From the perspective of one Seattle infectious disease doctor, access to COVID-19 shots won’t change much after a highly anticipated meeting of the nation’s top vaccine advisers.
Dr. Helen Chu, a UW Medicine physician, used to serve on the advisory committee before she was fired this year, along with 16 other members, by Health Secretary Robert F. Kennedy Jr., who has since replaced them all with his own picks. The committee now includes several vaccine skeptics who met Thursday and Friday to discuss whether to recommend the updated COVID vaccines to people 6 months and older this fall, as the panel has done every year since the shots have been available.
They ultimately did not, instead opting to encourage those who want a COVID vaccine to consult with a health care provider first.
But to Chu’s relief, the way Americans pay for the vaccines will remain “essentially status quo” for now, she said in a Friday news conference. Chu’s lab was the first in the country to identify community COVID transmission in 2020.
“This really does not change current practice,” she said. “Most providers are already talking about the risks and benefits of vaccines before they administer them.”
Importantly, she said, this means COVID shots will continue to be covered by health insurance, including Medicaid and Medicare.
The Centers for Disease Control and Prevention panel — known as the Advisory Committee on Immunization Practices — was, however, narrowly split on whether to require a prescription for COVID vaccines. Members ultimately voted against a prescription requirement, which would have made COVID immunization more difficult, Chu said.
The recommendations must still be approved by acting CDC Director Jim O’Neill before they become final.
While COVID vaccines will remain accessible for those who want one, Chu said she worries the ACIP vote will still bring confusion.
She also noticed the panel’s current members, who she said “do not have subject matter expertise nor an understanding of the basic structure of how the ACIP works,” did not appear to follow standard protocols for careful data review. That includes reviewing how the CDC might implement new vaccines, consider their cost or distribute them to clinics, she said.
Justin Gill, a registered nurse and president of the Washington State Nurses Association, said Friday the lack of a recommendation “further erodes trust in ACIP and our federal institutions.”
“When patients get mixed messages from institutions that were once trusted, it creates uncertainty and fear without context, which I feel is the main problem,” Gill said.
Confusion has already swirled around the topic this year, as the federal government makes unprecedented moves related to vaccine policy.
In May, Kennedy posted on social media that the CDC would no longer recommend COVID vaccines for healthy children and pregnant women. Former CDC chief medical officer Dr. Debra Houry, who resigned amid ongoing turmoil within the agency, said in a Senate committee hearing this week that Kennedy’s post was the first she had heard of the proposed policy change and that she “couldn’t implement guidance based on a tweet.”
Several months later, the Food and Drug Administration limited approval of this year’s COVID vaccine to only people 65 and older or who are at higher risk from the virus — another “highly unusual” federal health decision, Chu said in an interview this week.
The FDA’s role is typically only to determine whether a vaccine is safe and effective, she said. It’s the responsibility of the CDC and its vaccine advisory committee to recommend who should receive the vaccine based on age or health risk.
And now, CDC advisers have not technically recommended the shots to anyone.
In lieu of national COVID vaccine recommendations, several states have started to band together to push out their own guidance, including on the West Coast and in the Northeast.
The West Coast Health Alliance — comprising Washington, Oregon, California and Hawaii — published directions this week around immunizations for three respiratory viruses, including COVID. The coalition recommended the shots to everyone 6 months and older, especially children under 2, adults over 64 and people at higher risk of severe illness.
Washington health officials also issued a standing order this month that authorizes health care providers to give COVID shots to patients without a prescription. The order means people can get shots from physicians, nurses, pharmacists and other clinicians, as they have in the past.
“We want to ensure all Washington residents have access to the protection these vaccines provide based on the best available science,” state health officer Dr. Tao Sheng Kwan-Gett said in a statement at the time.
