The United States has officially adopted updated recommendations for a Covid vaccine, the U.S. Department of Health and Human Services (HHS). presentation Monday – paving the way to getting a Covid vaccine to more than half of America’s children who had not had access to it while recommendations were in limbo.
But delays and the announcement itself, compounded by misinformation and ongoing access issues, providers and experts say.
The Advisory Committee on Immunization Practices (ACIP) voted on September 19 to recommend the Covid vaccine for anyone for six months, with shared provider decision-making. The ACIP vote on a Covid vaccine was delayed from June until mid-September.
Jim O’Neill, acting director of the U.S. Centers for Disease Control and Prevention (CDC), officially signed the recommendation, according to an HHS press release. web page ACIP recommendations have not yet been updated with these details.
The CDC also said it has officially removed its recommendation for the combined MMR and Varicella (chickenpox) vaccine. This vaccine is preferred by 1 in 6 parents.
O’Neill said providers had previously been discouraged from counseling patients about the benefits and risks of the Covid vaccine.
“Informed consent has been returned,” O’Neill said in a statement. “CDC’s 2022 Blanket Recommendations on Permanent Covid-19 Boosters Prevent Health Care Providers from Talking to Individual Patients or Their Parents About the Risks and Benefits of Vaccination.”
There were no limits to such discussions, which are common between patients and providers.
“When people ask for a vaccine, there’s always a discussion before they take it,” said Dorit Reiss, a professor who focuses on vaccines at UC Law San Francisco.
When patients go to the pharmacy or doctor’s office, they are already experiencing shared decision-making, Reiss said. “What if the goal isn’t just to have a conversation to stop people?”
Additionally, calling for discussion is beyond the scope of ACIP.
“The problem is you can’t do this,” says Thomas Nguyen, a pediatrician and associate professor of pediatrics at Ohio University School of Medicine.
Federal law allows CDC to update the Vaccine Information Statement (VIS), which providers must provide to all vaccine recipients or caregivers. But “they have no basis for asking for a debate,” he said.
“Every pediatric Covid vaccine we’ve given, I’ve offered to discuss the risks and benefits with the family, and everyone has had a reduction,” Nguyen said.
Families receiving the Covid vaccine already know they want it, he continued. “The people who want to get the Covid vaccine for their children are really committed people, people who have done the research and feel it is a good idea for their children.”
But delays in recommending the vaccines have created obstacles for families who want them.
The Vaccines for Children (VFC) Program Covers 52% Children in the United States: Any person under the age of 19 who is uninsured or uninsured and enrolled in Medicaid or American Indian or Alaska Native.
Vaccines are included in the program only when recommended by the CDC, so children who would normally receive the Covid vaccine through VFC were not able to get it.
Elias Kass, a naturopathic doctor in Washington state who specializes in pediatric primary care, said it’s the same every fall. Families asked about seasonal vaccines and talked about annual flu shots.
“Then they say, ‘And Covid?’ Every time, he answers, “No. We don’t have a Covid vaccine.”
Washington is one of them 12 states and territoriesHaving a universal VFC program with the City of Houston means providing the vaccine to all children (and in some areas, all adults) free of charge. In universal states, providers order all vaccines through the VFC program, but they have not been able to order any Covid vaccines at all without CDC recommendations.
“We still don’t have any doses,” Kass said.
Timing was important, as flu vaccination campaigns were already underway for the fall.
“We’re missing a really important window to vaccinate our kids. We’ve been giving out the flu vaccine for several weeks,” Kass said. “It’s a huge lost opportunity. “I don’t know if we will ever bring those families back.”
In addition to limiting boosters for young children, “it’s created this huge gap for our infants,” Kass said.
Covid vaccines have already been plagued by ongoing access issues and misinformation, leading to already low vaccination rates among children.
“Approximately 10,000 six-month-olds are eligible to receive the daily Covid-19 vaccine, but parents continue to struggle to ensure access to that vaccine,” said Michelle Fiscus, a pediatrician and chief medical officer of the Association of Immunization Administrators.
But the stakes are high. I have two children, especially a toddler. danger second to people over 75 years of age in terms of hospitalization and death.
Children may particularly suffer from long Covid, especially after repeat infectionand unknown complications may occur long after infection. Sometimes it occurs from viruses such as measles, human papillomavirus (HPV), hepatitis B, Epstein-Barr, and cytogillovirus.
Cass said the delay caused “huge” stock problems.
There were already significant access issues plaguing pediatric vaccines across the country, with some providers refusing to stock the vaccines due to a perceived lack of interest and misinformation.
“The argument we often hear from pediatricians is that they are not stockpiling the Covid vaccine because demand is low,” Fiscus said. “But the reality is that parents are calling and requesting the vaccine, only to be told that it is not in stock.” So, to some extent, it’s a self-fulfilling prophecy.”
Some providers are giving outdated reasons for not stockpiling the vaccine, such as previous demands for very large storage bins or multi-dose vials, Kass said. “They are justifying not stockpiling it for reasons that are no longer relevant, but they assume no one wants it.”
The HHS press release also said that while Covid vaccines are very safe and effective, they highlighted “vaccine safety signals” and “unintended side effects during routine immunization.”
That’s “the biggest problem” among Nguyen’s patients, he said. He said certain health officials and Republican politicians have been very vocal about the risks of Covid vaccines, “to the point where almost no one wants them.” This fall, he gave 325 flu shots and 16 Covid shots.
