotten your shot yet — or wishing you could? Share experiences and other news tips to [email protected] and [email protected].

Driving the Day

A COVID RELIEF DEAL CREEPS CLOSER — Congressional negotiators are signaling progress on efforts to break their monthslong stalemate over coronavirus aid, with top lawmakers vowing to remain in session until a deal is struck, POLITICO’s Heather Caygle, Burgess Everett and Marianne LeVine report.

The optimism comes in the wake of the first meaningful meeting in months between House and Senate leaders, where the discussion focused largely on topline numbers and which elements could be packaged into the year-end deal.

“We're making significant progress and I’m optimistic that we are going to be able to complete an understanding some time soon," said Senate Majority Leader Mitch McConnell as he left the Capitol after a day of furious negotiating. "We're getting closer."

— The next 24 hours will make or break the talks. It’s unclear what exactly the coronavirus package would look like. But lawmakers are planning to attach the end product as an amendment to a separate government funding omnibus.

Still, congressional negotiators must still resolve the issues that have held up an agreement for months: Republicans’ insistence on liability protections for businesses, and Democrats’ call for additional funding for state and local governments.

Senate Republican leaders have suggested dropping the two altogether, but Democrats have not yet agreed to relent on the state and local funding.

— It's also crunch time for a 'surprise' bill bam. Washington’s health care lobbyists waited all day for news on whether McConnell would give the nod to the hard-won compromise to end “surprise” medical bills, POLITICO's Susannah Luthi writes.

Twenty-seven senators joined a bipartisan letter from Sens. Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.) Tuesday, urging the measure's inclusion in the year-end spending deal. But the American Medical Association made an eleventh-hour bid to stall progress in another letter, after staying relatively quiet in the last few months.

INSIDE THE TRUMP-BIDEN STANDOFF ON VAX MESSAGING — For once, Donald Trump and Joe Biden want the same thing: a vaccination campaign successful enough to end the pandemic. But that shared interest isn’t going to be enough to bring the two rivals together, POLITICO’s Anita Kumar, Alice Miranda Ollstein and Meridith McGraw report.

Trump has no plans to help Biden promote the Covid-19 vaccine, believing the president-elect is intentionally ignoring the current administration’s accomplishments. And Biden’s team hasn’t yet sought out Trump allies to help sell the vaccine to his conservative base.

The result is a standoff that threatens to hamper the nation’s ability to end its public health crisis, even though its leaders broadly agree on what needs to happen – and are grappling with vaccine hesitancy on both sides of the aisle.

— The Biden team has discussed enlisting conservative voices – but isn’t yet weighing trying to recruit Trump himself. Instead, they’ve floated well-known lawmakers like Sen. Rand Paul or Trump-aligned television hosts like Sean Hannity or Laura Ingraham.

But any agreement would likely require acknowledging Trump’s role in delivering on the vaccine. “The Biden team will have to acknowledge that, for all that we’ve criticized the current administration, part of the reason we have a vaccine is that they acted quickly,” a health policy adviser working with the transition said.

Inside the Humphrey Building

HHS TO CORONAVIRUS COMMITTEE: THERE's MORE TO REDFIELD STORY — The Trump administration is pushing back on the House select subcommittee's claims about political interference at the CDC in a 14-page letter to Chair Jim Clyburn shared by HHS with PULSE.

"We are disappointed by the misleading narratives placed in the media by your staff," Sarah Arbes, the HHS assistant secretary for legislation, wrote on Tuesday to Clyburn.

House Democrats last week released interview snippets with Charlotte Kent, the editor of the CDC's Morbidity and Mortality Reports, in which Kent alleged that CDC Director Robert Redfield instructed staff to delete an email where a Trump appointee asserted control over the MMWRs.

However, Arbes demands the release of Kent's transcript "so that the American public may know the truth," adding that "a full rendition of Dr. Kent’s testimony would show that [sic.] she heard about the purported deletion order third-hand" and that the email could not possibly have been permanently deleted.

POLITICO separately obtained and published the Aug. 8 email from then-HHS policy advisor Paul Alexander, who insisted that he needed to review all MMWRs moving forward and make retroactive edits to reports that he believed were attempts to undermine Trump.

Arbes also notes that the MMWR editor told House investigators that the scientific integrity of the reports had not been compromised, and that several delays to reports had been because career officials raised concerns.

— Meanwhile: HHS signals that Redfield won't do an interview. The subcommittee had pushed for an interview with Redfield on Dec. 17, citing the CDC director's alleged order to delete the email.

But "Dr. Kent’s testimony makes clear that an interview of Dr. Redfield is not warranted at this time," Arbes writes, defending the administration's process of making officials and documents available.

TRUMP's DRUG CARDS HIT ANOTHER SPEED BUMP — The Office of Management and Budget on Tuesday instructed the health department to pause work on the president's controversial $200 drug-discount cards for seniors, two people with knowledge told PULSE.

The $7.9 billion plan has raised concerns from drug-policy researchers, who say that it's a poor use of taxpayer funds, and from a wide array of government officials who have raised questions about the logistics and legality.

The order from OMB came just hours after an obscure-but-key industry panel that helps the IRS regulate benefit cards signed off on the cards on Monday after weeks of White House pressure, clearing a key hurdle.

— So when will the cards come? A White House official said that the cards would start being sent out by Jan. 1, Bloomberg reported Tuesday night.

But consider PULSE skeptical of that timeline, after months of calendar shifts and mixed messages from the administration. Just six weeks ago, the White House insisted to POLITICO that the plan was approved and that all cards would be sent in November and December. Officials also caution that operational challenges still remain.

White House

WHITE HOUSE NEGOTIATING FOR MORE PFIZER DOSES — The Trump administration is trying to secure an additional 100 million doses of Pfizer’s vaccine, after it passed earlier in the year on an option to pre-emptively buy more of the two-shot vaccine, POLITICO’s Nick Niedzwiadek reports. White House press secretary Kayleigh McEnany did not say when the U.S. would potentially receive that new allocation.

— The backstory: The U.S. has already committed to purchasing 100 million doses, or enough to vaccinate 50 million people. But after the government struck a deal in July that included the option to purchase an additional 500 million doses, it declined to exercise that right.

That decision has since sparked fears America could hit a so-called vaccine cliff, where the country is forced to wait months to secure the supplies it needs to fulfill its vaccination plans.

VACCINE MAY BE OUT OF REACH FOR QUARTER OF THE WORLD POPULATION UNTIL 2022 — That's according to a study in the British Medical Journal published Tuesday — and even that estimate assumes all the leading vaccine candidates prove safe and effective and manufacturers hit their maximum production capacity, POLITICO's Carmen Paun writes.

So far, rich countries have pre-purchased just over half of all vaccine doses from 13 manufacturers, including Pfizer and Moderna. The rest of the world, representing about 85 percent of the global population, would have to make do with the remaining half based on where things stand now, according to the study.

Biden World

ROCKEFELLER FOUNDATION: POUR BILLIONS INTO SCHOOL TESTING — A new Rockefeller Foundation white paper proposes that the U.S. spend tens of billions of dollars on testing aimed at fully reopening K-12 schools, POLITICO’s David Lim reports.

The plan would allocate roughly $8.5 billion a month to test students at least once a week and school staff at least twice a week – an approach that the organization believes would cut down on community spread and allow schools to safely operate.

The Rockefeller Foundation — which is advising the Biden transition team — also outlined a series of executive orders needed to launch the system, and recommends creating six new regional testing labs.

— But the Trump administration doesn’t agree. The report’s assertion that widespread testing is needed to safely reopen schools is “100 percent wrong and is not supported by any CDC recommendations or guidance,” HHS testing czar Brett Giroir said.

What We're Reading

At least 181 state and local public health leaders have departed since April 1, amid major political pressure over the pandemic, Anna Maria Barry-Jester, Hannah Recht, Michelle R. Smith and Lauren Weber report in a joint KHN/AP team-up.

The mayor of a Kansas city resigned effective immediately after she received threats over her support for a mask mandate, Vincent Marshall writes for the Dodge City Daily Globe.

A Santa Claus performer in Georgia tested positive for Covid-19, exposing 50 children to the virus, Alexandra Garrett writes for Newsweek. (h/t Steph Armour)