Why public health groups are concerned about changes to COVID vaccine recommendations

Amna Nawaz:

The World Health Organization said today that a new COVID variant is causing an uptick in cases around the world, and it's been detected in some states here in the U.S.

The COVID vaccine is expected to provide good protection against the variant, but the news comes after Secretary of Health and Human Services Robert F. Kennedy Jr. announced yesterday that the Centers for Disease Control and Prevention would drop the COVID vaccines from its list of recommended shots for pregnant women and children.

That decision and other recent changes under Kennedy are leading to major worries and unease among medical and public health groups.

Ali Rogin has more.

Ali Rogin:

Amna, many experts are calling the move unprecedented. Typically, the CDC makes recommendations about who should be vaccinated and when based on advice from an advisory committee of experts. But it's unclear if they were consulted before the announcement.

Joining us to discuss the potential impact of this announcement and wider concerns from public health experts is Dr. Richard Besser, former acting director of the CDC and now CEO of the Robert Wood Johnson Foundation.

And we should note, the Robert Wood Johnson Foundation is a funder of the "News Hour."

Dr. Besser, thank you so much for being here.

I want to take these two categories in turn. First, pregnant women, there are many public health experts who are expressing concern that they should absolutely still be getting the vaccine to protect not just themselves, but also their infants. What are the concerns there?

Dr. Richard Besser, Former Acting Director, Centers for Disease Control and Prevention: Yes, well, thanks for having me on, Ali.

It's very concerning. I'm a general pediatrician. I practiced for more than 30 years. And one of the wonderful things about vaccinations in pregnant women is, it not only protects them, but it provides protective factors to their babies, who often can't get vaccinated against many infectious diseases during that first year of life.

And so those factors will not be coming across to the babies of moms who are now going to be denied access to this vaccine. And the American College of OB-GYN — this is the body of experts who are in — who are obstetricians and gynecologists — raised concerns about this recommendation.

And a big concern for me is that the announcement didn't provide the thought behind it. It didn't provide the data. And that's what we're losing, is that ability to really understand the decision.

Ali Rogin:

Now I want to talk specifically about children over the age of 6 months.

FDA Commissioner Makary said there's no evidence healthy kids need it. And there are some countries that have stopped administering it routinely, including Australia, the U.K., as well as the World Health Organization. So what are the specific risks among that group?

Dr. Richard Besser:

Yes, thankfully, the impact of COVID has been going down over the years. The — talking about deaths of — in the thousands per week, that's no longer the conversation.

But it doesn't mean that COVID isn't still causing problems. And it does cause problems for children. One of the things that I like to see each year is the Advisory Committee. That expert body you were talking about to the CDC, they wrestle with these questions. They look and see, well, how many children are getting infected? Is the vaccine effective at preventing long COVID that we know so many people are suffering from?

What about a child who lives in a family where there's someone who has an immune problem, who's at greater risk? Would vaccinating that child help protect the others in that family?

We didn't get to hear any of those conversations, because this was the decision that just came down from the secretary, a secretary who told Congress just within the past couple of weeks that we should not take health advice from him and told Congress during his confirmation hearing that he would not be messing with the childhood vaccination schedule.

It's very concerning.

Ali Rogin:

Insurance plans have to cover recommended vaccines. So, if these vaccines are no longer recommended for these groups, how do you anticipate health insurance companies are going to respond?

Dr. Richard Besser:

Yes, it goes even beyond that. The Affordable Care Act says that, if it's a recommended vaccine, it has to be provided at no cost to people with health insurance.

But one of the things that's wonderful about our childhood vaccination system in the United States is, if there is a recommended vaccination, there's a program called the Vaccines for Children Program. And that requires Congress to pay for vaccinations for all children, regardless of whether they have insurance.

So a child who is from a lower-income family is going to get vaccinated just as easily as someone whose family has more income. Without that recommendation, there will not be those vaccines provided for free for lower-income children. So there won't be that choice.

A family with money can decide, well, maybe a doctor will give it to my child what's called off-label, so beyond the recommended vaccination schedule, but you won't have that opportunity for other children. And that's concerning as well, that we are going to have even more of a two-tier system, where, if you have money, you can get something. If you don't, you don't have a choice.

Ali Rogin:

And, Dr. Besser, lastly, on a slightly different topic, The Washington Post was reporting about an outbreak of E. coli that the FDA investigated, but never publicized, reportedly sickened 90 people.

Commissioner Makary, not referring to this specifically, but he has said that cuts to the agency have been all about reversing regulatory creep. They're not influencing any regulatory operations. But how does that square with what you see as the role of the FDA in communicating these public health risks and advisories?

Dr. Richard Besser:

Yes, I mean, one of the important roles of the Food and Drug Administration is to make sure our food supply is safe. And there's a lot of work that goes on between FDA and CDC on that.

I started my career at CDC as a foodborne disease investigator. And my first outbreak was one of this very same strain of deadly E. coli. You want people to know about it. You want people to know so that they can understand where risk comes from and how to protect themselves. By not sharing that information, you miss the opportunity to tell people about safe food practices, what things to avoid and how to make sure you stay safe.

And I worry that those massive cuts and layoffs at the FDA and at CDC have undermined this system. One of the groups that's critical are communicators. And my understanding is that, in both agencies, a lot of the public health communicators have been let go. Without them, public health is not going to be able to do its job the way it's supposed to.

Ali Rogin:

Dr. Richard Besser, CEO of the Robert Wood Johnson Foundation, thank you so much.

Dr. Richard Besser:

Thank you.