Introduction to COVID-19 Vaccine Recommendations

Health Secretary Robert F. Kennedy Jr.’s new vaccine advisers added confusion Friday to this fall’s COVID-19 vaccinations — declining to recommend them for anyone and leaving the choice up to those who want a shot. Until now, the vaccinations had been routinely provided to nearly all Americans who wanted them. The Food and Drug Administration recently put new restrictions on this year’s shots from Pfizer, Moderna and Novavax, reserving them for people over 65 or younger ones who are deemed at higher risk from the virus.

Background on Vaccine Recommendations

In a series of votes, advisers to the Centers for Disease Control and Prevention didn’t specifically recommend vaccination but said people could make individual decisions. The panel also urged the CDC to adopt stronger language around the supposed risks of vaccination, an idea that received pushback from outside medical groups who said the shots had a proven safety record. And the divided panel narrowly avoided urging states to require a prescription for the shot.

State-Level Guidance

A week before the advisory committee meeting, Gov JB Pritzker signed an executive order that aims to protect COVID-19 vaccine access across the state. The order also encompasses other routine vaccinations including flu, RSV, polio, measles and more. The state’s advisory committee will meet at 1 p.m. Monday, and the Illinois Department of Public Health is expected to issue its own guidance for providers before Sept. 26. Experts said they expect the state’s guidance will be more expansive than the federal government’s limited recommendations.

Availability of COVID-19 Vaccines

The updated COVID-19 vaccine is already available at large pharmacies in Chicago. But the vaccine is only available for those who meet the new, restrictive guidelines set by the U.S. Food and Drug Administration. At Walgreens and CVS, people getting vaccinated had to attest to their eligibility, though Walgreens was not requiring people to provide proof. Lurie Children’s Hospital and pediatricians around Chicago were still waiting for shipments of the updated vaccine along with guidance from the state and the CDC.

Insurance Coverage and Accessibility

There are lingering questions about if insurers will cover the vaccines in the long term. There are also questions about if children who receive vaccines through a federally-funded program, Vaccines for Children, will be able to access the updated COVID-19 vaccines along with others. This week, AHIP, a trade association of health insurance companies, said insurers will continue to cover updated COVID-19 and flu vaccines through 2026, according to a news release from the group. Insurers will also cover vaccines that the advisory committee recommended as of Sept. 1.

Public Health Implications

The Chicago Department of Public Health said earlier this month it plans to offer the COVID-19 vaccination to anyone 6 months or older, regardless of insurance or income, at immunization clinics. The advisory committee makes recommendations to the CDC director on how already approved vaccines should be used. CDC directors have almost always accepted those recommendations, which are widely heeded by doctors and guide vaccination programs. Committee Chairman Martin Kulldorff said committee members aim to reassure the public and remove unnecessary risks and harms.

Criticism and Concerns

But many doctors and public health experts say the committee is creating fear and mistrust around vaccines at a time when U.S. vaccination rates are already falling. Kennedy, a leading anti-vaccine activist before becoming the nation’s top health official, has made or proposed numerous changes to the nation’s vaccination system, including firing the entire 17-member panel earlier this year and replacing it with a group that includes several anti-vaccine voices. Dr. Sean O’Leary of the American Academy of Pediatrics called the decision not to recommend vaccination “extraordinarily vague” and said it would have “real-time impacts on American children.” He said the discussion involved clear efforts to “sow distrust” about vaccines.

Vaccine Safety and Effectiveness

The COVID-19 vaccines are not perfect, but CDC data shows they provide the strongest protection against severe infection and death, even if people still become infected. Likewise, people can get COVID-19 repeatedly as the virus continues to evolve. Like flu vaccines, COVID-19 shots now are being updated yearly, but only about 44% of seniors and 13% of children were up-to-date on the coronavirus vaccinations last year, the CDC said. “If you make a recommendation that people are simply not going to follow, I don’t think that’s wise,” said panelist Dr. Cody Meissner of Dartmouth College.

Other Vaccine-Related Discussions

Another question concerns a very rare side effect mostly in young men — a kind of heart inflammation called myocarditis — that was discovered in the early days of vaccination in 2021. A scientist studying whether people with certain genes are uniquely susceptible to that risk told the panel the Trump administration had canceled his grant before the research could be finished. The panel took up COVID-19 vaccinations as the virus remains a public health threat. CDC data released in June shows the virus resulted in 32,000 to 51,000 U.S. deaths and more than 250,000 hospitalizations last fall and winter. Most at risk for hospitalization are seniors and young children — especially those who were unvaccinated.

Conclusion

The decision by Kennedy’s vaccine advisers not to recommend COVID-19 shots for all Americans has sparked confusion and concern among public health experts. While the committee’s goal is to reassure the public and remove unnecessary risks, many fear that this move will create fear and mistrust around vaccines, ultimately leading to lower vaccination rates and increased risk of infection. As the COVID-19 pandemic continues to evolve, it is crucial that accurate and evidence-based information guides vaccination policies to protect public health.

FAQs

1. What is the current recommendation for COVID-19 vaccinations?
   The advisory committee to the Centers for Disease Control and Prevention did not specifically recommend vaccination for all Americans, leaving the decision up to individuals.
2. Who is eligible for the COVID-19 vaccine under the new guidelines?
   The Food and Drug Administration has restricted this year’s shots from Pfizer, Moderna, and Novavax to people over 65 or younger ones deemed at higher risk from the virus.
3. Will insurance cover the COVID-19 vaccines?
   AHIP, a trade association of health insurance companies, announced that insurers will continue to cover updated COVID-19 and flu vaccines through 2026.
4. What are the concerns about vaccine safety and effectiveness?
   While COVID-19 vaccines are not perfect, CDC data shows they provide strong protection against severe infection and death. However, there are rare side effects, such as myocarditis, mostly in young men.
5. How will this decision impact public health?
   Public health experts fear that the lack of a clear recommendation will lead to confusion, mistrust, and lower vaccination rates, increasing the risk of infection, especially among vulnerable populations like seniors and young children.