For parents, few decisions feel more important than protecting your child's health.

Now, with changes to childhood vaccine recommendations, many families are asking what's changed, who to trust and what it means moving forward.

Tonight, the Pennsylvania Health secretary weighs in, along with local experts to answer your questions and separate fact from fear.

During this community conversation, understanding childhood vaccine changes.

Here's your host, Brittany Sweeney.

Good evening, and welcome to a Community Conversation Understanding Childhood Vaccine Changes, brought to you by Lehigh Valley Public Media.

I'm Brittany Sweeney.

For generations, childhood vaccines have helped protect kids from diseases that once caused widespread illness, disability and death in the 1950s.

Polio terrified families each summer.

Measles infected millions before a vaccine became available in the 1960s.

Over time, vaccines for mumps, rubella, whooping cough, chickenpox, hepatitis and more became a routine part of pediatric care.

Public health experts credit vaccines with dramatically reducing hospitalizations and preventing countless deaths.

Today, many parents may never have seen the devastating effects of diseases that were once common.

Now, the federal childhood vaccine schedule is changing.

In January, the U.S.

Department of Health and Human Services announced a revised framework that reduces the number of vaccines universally recommended for all children from 17 to 11.

Some vaccines, including flu, Covid 19, hepatitis A and B, rotavirus and certain meningococcal shots were moved to recommendations for high risk children or shared decision making between parents and doctors.

Supporters say the move gives families more flexibility.

Critics, including many medical groups worn it could create confusion and lower vaccination rates.

The decline in vaccinations is believed to have contributed to the 2025 measles outbreak in the U.S.. Senator, we under my leadership, handled the measles outbreak better than any country in the world as a global outbreak.

With over 2000 cases last year, the country saw the highest number of measles cases in 30 years.

Most recently, a federal court paused parts of the policy while legal challenges continue.

And for now, pediatricians say parents with questions should talk directly with their child's doctor about what vaccines are recommended and when.

We're going to speak to some of those doctors during the course of tonight's program.

And to begin, we welcome the state's top position to discuss the changes throughout the Commonwealth.

Joining us now is Pennsylvania Health Secretary Doctor Deborah Bogan.

Secretary, thank you so much for joining us for this really important conversation for some of our youngest members of the Commonwealth.

Yes.

Thank you so much for having for having me here and for holding this really important conversation.

Absolutely.

So, Doctor Bogan, let's talk about Pennsylvania's approach to these changes.

Pennsylvania is pushing back, even included in a multi-state lawsuit against these changes.

So tell us about that and why it's happening.

Yeah.

Thank you so much.

I think most importantly, I want to tell people here in Pennsylvania that in Pennsylvania, we are still recommending the childhood vaccine schedule from early 2025.

That is the recommendations from the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetrics and Gynecology.

That vaccine schedule is evidence based and informed from decades of research and experience.

And we know that vaccines are the best way to protect individuals and communities.

And so we want to make sure that people know that in October of 2025, Governor Shapiro signed an executive order asking all of his folks that work under him to ensure that vaccines remain accessible and available to all people here in Pennsylvania.

And again, adhering to the recommendations from those professional organizations.

You know, the American Academy of Pediatrics has been putting out vaccine recommendations for children in this country for almost 100 years now.

And so we really want to lean on those recommendations that come from the medical professionals across the country.

So from the federal level, it's a recommendation.

On the state level, the state can make the mandates.

And so what's the state's biggest concern right now when it comes to public health concerning some of these changes?

I think we have a couple of concerns.

One is, of course, that there is a lot of information out there, and some of it just isn't quite right.

And we want to make sure that people have access to really important information and that they get it from a source that they trust.

And I know you said at the beginning, talk to your pediatrician, right.

Talk to your family physician.

And I think that's really important advice, because we all know that parents want to do what's best for their children, right?

We all come.

I'm a pediatrician.

I spent 25 plus years talking to families.

They come from the right place.

They want to do what's best for their children.

And so we need to meet them and have those conversations.

And and I think that's really important.

So we want people to have access to good information.

One of the parts of the governor's executive order was to ask us to put all of our vaccine information from across all of our agencies into one place.

So it's at vaccines.

People can find one source, but go to sources.

The Children's Hospital of Philadelphia has a wonderful vaccine education website as well.

So we want to make sure people have good information that they are talking to their pediatrician, family doc, and having the conversation so that they can get the answers to what concerns them.

Sure, some of the vaccinations that have been taken off the recommended list are now rotavirus, flu, hepatitis A and B. They've all moved to a different category.

And in that category it says these are shared decision making vaccinations.

Aren't we already doing shared decision making?

When you speak about talking to your family physician.

Yeah.

Let me let me go back and just share, if I could, a little bit about my personal experience with vaccines.

So I trained in the early 1990s in my pediatric residency, and at the time, the pneumococcal vaccine had been introduced.

I'm sorry the vaccine had been introduced.

And in my entire career as a pediatrician, I only saw one case of Haemophilus influenzae type b infection invasive disease.

Before that vaccine had been introduced, it was caused meningitis and hearing loss and many other problems.

And then during my residency, if a child presented with a fever without a with a not known source, we were very worried about an infection called pneumococcal.

And we would do spinal taps and blood cultures and urine cultures.

But then in the early 2000, the pneumococcal vaccine came out and we changed the entire practice of pediatric medicine.

And now almost no child needs to get that kind of an evaluation as a young infant, because we have that vaccine.

And then I got to experience rotavirus vaccine being introduced into the into our practice.

And in the first year alone of that vaccine being offered, we saw half the number of children being hospitalized for severe vomiting and diarrhea in young ages.

These vaccines and now we have RSV.

And in the first couple of years of RSV, we've seen the same thing.

So the evidence is really important.

We have always done informed consent for vaccine.

I have never given vaccine to children without talking to parents about what are we trying to prevent?

What is the infection that we're preventing?

What is the what are the typical things that you would see if you didn't get vaccines?

And we always did that conversation and we would never, of course, give a vaccine to a child without that consent.

And so we have always done that.

Shared decision making is slightly different.

And that is really an important point, which is shared decision making is really a conversation we should have when there is uncertainty in the recommendation, there is no uncertainty.

I've just shared with you just a few examples of the data that suggests that these vaccines are highly effective.

Flu reduces hospitalizations.

It reduces spread to the rest of the community.

I could go on about each one has data, and each vaccine is recommended for a specific age group because that's the age group that is most negatively impacted by those infections.

And so we do.

Always informed consent for all vaccines and will continue to do that.

But I, as a pediatrician, give a very strong recommendation to to get the vaccines because I have the experience and I've read the literature and I've seen their effectiveness.

And so it sounds like you've had experience with rolling out vaccines.

Can you walk us through the scheduling?

Why do these scheduling, why do they schedule the vaccines the way that they do in the in the medical world?

Yeah, we schedule it based a lot on when children.

Well we do research studies and we show when should we be given.

How many do you need.

But again, each one is geared towards the right age group.

So young infants get vaccines that are really to protect against infections where their immune system doesn't fight as effectively as when you're older.

Rotavirus again, because of small size children get vomiting and diarrhea, are more likely to get dehydrated and need to be hospitalized than an older person.

And so the rotavirus vaccine is given to young infants.

The pneumococcal vaccine, each one is age appropriate based on their risk and through studies, and those also often coincide with when there are well child visits scheduled as well.

All right.

So Doctor Bogan, on the other side of the coin here we talk a little bit about insurance coverage.

Right.

Right ahead of these recommendations.

Insurance cover these vaccinations.

There was some concern that maybe they wouldn't be covered if they weren't recommended on the federal level.

Where do we stand on that now?

I know in Pennsylvania.

They said at least through the end of the year, they are going to be covered.

So where does that stand now?

Absolutely.

So right now there is no change, right?

We still recommend the 2025 early 2025 vaccine schedule.

And all the vaccines are covered so children can get vaccines through a couple of sources.

One is the vaccine for children's program, and that has been around for decades now.

And that covers children who have Medicaid insurance or are uninsured.

And then we also have or underinsured.

And then we have insurance covered vaccines.

So children are broadly covered through those programs.

And that has not changed.

And we don't anticipate that to change.

And part of the governor's executive order was to ensure that children have vaccines covered through their insurance.

Sure.

And we're going to have an insurance expert on a little bit later in the program to talk a little bit more about the insurance angle of this.

But, Doctor Bogan, do you know, why have you has the state been given any information why these changes were made in the first place?

Well, I think the the difficult thing is there was no additional scientific information shared with anyone.

As for the reason for the changes.

And I think, again, you know, I have always followed, we have always followed the American Academy of Pediatrics.

It's always followed the data and the science, and there was no introduction of new studies or new information that would change our recommendations at all.

Okay.

And so when you are educating folks through the state, of course, through the pediatricians offices where parents are getting firsthand experience and information, but where can folks get more information about vaccinations and the recommended schedules and other information that really could be pertinent to their child's health through the state?

Are their programs right now?

So, yes.

So you can obviously talk to your pediatrician.

You can go to our website.

We have a lot of information there.

The American Academy of Pediatrics has information on their website as well.

And again a lot of pediatric practices also put information up on their websites for people.

And I think it's really important that that people read that information, come with their questions and then have a conversation because we want to make sure I'm confident in vaccines, but I've been doing this for 30 plus years, and I want to make sure that parents understand and feel confident in their decision making to so that they understand and can feel, like I said, confident like I do to give their children their vaccines.

Sure.

So where's the best source for folks to get information if they have their phone, if they have their computer websites?

PA gov Maxine's again.

The Children's Hospital of Philadelphia has a very comprehensive website.

Oh, and I also will put a little plug for our vaccine videos.

So we wanted to make sure that parents had information that was relatable.

And again, I can share my stories, but every pediatrician has their stories about vaccines.

Since we asked pediatricians, obstetricians, internal medicine physicians, family physicians to make videos, and we put them up on our website so that people can hear short vignettes about why individual doctors recommend vaccines for children.

Some great resources for people.

Secretary, thank you so much for this really important information.

We're going to keep you around for this program in case some of our audience members or those watching at home have some questions.

But thank you for joining us.

Thank you so much for having me.

Absolutely.

And as we said, HHS and the CDC announced the overhaul of the childhood immunization schedule in January.

Since then, we stopped by a local pediatricians office to find out how some parents and practitioners are addressing the news.

A new childhood vaccination schedule is now in place, reducing the number of recommended vaccines.

The update comes from the U.S.

Department of Health and Human Services and the centers for Disease Control and Prevention.

So important to protect those that can't protect themselves.

I mean, I got every shot in the book when I was pregnant with him.

Jordan Freedman, her husband and three year old daughter, welcomed a new family member just days after the change was announced.

It was so nerve wracking because we did everything with her up to even extra vaccines, so with him we were like, okay, can we please make sure we get the happy?

Can you please make sure we stick to the old guidelines?

The freedmen's or patients at Children's Health Care, a private pediatric office in Allentown.

So initial thoughts were, what are we doing?

The question is, are we following science or are we following politics at this point?

And so it was very shocking because a lot of the things that we're eliminating are diseases that have been eradicated because of vaccines.

Patients are very frustrated.

They're very upset.

They're confused.

And that's the biggest thing that we're finding is that they're just unsure because we're here as pediatricians to guide them.

And that's what we're doing.

The CDC now recommends vaccinating against 11 diseases, no longer broadly recommending protections against flu, rotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV.

We still have the Pennsylvania guidelines, and that's what we're following and that's what the schools are following.

And so they have to get their mandated vaccines in order to go to school.

We just want to make sure we do what's best for him.

It's worked for her and she's been phenomenal.

So I want to make sure do the same thing for him.

And physicians at Children's Health Care say they will continue to recommend the previous vaccine schedule, according to the American Academy of Pediatrics.

Since the change, as you heard, some Lehigh Valley physicians say they are fielding questions from a lot of those parents.

So here to address some of those inquiries are Doctor Jennifer Genco, the chair of pediatrics for Saint Louis University Health Network, along with Doctor Alicia Waltz, the chief medical officer at Star Community Health.

Thank you so much for joining us.

Doctor Janko, let's start with you.

Are you getting these questions right now and since the beginning of the year?

Absolutely.

I'm a practicing pediatrician myself, so I'm in the office personally doing this.

But as the chair of the department, I will tell you, all of our pediatricians are getting these questions.

As somebody has said previously, parents are confused.

I think it's the most confusing time for a family.

They want to do what's best, but they're getting inundated with information.

Some of it is accurate, a lot of it isn't, and they don't know where to turn.

So I'm glad when parents engage in conversation with me so that I can help correct whatever misinformation they might have.

Doctor Walt, what do parents need to know right now?

What's the first thing you're telling them when they walk into the office?

Especially when they have questions?

I think it's really just a matter of remembering that they're worried.

They're trying to make the absolute best decision for their child in that moment.

Something that we've been kind of repeating is that nothing has changed.

Nothing has changed.

There's been no new information.

There's been no study.

There's been no new change to anything that the American Academy of Pediatrics recommends.

There's been no change to anything that we start community Health recommend.

We are evidence based in what we practice.

And so all of those things have remained exactly the same.

And I think we also try to ask them, if you have a question, come to us with it.

I'd love to hear what it is that you're worried about.

I want to see what you read.

I want to see what you saw and let me talk about that with you.

There might be something I'm not sure of.

Vaccines aren't one of those things.

So let's kind of meet in the middle somewhere.

Sure.

Doctor Janko, what are some of the pros and cons of delaying or not giving some of the vaccinations?

Are there any pros?

What are the cons?

What are you telling your folks in the office?

So in terms of the cons, there's a long list of those things.

And for the sake of this program, you're allowing your child to forgo the opportunity to become vaccinated, meaning that they could then become exposed and ill from the very thing that we're trying to prevent.

As we heard earlier in the program, these vaccines are designed to be given at certain points in time, because that's when a child is most at risk and really needs that vaccine.

So by not giving the vaccine, all that you're doing is leaving your child vulnerable.

In terms of a pro of not vaccinating, I can't really think of one.

There are certain medical conditions when a child perhaps is getting cancer treatment and their immune system isn't ready to take a vaccine, and doctors are educated about that.

And we'll let you know that that's not the best time to give your child a vaccine.

Those exceptions are few and far between.

So on the pro list, I really can't think of any.

But on the con list, I think it is concerning, certainly for that child, for the household that they live in, for the community at large, to delay vaccines.

Sure.

Would you mind touching upon some of the conditions that maybe a child cannot get the vaccination, and then why it's so important for maybe their classmates and their peers to get that so certain children that have a compromised immune system.

So think of a child with something like HIV who has end stage Aids, something along that which we don't see that much anymore.

Another way you could have a compromised immune system is if you're born with something, not the child that gets a lot of cold, because I know they're all out there, but a child who truly has something a typical about their immune system, or on medications that allows their immune system to not function properly.

So cancer would probably be one of those common things that we see or some other immune modulating types of medicines that children take.

So that would be one that we would say, okay, maybe not right now, let's get you over this illness or off this medication, and then go ahead and give that a vaccine to you.

Sure.

Doctor.

Walt, what's a common misconception that you hear about vaccines that you'd like to correct or that you find yourself correcting often in the office?

Probably the most common one that we hear is that there's a link between vaccines and autism, which has been disproven repeatedly time and time again.

But again, people are very worried, and they want to make sure that they're keeping their children safe.

Another one that we often hear is kind of a comparison as vaccines to medicine.

I want to wait.

It's too much medicine.

It's too much on a smaller body.

And vaccines aren't really medicine.

They're tools to help your immune system learn how to fight it on its own.

And we do that again at a very precise timing and a very precise cadence, and at the smallest possible dose of exposure to that bacteria or virus, so that we can teach your children's body how to do it on its own.

And if we're recommending it at a young age, it's because we know that, again, that's when the child is vulnerable.

All right.

We're talking about children who are vulnerable.

And parents who may choose to vaccinate are not vaccinated.

Vaccinate.

And that choice to vaccinate or not is one of the reasons a local mom says she welcomes the vaccine schedule change.

We sat down with her and her family at their Emmaus home to talk about why she has chosen to slow down on her children's vaccinations.

Protections against the diseases taken off the list are now only recommended for certain groups deemed high risk, or if their doctors recommend them in what's called shared decision making.

I feel like it's a good step towards body autonomy and letting people choose what is best for them.

Humans are different, and it's great to allow people to personalize their health care according to their body.

Alexa Searcher is a mom of four with a fifth on the way.

She started out vaccinating her children, but stopped when her oldest started regressing in his development.

We felt like we were kind of in the dark.

We wish there was something to question, and we didn't know there was something to question until something went wrong.

Your son was diagnosed with autism and is nonverbal.

She says she doesn't think vaccines are solely to blame, but the diagnosis gave her reason to pause her children's vaccination schedules.

We found out through genetic testing that he is sensitive to heavy metals, breaking down heavy metals in his body and absorbing essential minerals.

It's a gene that I pass down to him, and I also passed down to my third born, that my second born and and we're waiting for our fourth born.

So after that, we just totally stopped vaccinating our children.

And until we got a deeper understanding of how they might respond to the ingredients in the vaccines, extensive research shows no link between vaccinations and autism.

Still, searcher says she wants more information when it comes to her children's health.

Any parent that wants to vaccinate their child.

Do what you feel is the best for your child.

But I feel like we definitely should have the choice of being like, we're going to delay that because I don't feel comfortable.

I don't feel like I'm totally informed with everything yet.

Insurance companies in Pennsylvania are required to still cover most of the vaccines, even those not recommended through 2026.

And we thank the searcher family for sharing their input.

So, Doctor Janko, Doctor Waltz after hearing from that family.

Do you have families coming in with any reservations?

How do you talk to these families?

And is this one of those cases that that it's a rare case and it's a high risk child.

How do you address this?

As this family said, she wants to feel more informed.

And so I think coming to the pediatrician is a great way to get more information about things.

So yes, we see families coming in with whether it's that example or some other example, seeking more information.

We want to make sure we're giving accurate and credible information and meet them where they are.

So I will oftentimes say, where are you on your vaccine journey?

I am strongly recommending this vaccine today, but if you need more information, let's let's have that conversation and try to kind of get you there.

Leaving a child unvaccinated is not a risk free choice.

And so there is risk associated with that decision.

Sure, doctor Walter, you're shaking your head.

Would you like to add to that?

Yeah, absolutely.

We get a lot of families that are in very different places anywhere from I want absolutely nothing and no intervention to.

I want everything all at once.

As many as you can give me.

I think the important part is to remember, a, that the most important ingredient in a vaccine is the vaccine itself is what we are trying to do to make sure that your child stays healthy, but also to to kind of back up a little bit of what she was saying, the vaccine timing and the cadence that the American Academy of Pediatrics recommends isn't one size fits all.

You should absolutely have that discussion with your doctor, because we do want to know if there's a reason that we should be waiting, we should be looking and what your concerns are.

I think that's the most important part.

The mother I spoke to, the family, she said that she ran into a couple instances where doctors were kind of like, if you're not going to get the vaccinations, we can't see you kind of my way or the highway approach.

How do you keep that dialog open with families who are really hesitant to get their their children vaccinated?

And does does malpractice medical malpractice play into this because you have to give, you know, accurate medical advice?

How does that all play into this conversation?

We actually have any parents that declined to follow the American Academy of Pediatrics schedule and our offices at Star Community Health.

They do have to sign a declination form, kind of going through all of the information that we presented with the risks of not being vaccinated to the community and to the child, so that we do have that coverage.

But more importantly than that, it should never be in my way or the highway.

It should be a discussion.

I have plenty of families that have chosen not to vaccinate, but we do remind them every single time they come in and I say it kind of turns into a joke, is I'm doing my job.

I'm advising this because this is what I recommend as your child's pediatrician.

I wouldn't tell you to do anything that I haven't done with my own children, but have you have you come up with any new information?

Have you changed your mind at all?

Is there anything that you'd like to discuss?

Maybe there's something that we can talk about.

Sure.

And doctor, I welcome your response as well.

It seems like you.

Yeah.

Not along.

And I think it's not the my way or the highway and different practices.

Saint Luke's will also follow the same process of having that discussion and documenting that discussion with a signature that says, this is what was recommended.

And the conversation we had on this day, I also share with my families if your choice is to not vaccinate and your child becomes ill with fever cough, you know, we need to think of this a little bit differently of how we're going to address this without exposing other people in the community or in the office to something that might be a vaccine preventable disease.

A couple other factors play into this.

Some people come in and they want to spread out their vaccination schedule.

How does that play into this?

So if that's what a family wants to do, we will work with them on that.

I will say there is no science to support doing that.

When we recommend the vaccine schedule, it's because those vaccines were studied individually and together at that particular time.

So I know that works and I know that's safe and recommended.

If a family says, I'm going to do this and then that and then something else, I don't know if that's the family's choice.

As we heard earlier, we never just secretly give someone a vaccine without a parent's knowledge and consent on it.

So if that is the way that we're going to get a child vaccinated, we'll work with them on that.

But that isn't what I would routinely recommend.

Thank you, Doctor Walt.

The Lehigh Valley has a really diverse population.

You're seeing a lot of folks who are uninsured or underinsured.

Are there barriers to families who would like to seek vaccines and barriers to them getting those vaccines or following that schedule?

There are no barriers.

And if anything, I'd love to make that absolutely clear that we will vaccinate you if you want to be vaccinated, there are resources for you.

If we can't do it in our office, there are plenty of other places that will.

I will tell you that I really don't see as much concern or questioning from different populations of the underserved, specifically immigrants, because they have seen a lot of these diseases already.

So actually, it's the opposite.

They, you know, our patients will come in and in Spanish be telling us like, how come there's no vaccine today?

I think we need a vaccine today.

Find one, go back and get it.

So we we tend to see different concerns in different diversity groups, but we will absolutely find a way to get you that vaccine.

Whether you have insurance, whether you don't have insurance, it's that important to us.

It's what we believe is going to keep your child healthy.

We heard from the health secretary that right now, insurances are still covering the vaccination.

Is there any concern that in the future that they may not be covered, especially with the recommendations that are that are underway right now?

Yeah, absolutely.

I think that's always a possibility.

I was very happy to hear Secretary Bogan describe the state of Pennsylvania on things, but I can't I don't know what the future is going to bring.

I will say that's a worry on parents minds.

I've had parents coming in saying I'm concerned.

I know my child isn't due for these vaccines yet, but can I get them now?

Because I'm worried that we may not have them accessible for for when we need them?

Sure.

And ladies, this is some great information.

I encourage our audience members and those watching to submit questions for our physicians to answer towards the end of this program.

But for now, ladies, thank you so much for joining us and for your input on this program.

Thank you.

Absolutely.

Not only could there be changes to visits in the office, as we mentioned, the new recommendations could eventually change insurance coverage.

Joining us now via zoom to explain that perspective is the chief medical officer for Capitol Blue Cross, doctor Jeremy Wigginton.

Doctor Wigginton, thank you so much for joining us.

Thank you so much for having me to really talk about this really important topic.

Absolutely.

And thank you for joining us.

You're at a conference now but still found the time to weigh on, weigh in on this really important topic.

And so let's get into it.

The state is saying all the previous vaccines are still covered by insurance.

Do you see that changing anytime soon?

Well, like I said, and Doctor Bogan reiterated very expertly, the Shapiro administration did take those steps to ensure that both private insurance and Medicaid cover all recommended vaccines that were issued in 2025 without any cost sharing.

That means deductibles, co-pays, any out-of-pocket cost to the patient, at least through the end of 2026.

Now, some insurers, including Capital Blue Cross, have gone even further to say that we are committed to covering them, at least through the end of 2027.

And so many of the Blue Cross plans nationally have made that additional commitment to change nothing about the current coverage through the end of 2027.

Now, something that could change is if this federal if the federal coverage continues to evolve, and if some of the organizations like the American Academy of Pediatrics or the Academy of Family Physicians, or to make adjustments, there could be some changes.

But what I can tell you is that right now, if you get your insurance through Pennsylvania, you're going to be solid on coverage at least through the end of 2026.

And if you have Capital Blue Cross coverage, no changes to the end of 2027.

But again, many of the experts that have already spoken have said if you have questions, first thing we always recommend is certainly talking to your regular health care provider about questions or concerns you have about vaccines.

And if you have specific questions about your coverage on insurance, especially if you get coverage through another state.

So if you get coverage through, you know, any other state in the US for insurance, the best thing to do if you have questions about that coverage or anything that may have changed, is to look at your ID card.

And on the back of that card, they're going to be numbers, including customer service.

To call that number and ask any questions you have about specific vaccine coverage.

But for right now, we do see that coverage staying fairly consistent for the foreseeable future.

Doctor Wigginton, how does insurance coverage impact access to childhood vaccines for families, specifically in the Lehigh Valley?

Well, like I said, right now, the vaccine coverage is going to continue without any cost share.

And I think that's really, really important that as part of our preventative health care coverage, as part of our wellness benefits, that we get access to these vaccines without any cost, to remove any barriers to care, remove any barriers to needed vaccines.

The experts, including Doctor Bogan, also mentioned the vaccines for children program, and that program, through the state of Pennsylvania, continues to provide free vaccines to children who are both uninsured or even underinsured.

So still really good options for vaccine coverage regardless of what your what your insurance plan is.

So again, questions about that.

Talk to your regular health care provider.

Sure.

Are there ways that insurance partners can partner with providers to improve access?

And, you know, the access to vaccination rates and improved vaccination rates in the region?

Is there a partnership?

There is a partnership, and there should continue to be a partnership in terms of how we communicate with our provider community, health care community that we are committed to, to that coverage.

And so we want to make sure we're very clear that we want to remove any barriers to vaccine access and making that information very clear for both health care professionals and for patients, I think is extremely important so that they know the access is there.

So I think the step one is education information sharing in a very clear and concise way.

And so we are really committed to doing that.

And also when patients, members of ours call in to Capitol Blue Cross, we are also doing what we can through care management or through our customer service line to also provide clear education.

And I will say capital continues to be committed to providing education and guidance that is consistent, as the experts have said, with the American Academy of Pediatrics and that original vaccine schedule, because we still believe that coverage should align with medical evidence, regardless of some of these changing federal guidance, that we have seen some really valuable information there.

Doctor Jeremy Wigginton, chief medical officer for Capitol Blue Cross, thank you so much for joining us via zoom.

Thanks so much.

All right.

The medical community argues that processes and procedures for the new recommendations were not followed.

We sat down with an infectious disease specialist to discuss what that looks like.

Doctor Jeffrey Gerry is the senior vice president for medical and academic affairs at Saint Louis University Health Network.

He says he encourages continued research and understanding in medicine.

There is nothing wrong with a reevaluation of vaccines, protocols which one should be given and which one shouldn't.

We have been doing that ever since the dawn of vaccination, and that should continue.

But there is a scientific process for doing so that needs to be followed.

The physician has decades of experience in preventing and treating infectious diseases.

The way it should be done is that you need to ask a whole bunch of different stakeholders for their opinion, and that includes many of the academic bodies that represent your broad swath of physicians like the Academy of Pediatrics, the Academy of Family Practice, the Infectious Disease Society, the American Public Health Association.

That was not done.

Jerry says protocols are also in place for decisions to go through the Advisory Committee on Immunization Practices, or ACIp, which he said did not happen before the new recommendations.

HHS says the decision was made based on how peer nations approach vaccines.

When you look at the United States, we have a population that's somewhat greater than 340 million people.

Currently, Denmark has a population of 6 million.

It's been described to be about the same as Wisconsin.

Secondly, their population is much more homogeneous.

Our population is very diverse.

Its diverse in terms of income.

It's the verse in terms of race, ethnicity.

It's it is diverse in the way people get health care.

And we thank doctor Jerry for weighing in with his expertise.

Trends are showing a decrease in vaccination participation across the country and here in Pennsylvania.

Back here in the studio with us now are the director and associate professor emeritus of public health at Muhlenberg College, Chris Anne Cronin, and the health services supervisor for the Bethlehem Area School District, Kim Brannon.

Ladies, thank you so much for joining the conversation.

And, Christiana, I'll start with you.

What are some of the biggest public health risks that we face with people not getting the vaccinations at the same rate as we've seen historically.

So, I mean, first of all, we're going to probably see a resurgent resurgence of control diseases.

We're going to lose a herd immunity, which you're going to hear me talk about a lot.

So just heard immunity is, you know, just the immunity that comes from most people in a community being vaccinated or immune.

We're going to lose lose a lot of that herd immunity.

We already are losing some of that herd immunity.

This is going to increase risk of disease and death in vulnerable populations like infants and children, the elderly, pregnant women and immunocompromised people, as I think other speakers have said tonight.

And really, one other thing from a scientific standpoint, a biological standpoint is that the more that a virus or even a bacterial infection can infect a host, the more likely we're going to see mutations in these organisms, in these pathogens, which means that they are not going to be as responsive to vaccines or antibiotics when we actually need them to.

So we need to prepare for that.

Chris Anne, if you could explain what her to mutant immunity, as we heard a lot about it during the pandemic, we haven't heard as much since.

But now that these vaccination recommendations have changed, what is herd immunity?

Well, when I teach about herd immunity, I use this example when I was on a safari in Africa.

There were water buffalo at the watering hole, and there was a baby water buffalo, and a lion came upon them, and the herd began to stampede.

While all of the adult water buffalo surrounded that baby water buffalo so that that lion couldn't get to it.

Now think of that as a population of people where most of us have immunity because we've been vaccinated.

But there are those who can't.

Those immunocompromised people who who can't get vaccinated or who don't react as well to it.

It's up to us as a population to protect those weaker people.

That's herd immunity.

And we really like to see about 95% or higher of the community immunized against a certain disease in order to really get that robust effect.

Sure.

And schools play a role into this.

Can I ask you, how do vaccine requirements affect schools and what happens to the students that are not up to date, especially in the Bethlehem Area School District?

So before 2017, students were allowed to be in school without being compliant in their vaccines.

But in 2017, Pennsylvania implemented the school immunization law.

So any kindergartner or 12th grader, any new student needs has five days to be compliant in their vaccines or they're excluded on the sixth day.

For seventh graders, it's different.

They need a minister on the first day of school, so if they do not have those vaccines, they cannot come to school on the first day.

We have also implemented two vaccine for children programs, and that has been brought up in several speakers.

We have one at Northeast Middle School, which started in 2022, and we just started a new site at Freedom High School in January.

So since 2022, our compliance rates have been 99%.

This year they were 100% because of the school Immunization law and the vaccine for children program.

And the recommendations on the federal level include some of the vaccines that are then required for school.

And they've been dropped from the recommendation list, not dropped.

But they they're not recommended for everyone.

How does that all work?

We we are following the American Academy of Pediatrics.

We have those vaccines to give to our students for the vaccine for children program, which covers 18 year old students and under under insured Medicaid and Alaskan Indians, which we don't see much in our area, but those those populations are given vaccines.

We give them to the to the nurses to give in their schools so parents don't have to come get miss work and take their child to an appointment.

So our nurses give them right in school.

Chris.

And when it comes to public health, we have a question.

It pertains to public health and schools.

And so we have a question from one of our viewers.

And it says, do you have a response to the recent reports from the Pennsylvania, the Pittsburgh Post-Gazette?

They reported on how the rates of immunizations within school are falling in different parts of the state.

And so is that happening locally and kind of what could happen if we see this trend continue throughout the state?

Well, typically in the Lehigh Valley, we see the similar trends to what's happening in the state.

And we are seeing vaccination, vaccination rates falling a little bit.

We're also seeing vaccination exemptions rising.

And so, you know, I think we need to do a better job of making sure that we are more aggressive and enforcing those vaccine requirements for schools, because if we have I mean, literally have Valley is a very high density school district area.

And, you know, a outbreak can take hold and really shut down schools.

It's happened, you know, in the past.

But I expect that we need to be prepared for things like this if if we don't start getting really tough on those vaccine requirements.

Sure.

And I just want to point out that the exemptions include medical exemptions, religious exemptions or philosophical vaccination exemptions.

And so, Kim, are you seeing this trend trickle into the school district?

I know you're just Bethlehem area, but do you talk to some of the other schools at all?

Are we seeing this locally?

We're seeing locally more the philosophical.

But for Bethlehem Area School District, we have about 12,000 students enrolled.

We only have 35 medical exemptions.

We have 184 moral and 147 religious.

But since 2022, we've seen an increase in the philosophical.

Okay.

And so how do school nurses help advise these families who are making these decisions about vaccinations?

What role do they play?

So we do have an exemption form.

Parents need to sign for all three.

And on that form it does specify that if there is an outbreak, their student will be excluded from school.

Depending on what the vaccine preventable disease is, and that they still have to make up whatever assignment.

So they would be the first to be excluded.

Sure.

So what what should parents know about these exemptions?

Exemptions.

Do you do?

Are they well informed when they're handing them in?

Do you think or are they just handing them because they don't want them and they hear they shouldn't get them?

Or how is this all working?

The nurses do talk to them and the parents sign them in the health room.

So we do a lot of education about the vaccine preventable illnesses, and as I said, and then go over what would happen if they did choose to sign for that exemption.

Okay.

Chris and I want to talk about your own personal experience.

You had mentioned to me that you grew up in a home that didn't traditionally vaccinate.

So tell me a little bit about your story and your experience with some of these diseases.

Yeah, well, I did grow up in a anti-vax household.

I don't think it was called that way back in the 1960s, but I, I have had almost every childhood illness that we typically get vaccinated against.

The only vaccine that I had was polio because my parents were so worried about it.

But other than that, I had the measles, I had mumps, I had whooping cough when I was nine months old, and my mother said I would stop breathing and she'd have to tip me upside down to make me start breathing again.

And, you know, hearing that growing up, I thought, why?

Why would you want that for your kid?

And so, you know, I'm still here and I hear a lot of people my age say, well, we had the measles and we're still here and we're fine.

Well, that's because the people who aren't still here from the measles can't, can't speak for themselves.

And so, you know, I missed a lot of school.

I was sick all the time.

I spent two weeks in a dark room with sunglasses on with the measles.

I mean, that's that's the reality of these diseases.

And and I think what's happening these days is parents don't understand what those diseases are anymore.

They don't understand that if you have rubella and you get pregnant, you know, when you're older that you could have severe birth defects, your child could have severe birth defects, or if you have mumps and your, you know, post adolescent male, it could cause infertility or sterility.

And so, I mean, there's just so much we don't know anymore.

Sure.

Thank you for sharing your personal experience.

I want to ask, on a public health level, how does misinformation play into all of this, and does it impact public health and the decision making of the public?

Very much.

And I don't want to just blame misinformation, but we have we have to acknowledge that it is a big problem.

And the problem is misinformation spreads way faster than accurate data.

And it's much simpler for most people to process than the science and the data.

I say it's like the genie is out of the bottle at that point, and it's really, really hard to put it back in.

So we have a new term in public health called pre bunk.

I don't know if you've heard it, but it's not debunking information.

It's pre bunking it.

Right.

So like preempting that misinformation from coming out.

It's really hard to get ahead with how fast social media works right now.

Sure.

And I actually want to ask that same question to our health secretary who has stuck around in the in the audience with us now still online, we have some viewers asking what your opinion is on that.

How do you fight misinformation?

How do you get the correct information out there?

Yeah, thank you for the opportunity to answer that.

I think it's really important.

Conversations like this, having honest conversations between people.

We need to make sure that people have safe and accurate places to get information.

And I appreciate the idea of preempting misinformation by by giving information that's accurate up front.

Social media as a challenge, right.

We I always joke that when I was a child, you got there was one radio station and one TV station, your town and everybody listened to the same one.

And now people get information from so many sources and that makes it challenging, right?

We talk a lot about how do we make sure that we get information to people and they get it, you know, from social media they get it.

Not so many from the newspaper anymore.

And so we try to put out accurate information.

We try to hear from our experts.

So again, I think the videos, people like videos.

It depends also on the generation you're trying to reach.

Every generation is learning a little bit differently and gets information.

So who are you trying to reach and with what information?

Videos are great for younger generations.

I think, you know, the older generation probably still reads the newspaper, so making sure we're getting information out to everybody.

But I also think it's really about conversation.

And I, I share a story.

Many years ago, I had a family that I cared for that came to me around age six.

So after the basic vaccine schedule, school vaccine schedule, and he had been diagnosed with autism, and the parent was very upset because the information had started to trickle out, that the misinformation, the disinformation about autism and vaccines.

And after about six.

So I took care of the child at every visit before the 11 year old visit, which is when we gave most of the vaccines at that time for young pre-teens.

I had a conversation about vaccines with that family and the mother every year would say, yeah, I'm still worried.

I'm still worried.

But over building trust and time with that family.

At the 12 year visit, she walked in the door and she said, you know what?

I'm ready.

Let's do it.

And we gave that child all of his vaccines.

And and I think that building trust over time is really important.

And so it kind of gets your point about pre bunking information.

But I think again I'm going to go back to people having conversations with individuals that they trust that have read the literature, that have experience and that really care about you and your child.

Thank you for that answer.

And I think a key word there is trust.

Kim, I want to bring it back to you.

How important is trust between families, the school and their health care providers?

I know that the school does work with Doctor Walt as well.

Bethlehem area.

How important is that trust within the school district and and communicating with parents?

It's very, very important.

We have to all be on the same page because they go to the doctor's office, the office, come to the health room and talk to us.

So we all have to be on the same page with parents so that they trust us as well.

Because if we don't give the proper information, misinformation, they are not going to talk to us and they won't trust us to share and we need to educate.

It's one of the school nurses.

Primary goals is to educate, keep our students in school and maintain them to be healthy.

And what about those families who don't have a primary care physician who are not regularly seeing a doctor?

What kind of resources, if any, is the school offering to those families?

So we have a community health navigator from Saint Luke's Hospital who we can call and just inform them, inform her of what the needs are, and then she will connect them with whatever resources.

As I said, we have the two vaccine for children programs now that we can give students immunizations, but our Community Health Navigator will connect them with resources.

Great.

Thank you for that information.

And, Christiane, I want to ask you, what trends are we watching right now in terms of vaccinations?

We talked about the declining in vaccinations that that schools are seeing, you know, the high exemption rate.

What other trends are we seeing when it comes to vaccinations, whether it be childhood or vaccinations and public health in general?

Well, I think post-Covid we're seeing more vaccine hesitancy.

You know, we've learned a lot from what went on in 2020.

But I we are seeing more vaccine hesitancy.

It's not that people are not getting vaccinated so much as that they are worried about it or they're reconsidering it.

And, you know, we've already been through this 100 years ago.

We did a really good job.

And, you know, people aren't dying of affection diseases like they were in the early 1900s.

And here we are back again battling the same thing when we should, in my opinion, be putting our resources in moving forward with other public health initiatives.

You mentioned Covid 19.

What, if any, lessons did we learn from that vaccination process and how does it pertain to the childhood vaccination process we have now?

Well, like I said, misinformation spreads much faster than the corrections.

But also that trust is very fragile.

And I think during Covid 19 and this was justified because information was changing so quickly.

But I think the public got fatigued with all the changes and sort of tuned out and then actually became angry and frustrated.

And so, you know, I hope we have another 100 years before we have to figure out how to fix that.

But we need to do better.

All right.

And Kim, you're shaking your head.

Would you like to add to that?

Yeah.

Just yes.

I mean, we had our nurses on calls until 1130 at night, you know, trying to explain to parents, you know, when they can bring their students back, but just to keep that trust and to get the students back because they need it to be in school.

But just a lot of communication, a lot of phone calls between parents and our nurses.

Sure, Chris, and what local what role do local communities and organizations play and building that trust in getting the right information out?

Such a huge role?

I mean, community partnership, community engagement is paramount to earning the trust of, you know, a population.

And I'm talking about faith based leaders, local clinicians like we had on today, community health workers, community organizers, people are much more likely to pay attention and trust, you know, people at the local level as opposed to federal government.

And so the more that we can community engage, the better off we're going to be sure.

And I want to open that up to our other panelists.

Doctor Genco, let's go to you.

How do communities and providers and, you know, doctors and families all come together?

What what does that look like to work together, not only in the in the office but in the community as well.

So when it works well, it looks like a beautiful thing.

And I think as many opportunities as the were during Covid, we leaned into our schools, we held zoom sessions with the schools.

We were out there.

I personally was out there vaccinating some people that are sitting in this audience.

And so like showing up for your community, I think is what that looks like.

And I think that's at the community level.

We have our physicians, our school medical directors at the schools.

They may be the coach on the sports team like they live and work in the same place that all of our patients are, you know, part of the fabric of that community.

And I just want to echo the comments about trust.

I think patients, it's a privilege to take care of them.

And when a parent brings their child to me or any of our pediatricians, we don't take that lately.

And you trust us to help figure out why your child is crying in the middle of the night, and why they have a fever, and whether they have some mental health issues.

And we also want you to trust us when we make vaccine recommendations.

So I think it's building that trust throughout the medical continuum.

Sure.

And Doctor Walter, you serve a different audience, the underinsured, the uninsured, sort of the the underserved communities in our area.

And so how do you reach them?

How do you reach the folks who aren't just walking into your office?

All of the different community members that we just discussed.

So finding trusted messengers in their community, making sure that the information is available in a language that they understand in a place that they will go to, and kind of at a literacy level that that makes sense.

It doesn't do any good.

If I am getting up and citing scientific data and going through research and review and explaining all these things, parents, like I said, are concerned and they want to know that they're doing the right thing.

And again, if they trust their pediatrician or they trust their family physician, they're going to be able to make that informed consent.

They're going to make that decision for them.

Sure.

I want to turn back over here to Chris Ann Cronin.

And when we're looking at public health, what do we want to look ahead at?

What should the Lehigh Valley be focusing on as we move forward here with these recommendations that have been challenged by courts and some parts have been halted.

But as they fight this in court, if these recommendations stick, what should people be focusing on when it comes to their children's health?

I think that people need to trust the experts, the pediatricians, the family doctors, the school nurses trust, the experts.

They went to school for a long time.

They read the studies, they see the data.

Public health people like myself, I'm an epidemiologist.

I write some of the papers.

I see the data.

We're not all lying to you.

We have nothing to gain except a healthy community.

We're not making money on this.

We just want the healthiest community that we can possibly have.

And what's the best resources for families to look for that information and to look at kind of trends that are happening in our area.

They're definitely their family doctors.

If they don't have a family doctor, you know.

Public health departments, we have the Allentown Public Health Department, the Bethlehem Public Health Department, the School Nurses Association.

That's where they can turn.

There's a plethora of resources.

And I really thank you, ladies, for your resources and your valuable input on this program.

Thank you so much for joining us.

And as our program comes to a close, we want to invite those watching at home to join us on the PBS 39 YouTube page for further conversations on this topic.

Directly following the broadcast, we will take questions from the audience and online for our experts here this evening.

We want to thank our panelists and of course you for watching and joining for this important community conversation.

Understanding childhood vaccine changes from all of us here at Lehigh Valley Public Media.

I'm Brittany Sweeney.

Have a good night.