\n<\/p>\n
The US has officially adopted recommendations for the updated Covid vaccines, the US Department of Health and Human Services (HHS) announced on Monday \u2013 paving the way to offer Covid vaccines to more than half of children in the US who were unable to access them while the recommendations were in limbo.<\/p>\n
Yet the delays, and the announcement itself, compound misinformation and persistent access issues, providers and experts say.<\/p>\n
The Advisory Committee on Immunization Practices (ACIP) voted on 19 September to recommend Covid vaccines to anyone over the age of six months with shared provider decision-making. The ACIP vote on Covid vaccines was itself delayed from June to mid-September.<\/p>\n
Jim O\u2019Neill, acting director of the US Centers for Disease Control and Prevention (CDC), officially signed off on the recommendation last week, according to an HHS press release \u2013 though the CDC webpage on ACIP recommendations has not yet been updated with these details.<\/p>\n
The CDC also officially removed the recommendation for the combined MMR and varicella (chickenpox) vaccine, the statement said. This vaccine is preferred by one in six parents.<\/p>\n
O\u2019Neill said providers were previously deterred from counseling patients on the benefits and risks of Covid vaccines.<\/p>\n
\u201cInformed consent is back,\u201d O\u2019Neill said in the statement. \u201cCDC\u2019s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent.\u201d<\/p>\n
There were no limitations on such discussions, which are common between patients and providers.<\/p>\n
\u201cUnless people mime their vaccine request, there\u2019s always some discussion before a vaccine is given,\u201d said Dorit Reiss, a professor focused on vaccines at UC Law San Francisco .<\/p>\n
When patients go to a pharmacy or a doctor\u2019s office for vaccines, they are already undergoing shared decision-making, Reiss said. \u201cUnless the goal is to only have the conversation to deter people, what does this do?\u201d<\/p>\n
It is also beyond the ACIP\u2019s purview to require discussions.<\/p>\n
Thomas Nguyen, a pediatrician and associate professor of pediatrics at Ohio University Medical School, notes \u201cthe problem is they aren\u2019t allowed to do this\u201d.<\/p>\n
Federal law allows the CDC to update its Vaccine Information Statement (VIS), which providers must offer to every vaccine recipient or their caregiver. But \u201cthey have no basis to require a discussion\u201d, he said, and informed consent is already the standard for vaccination.<\/p>\n
\u201cEvery pediatric Covid vaccine we have given, I have offered to discuss the risks and benefits with the family and every single one has declined,\u201d Nguyen said.<\/p>\n
The families who are getting Covid vaccines already know they want it, he continued. \u201cThe people who want to get a Covid vaccine for their kids are the ones who are really committed to it, who have done their research and feel like it\u2019s a good idea for their kids.\u201d<\/p>\n
But the delays in recommending the vaccines have created obstacles for families who want them.<\/p>\n
The Vaccines for Children (VFC) program covers 52% of children in the US: anyone under the age of 19 who is under-insured or uninsured, eligible for or enrolled in Medicaid, or Native American or Alaska Native.<\/p>\n
Vaccines are included in the program only when they\u2019re recommended by the CDC, so children who would normally receive Covid vaccines through VFC have not been able to get them.<\/p>\n
Every visit this fall has been the same, said Elias Kass, a naturopathic physician in Washington state specializing in pediatric primary care. Families asked about seasonal vaccines, and he told them about the annual flu shot.<\/p>\n
\u201cThen they say: \u2018And Covid?\u2019\u201d Each time, he answered: \u201cNope. We don\u2019t have Covid vaccines.\u201d<\/p>\n
Washington is one of 12 states and territories, along with the city of Houston, with a universal VFC program, which means they offer vaccines for free to all children (and, in some places, all adults). In universal states, providers order all vaccines through the VFC program \u2013 but they couldn\u2019t order any Covid vaccines at all without the CDC recommendation.<\/p>\n
\u201cWe still don\u2019t have doses in hand,\u201d Kass said.<\/p>\n
The timing was critical, as flu vaccination campaigns have already gotten under way for the fall.<\/p>\n
\u201cWe are missing a really crucial window to vaccinate kids. We have been giving flu vaccines for a couple of weeks,\u201d Kass said. \u201c\u200b\u200bIt\u2019s a huge lost opportunity. I don\u2019t know if we\u2019ll get those families to come back.\u201d<\/p>\n
In addition to limiting boosters for young children, the delay has \u201ccreated this huge gap for our infants,\u201d Kass said, \u201cwho are at very high risk of complicated Covid.\u201d<\/p>\n
Covid vaccines have been plagued by persistent access issues and misinformation, resulting in already low vaccination rates among children.<\/p>\n
\u201cApproximately 10,000 six-month-olds become eligible to receive Covid-19 vaccines every day, but parents continue to struggle to find access to that vaccine,\u201d said Michelle Fiscus, a pediatrician and chief medical officer of the Association of Immunization Managers.<\/p>\n
Yet the stakes are high. Children under two, especially infants, are at high risk for hospitalization and death, second only to people aged 75 and older.<\/p>\n
Children may also suffer from long Covid, particularly after repeat infections, and unknown complications could arise long after infection \u2013 as sometimes happens with viruses like measles, human papillomavirus (HPV), hepatitis B, Epstein-Barr, and cytomegalovirus.<\/p>\n
The delay caused \u201chuge\u201d equity issues, Kass said, especially among children who have been marginalized within the health system because of socioeconomic status or racism.<\/p>\n
There were already significant access issues plaguing pediatric vaccines across the country, with some providers declining to stock the vaccines due to a perceived lack of interest and misinformation.<\/p>\n
\u201cThe argument that I often hear from pediatricians is that they don\u2019t stock Covid vaccines because there\u2019s low demand,\u201d said Fiscus. \u201cBut the reality is that parents do call and ask for the vaccine, but are told that it\u2019s not being stocked. So to an extent, that\u2019s a self-fulfilling prophecy.\u201d<\/p>\n
Some providers offer outdated reasons for not stocking the vaccines, like previous needs for ultra-cold storage or multi-dose vials, Kass said. \u201cThey\u2019re justifying not stocking it with reasons that are no longer relevant, but they\u2019re assuming nobody wants it anyway.\u201d<\/p>\n
The HHS press release also highlighted \u201cvaccine safety signals\u201d and \u201cunintended side effects during routine immunization\u201d, even though the Covid vaccines are extremely safe and effective.<\/p>\n
That\u2019s \u201cthe biggest problem\u201d among Nguyen\u2019s patients, he said. Certain health officials and Republican politicians have been very vocal about the purported risks of Covid vaccines \u201cto the point that almost nobody wants them\u201d, he said. This fall, he has given out 325 flu shots and only 16 Covid shots.<\/p>\n","protected":false},"excerpt":{"rendered":"
The US has officially adopted recommendations for the updated Covid vaccines, the US Department of Health and Human Services (HHS) announced on Monday \u2013 paving the way to offer Covid vaccines to more than half of children in the US who were unable to access them while the recommendations were in limbo. Yet the delays,<\/p>\n","protected":false},"author":1,"featured_media":26479,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[3874,1348,2132,5333,1326,15898,2056,3807,150,11410,11676,78],"class_list":{"0":"post-26478","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-access","9":"tag-backs","10":"tag-cdc","11":"tag-covid","12":"tag-dont","13":"tag-doses","14":"tag-hand","15":"tag-issues","16":"tag-news","17":"tag-persist","18":"tag-updated","19":"tag-vaccines"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/26478","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26478"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/26478\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/26479"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26478"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26478"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}