A federal vaccine advisory committee signaled a new approach to U.S. vaccine policy after a two-day meeting.
SCOTT DETROW, HOST:
Health and Human Services Secretary Robert F. Kennedy Jr. has promised to change the country’s vaccine policies. And during contentious meetings in Atlanta this week, vaccine advisers for the Centers for Disease Control and Prevention began to do just that. The panel was handpicked by Kennedy. NPR health correspondent Pien Huang was at their two-day meeting and joins us now. Hi, Pien.
PIEN HUANG, BYLINE: Hey, Scott.
DETROW: What kind of changes did the advisors make?
HUANG: So they voted to narrow the recommendation on the COVID booster shot, and they also made a change in the childhood vaccine schedule, recommending against a measles and chickenpox combo shot for young children.
And while these changes weren’t as drastic as some medical and public health experts had feared, this meeting did show that these members, who Kennedy chose after firing the entire panel back in June, is starting to figure out how this works, and they’re starting off on an ambitious agenda, backed by Kennedy, who has a history of being very critical of vaccines.
DETROW: Let’s just make this news you can use for a moment. I’m sure a lot of people listening or wondering, can I go into a pharmacy, a CVS, whatever, and get a vaccine shot like I have the last few years?
HUANG: The answer is mixed. So in some states, yes, and in other states, it’s not clear. And that’s because the group has recommended the vaccine to everybody under something called shared clinical decision-making, which means that patients are supposed to talk to a medical provider about risks and benefits before they get one. But at this point, billions of COVID shots have been given out, so this kind of counseling would add a new hurdle.
Also the panel wanted input on what goes into that counseling. They voted to add more discussion about theoretical risks to the vaccine information sheet, and Retsef Levi, the panel member who led that discussion, focused on things he said were unknown.
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RETSEF LEVI: Do we know all the answers? No. Did we hear satisfactory explanations from the companies and the FDA? Absolutely, no.
HUANG: So that information sheet for consumers could go from one that summarizes the most important documented side effects of the COVID vaccine – things like fevers, body aches, a rare risk of heart problems for young men – to one that includes a lot of speculation, which could confuse people and dissuade them from getting vaccinated.
DETROW: OK, so that’s clearly the headline here, but I’m wondering what else was on the table?
HUANG: So there was a proposal to recommend that states require prescriptions for COVID vaccines, which would make them much harder for patients to get. And after a charged discussion on it, it was defeated.
And the panel also tabled a proposal to change the hepatitis B vaccine schedule for babies. Now, some members said that the current policy, which recommends a shot right after birth, is working fine, and they saw no reason to change it.
Now, there was some confusion, and it did seem at times that members didn’t seem to fully understand how their votes would affect policies and coverage.
DETROW: To that point, what is the impact of these votes? What do they affect?
HUANG: This group’s recommendations form the basis for which vaccines are covered by health insurance or subsidized through federal programs, and an example of how that works is to look at the other vote that they did take on the MMRV vaccine. That’s a combination shot for measles, mumps, rubella and chickenpox.
And this vaccine comes with a slightly higher risk of causing fevers that can lead to seizures in children under four. Kids generally recover from them pretty quickly. But they can also get the same protection from getting the MMR and the chickenpox shot separately, so that’s how most kids get it.
But up to 15% of parents ask for the combo shot, and here’s why, according to pediatrician Cody Meissner, who’s the only member who served on this panel before.
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CODY MEISSNER: Some parents don’t want to administer two doses of a vaccine if they can receive one and get the same degree of coverage. Why are we taking away that option?
HUANG: Despite Meissner’s objections, the committee voted to stop giving it to children under four, and while that recommendation seems like a small change, what it could do is make it so that Medicaid, the Children’s Health Insurance Program and the Vaccines for Children program no longer cover the shot for this age group.
DETROW: I mean, is the top line of all of this that all of these policies are about to become a lot more confusing?
HUANG: Yeah. I mean, there’s gonna be a lot of different people saying different things. So a lot of states have started to do their own thing. About a dozen states led by Democrats are moving away from their reliance on this committee, and also quite a few medical groups are breaking with this committee and making their own recommendations.
DETROW: That is NPR health correspondent Pien Huang. Thanks so much.
HUANG: You’re welcome, Scott.
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