As kids across the country head back to school, confusion reigns over vaccines.
Changing federal policies and a dramatic shakeup at the Centers for Disease Control have left many parents uncertain — especially when it comes to COVID-19 boosters.
Dr. Daniel Kuritzkes, Chief of Infectious Diseases at Brigham and Women’s Hospital, joined GBH’s All Things Considered host Arun Rath to break down the latest vaccine guidance and highlight what parents should be keeping an eye out for this fall. What follows is a lightly edited transcript of their conversation.
Arun Rath: So, let’s start with the COVID vaccine. Who exactly is eligible right now for a COVID booster? What is the latest vaccine guidance?
Dr. Daniel Kuritzkes: The current vaccine guidance is a bit up in the air because the [CDC’s] Advisory Committee on Immunization Practices has to meet to make recommendations regarding the most recently approved vaccines for the current season.
The vaccine is currently available for older children; the issue has been, now, for younger children, where the vaccine was authorized under an emergency use authorization, and the changing issues around that authorization coming out of the U.S. Department of Health and Human Services.
Rath: Say a parent wants to get their young child the COVID vaccine. If they think that they want to go back to the original guidance on this, is it possible for them to do that? Is it advisable for them to do that?
Kuritzkes: I think that for the youngest children — that’s infants aged six and above who have never been exposed to COVID and never had a COVID vaccination — they should receive at least one COVID vaccination in order to establish that immunity.
For older children who may have had the vaccine already, it may or may not be advisable for them to get a booster. I think a discussion with your pediatrician is the best advice — and certainly for children who have any medical conditions, particularly asthma, cystic fibrosis, or other pulmonary and heart conditions, they would be advised to get the vaccine. But I would defer, again, to the guidance of the child’s pediatrician.
Rath: Beyond COVID, which routine school vaccines should parents be double-checking this fall? Are there any new or different catch-up recommendations?
Kuritzkes: I think you raise an important point, and that is one shouldn’t confuse any of the current uncertainties or controversies around COVID vaccinations for children with the well-established recommendations for routine childhood vaccinations. These guidelines have been in place for many years.
They vary by age group, so there are certain vaccines that are recommended for newborns and infants, and then for preschoolers, and then as children get into grade school, and then, of course, in middle school and high school. The most important vaccines, from my perspective, are that you want to make sure everybody has a polio vaccination and is up to date on their measles, mumps and rubella vaccinations — especially with the current measles epidemics that we’ve been seeing.
But there are other important vaccines. There are vaccines for diphtheria, tetanus, pertussis, hepatitis B, and for chickenpox. For the oldest children, there’s the recommendation for the meningococcal vaccine, because we tend to see meningococcal infection in teens, and not so much in younger kids.
Again, the best advice is to consult your pediatrician and make sure that your child is up to date, and don’t let current discussions around COVID vaccines confuse you or derail you from making sure that your child has gotten all of the vaccines that they need to get in order to keep them healthy, to keep the rest of your family healthy, and to keep us healthy as a community.
Rath: While we’ve got you here, let’s just look a little bit further down the road, because before we know it, we’ll be into flu and RSV season as well. What are the most important things for families to know about prevention there?
Kuritzkes: Influenza vaccination is currently recommended for everybody aged six months and older, and so it would be important when the flu vaccine becomes available this season that everybody in the household should be vaccinated if they’re six months or older.
RSV vaccination is a bit more limited — and again, there, a conversation with your pediatrician is going to be important. We don’t give RSV vaccines to older children or to most adults, although [for] elderly people, there is a recommendation for the administration of RSV vaccines.
I should just clarify that for the youngest children, it’s not actually a vaccine; it’s an antibody that’s given to protect against RSV.
Rath: Finally, with all the conflicting messages we talked about — the latest news we have is that CVS is currently not offering the COVID vaccine at all in some states, including Massachusetts, until further notice — do you have any advice for parents trying to cut through the noise and trying to get access to vaccines?
Kuritzkes: Yeah, I think that issue is because of an arcane regulation where pharmacists can administer vaccines on their own initiative only when it’s approved and recommended by the [Advisory Committee on Immunization Practices]. Absent that recommendation, they’re sort of in a bit of a no man’s land at the moment.
But the vaccine should still be available from hospital pharmacies, so if you have a primary care provider who’s affiliated with a hospital, you may be able to get it there. The hope is that once the ACIP makes its recommendations, the vaccine will be available again through CVS and other commercial pharmacies.
It’s also possible that the state could change the regulations to allow pharmacists to give the COVID vaccine once recommended by, for example, the State Department of Public Health or a similar body, but that would probably require some regulatory change here in the state. It’s not a federal issue; it’s a state issue.
