CDC adds consultation before COVID vaccination : NPR

The centers for the control and prevention of diseases on Monday adopted conflicting new leadership principles for the updated Covid-19 vaccines, which may make it difficult to protect many people this winter compared to previous years.

The acting director of the CDC Jim O'Neill agreed with the recommendations for the Kovid shots from the Minister of Health Robert F. Kennedy, the selected advisory committee for the practice of immunization, which met in September.

Unlike earlier years, new leadership principles urge people to talk to a doctor, pharmacist or other provider of medical services about risks and advantages of vaccination before they receive a chance. This additional step is called “general decision -making” or “making decisions based on the individual” in accordance with the language in the language The press is releaseField

This step is the final action necessary for the implementation of new guidelines that affect who can receive and give the Covid shot, and whether vaccination will be covered by private and state insurance without surcharges.

The final recommendations were postponed

The step came after Unusual, inexplicable two -week lag Meanwhile, when CDC consultants issued recommendations, and the agency accepted them. Official decision Allows CDC Finally, start the delivery of vaccines for doctors, clinics and other suppliers as part of a vaccine program for children, which provides vaccines for free of about 40% of all US children.

“Informed consent has returned,” O'Nil said in a statement announcing a step. “The general recommendation of the CDC 2022 for permanent boosters COVID-19 kept medical workers from talking about risks and advantages of vaccination for a separate patient or parent. It is changing today. “

Independent vaccine experts challenged this requirement.

“There is no reason to say that ordinary recommendations do not allow doctors to discuss risks and advantages with patients,” said Dry ReissWhich is studying the vaccine policy at the University of California at San Francisco. “Doctors [have always been] Required to obtain informed consent. The general adoption of clinical decisions simply signals that the vaccine is usually not recommended and reduces absorption. ”

Others agree that the statement of O'Nela is false and can undermine public confidence in vaccines.

“The assertion that past recommendations kept medical workers from conversations with patients about risks are completely inconsistent with reality and is another example of misinformation and the information compiled, which this administration continues to publish the public and even more creates confusion and distrust of health and vaccines suppliers,” the doctor writes. Tina soPresident of the American Society of Infectious Diseases in an email. “This is extremely regrettable and critically increasing the risk of serious diseases, prevented by vaccines.”

CDC also formalized the recommendation that complicates for some parents the vaccination of their children against measles, mumps, rubella and chickenpox.

“If this is his approach, it bothers me [additional] In childhood, the vaccines were recommended for ordinary use, ”the Reiss said in an email.“ If he thinks that the usual recommendation undermines an informed consent, that it may not even more reduce the absorption and can make the outbreaks of the cinquefoil in the bark and whooping cough, which we see even more. ”

Warranty of the moves is continuing the insurance coating for COVID images and allows pharmacists throughout the country to continue to introduce vaccines. But the changes remove some state coverage for a combined shot, which protects against measles, mumps, rubella and chickenpox, and some parents prefer.

In previous years, Covid-19 vaccines were easily available for free for all 6 months and older, they simply entered the pharmacy, the doctor’s office or the clinic and asked to shoot.

Barriers for vaccination

But vaccines It has become more difficult To get into August, when the management of products and medicines approved updated versions of Moderna, Pfizer/Biontech and Novavax vaccines only for people at risk of serious diseases, because they are older than 65 years of age or they had other health problems.

The changes came from the fact that the high -ranking officials of the Trump administration say that they have fears about the safety and efficiency of vaccines, even if there are huge evidence that vaccines are very safe and very effective. Federal health officials also claim that most people have so much immunity that they no longer need annual booster.

Many public health experts agree that Covid no longer presents a serious risk, which he once became for many people, especially those who are younger and otherwise healthy. Other countries also switched to a more “founded in risks” strategy for vaccination.

But some healthy people still want to get vaccinated in order to reduce the risk of disease, skip work or school, develop a long cycle or spread the virus with vulnerable people, such as older family members and friends with other health problems.

Over the past month, the change caused anger, disappointment and confusionA field in such states as Georgia and Utah, people had to get a recipe to get a chance, and some could not get vaccinated at all.

The situation was even more complicated, because Kennedy, who had a long history of vaccines, said that the government no longer recommends vaccines for pregnant and healthy children, even if the pregnancy is indicated as a risk factor from the CDC and FDA and Covid can still make some children very sick.

Earlier this month, the vaccine panel, which gives influential CDC advice, voted for the recommendations of shots For all 6 months and older, provided that they are consulted with the supplier of medical services about risks and benefits.

Confusion still reigns

Requirement for General adoption of clinical decisions It creates a new obstacle to vaccination compared to previous years, clearly demanding a conversation with a supplier about the risks and benefits of a person before they receive it.

New recommendations are still covered by private and state insurers, including Medicaid, Medicare, a vaccine program for children and a program of medical insurance of children.

The recommendation should also clarify that any at the age of 6 months and older is entitled to a prominent vaccine, including healthy children, pregnant women and young people. (The only way to protect younger children who are one of those who are faced with the greatest risk from Covid is to immunize their mothers during pregnancy.)

But some suppliers may remain confusing or indecisive to control shots from protracted uncertainty and mixed messages, for example, speculative security risks presented at a meeting of the CDC advisory committee, which are not supported by convincing evidence.

In some states and large medical groups, such as the American Academy of Pediatrics, the American College of Obstetrics and Gynecologists and the Society of America of infectious diseases, they have issued individual guidelines recommended by most of all aged 6 months and older to protect themselves and their communities in this upcoming season of respiratory viruses.

In addition, more and more offices of a doctor can choose from the reserve of new vaccines from -with fears that debate can even more weaken demand, demanding that people go to another place, such as a pharmacy.

Some pharmacies may require patients to read and fill the form in which potential risks and advantages of vaccines are discussed. But CVS, the largest pharmacy network in the country, says that people will be able to get vaccines with a bicycle by simply asking it. Pharmacists do not need to demand anything, including even a conversation, if patients have no questions, says CVS.

A separate picture for chickenpox is recommended

O'Neill also took the panel's voice to ban the MMRV combination, which protects against measles, mumps, rubella and varicens or chickenpox for children under 4 years old.

Small children can receive the same protection, receiving individual pictures for MMR and Varicella, and most of them – about 85% – are already doing, according to CDC Data Shared and is discussed at the September meeting of the advisory committee.

This is due to the fact that the combined picture is associated with a slightly higher risk of fever, which can lead to seizures in children under the age of 4 years. From the risk of CDC for more than 15 years, it prefers that children under the age of 4 years receive shots separately. Nevertheless, some parents decided to get a combo -name because it was simpler or more accessible, and a risk associated with a potentially frightening but temporary side effect is low.

From the recommendation of the MMRV vaccine will no longer be covered by federal programs that offer subsidized vaccines. “This panel has given a recommendation for practice, which in any case exists, but deleted the opportunity to provide these vaccines financed for those who might think that this is the best option,” says Dr. Katrina Cretsinger, a medical epidemiologist who worked on the vaccine policy for more than ten years in the CDC, before leaving the agency in 2023, ”this effectively chooses the choice from parents.”

According to Cretsinger, the creation of various politicians from the same security information that was carefully studied many years ago will also cause distrust among parents. “There is confusion regarding how to continue, and also doubts the fact that it is revised,” she says, “this contributes to the cooling effect on the absorption of the vaccine.”

The change can also cause a lack of individual vaccines, at least at the initial stage, until manufacturers can adjust their production in accordance with new demand.