Vaccines – The Latest Developments
Two weeks ago, I wrote a blog about how vaccines save lives, detailing that because of them an estimated 154 million deaths have been averted since 1974. I thought I had said what needed to be said and had planned on writing about other issues. Yet two recent events have caused me to return to this important subject - the deaths from measles of two unvaccinated persons in Pennsylvania, one of them an infant, and a request for information concerning the changing of some of the categories concerning vaccine guidance.
We’ve all been reading about the increase in cases of measles in the U.S. which many have attributed to the increase in unvaccinated people. In my earlier blog, I highlighted how older adults felt about using vaccines to protect their kids and grandkids from getting sick, but it has become very real for those families who lost loved ones to measles. We all recognize that life is fragile, and we are all at the mercy of the many diseases and maladies that may affect us, but the fact that a disease that had been effectively eradicated because of vaccines can raise from the ashes like a phoenix and take two lives angers me. There have been virtually no deaths from measles for 25 years and we can point without reservation at the increase in unvaccinated people as the reason for these recent two deaths. We had proven that getting vaccinated eliminated the threat posed by this viral illness, yet we chose to regress and allow this threat to kill once again. How can we as a country allow muddled guidance and misinformation make us retreat from the decades of proof that vaccines are effective.
The second item that returned my focus to vaccines was the request for information the administration released that revealed its desire to broaden some vaccine categories and change others. These categories were created to identify which are “routine” vs. “risk‑based” vs. “shared clinical decision‑making” (requiring a discussion with a clinician). It seemed like an innocuous request, but it has troubled almost all parts of the healthcare community.
Pediatricians are alarmed that his would weaken evidence-based standards, that the shared clinical decision‑making would cause confusion and it would not resolve the freeze on the Advisory Committee on Immunization Practices (ACIP).
Public‑health groups are worried about how it would be implemented and how it would further reduce the public’s trust in the CDC.
Manufacturers see it adding confusion on coverage and a weakening of regulatory stability.
Payers see it mudding the waters concerning ACA obligations and the cost‑sharing rules.
Seniors Speak Out is a project of the Healthcare Leadership Council (HLC) which is the only Washington organization representing the full spectrum of the U.S. healthcare industry. We focus specifically on issues that affect all parts of our healthcare and this step toward changing these categories has certainly raised the concern of the full spectrum of the healthcare industry. I’m especially worried about the continuing disruption of the ACIP panels. I have testified multiple times at these ACIP panels and have found them pragmatic, science driven and non-political. I can’t say that is the case today and I hope we can find our way back to following and respecting their science-based guidance.
What concerns me even more about these latest developments is that it fits into what seems to be a long range, coordinated shift toward weaking our country’s guidance on vaccines. There are three main areas where this shift is especially harmful.
Aligning U.S. childhood vaccine policy with “peer developed countries” – I talked about this in a little more detail in my blog earlier this month. Importing another country’s approach is not a move that strengthens our own healthcare.
Elevating parental choice and individual autonomy – I’m a fan of individual choice but I’m also a fan of supporting and protecting my community. Getting science driven recommendations that strengthens the herd immunity of my community is a choice that I feel emboldened to take and I’m grateful to those who choose to return the favor and protect me.
Re‑examining ACIP’s role – My experience with the ACIP has been very positive, to return to an old phrase I’ve often used, “If it ain’t broke don’t fix it.” The ACIP did not need to be fixed.
There is one other recent development that increases my hopes for the use of vaccines. Prescription drug manufacturers Moderna and Merck have announced encouraging Phase 3 results for an mRNA cancer vaccine for melanoma. The science behind this has given us reason to hope for other advances in vaccines for cancer. This breakthrough is hopefully the first of many.
We all need to push back on any attempts to weaken vaccine policies and tell our lawmakers that we believe they are the best preventative medicine – and now even a medicine that can slow the growth of a form of cancer. It is vital that we ensure that we retain the science-based recommendations that continue to save lives.
Best, Thair