← Consider This from NPR
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- [00:00]
Ping Huang
Health and Human Services Secretary Robert F. Kennedy Jr. Entered office with the stated goal of making America healthy again. We cannot have a strong country if we have sick citizens, he said. That means restoring public trust in vaccines. And I'll tell you how to start taking vaccine safety seriously. Consider the best science available, even when the science contradicts established paradigms. To do so, he fired all the members of a key group that recommends vaccines, the Advisory Committee on Immunization Practices, or acip. And we're going to be bring people onto the ACIP panel, not anti vaxxers. We're bringing people on who are credentialed scientists, who are highly credentialed physicians, who are going to do evidence based medicine. Kennedy handpicked seven new members for the committee, which included Dr. Robert Malone, who has spread vaccine misinformation before. And when the new committee members met at the end of June to discuss the vaccine schedule for kids, the things got pretty contentious, frankly.
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Jason L. Schwartz
If you'll forgive the coaching, the slide that lists a series of AES.
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Ping Huang
That's Dr. Robert Malone, a newly appointed member of ACIP.
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Jason L. Schwartz
It would be preferable if that was structured in a way that we really.
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Dr. Alexandra Svjanovic
Knew what all of those 65 analyses were.
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Ping Huang
He was questioning CDC medical officer Dr. Sarah Meyer, who was giving a presentation on how the agency is continuing to make sure that Covid vaccines are safe. We have looked at their data a number of different ways and I'll try to walk through some of that. It was a highly unusual moment that highlighted the tension between longtime vaccine experts like Dr. Meyer and Kennedy's new guard, many without that deep expertise who questioned whether vaccines are safe. What I can say is based on our comprehensive approach to looking forwards and backwards and sideways to try to figure out, you know, are there any adverse events that were missing after COVID 19 vaccination, myocarditis and then common reactions found with all vaccines is what we have found. The CDC is reconsidering long standing vaccine guidance and it's raising major questions for patients and medical providers. Coming up, a pediatrician and a vaccine researcher discuss how these changes might affect public health. From NPR, I'm Ping Huang. This message comes from Capital One with the Capital One Saver Card. Earn unlimited 3% cash back on dining and entertainment Capital One what's in your wallet Terms apply details@capitalone.com this message comes from Carvana why spend time wondering what your car is worth? Instantly track its value on Carvana Value Tracker, answer a few quick questions and stay up to speed on your car's value. Track your car's value@carvana.com the House of Representatives has approved a White House request to claw back two years of previously approved funding for public media. The rescissions package now moves on to the Senate. This move poses a serious threat to local stations and public media as we know it. Please take a stand for public media today@goacpr.org thank you. It's considered this from NPR. The CDC's Advisory Committee on Immunization Practices under HHS Secretary Robert F. Kennedy Jr. Is walking back long standing vaccine recommendations, including the one recommending universal Covid vaccines for kids and pregnant women. Kennedy says these moves are designed to restore public trust in vaccines, but doctors groups say they undermine it. That puts a lot of folks in a confusing situation to navigate. To help us better understand what's going on and where we go from here, We've called pediatrician Dr. Alexandra Svjanovic and Professor Jason L. Schwartz from the Yale School of Public Health. Thank you both for joining us.
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Jason L. Schwartz
Great to be with you.
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Dr. Alexandra Svjanovic
Thank you for having us.
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Ping Huang
Sounds like there's a lot that is still up in the air. Jason, what are some of the biggest changes that you've seen recently when it comes to vaccines?
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Jason L. Schwartz
You know, what we've seen really since the inauguration back in January is week after week, new announcements, new personnel changes, new decisions, new messages that call into question how the federal government views the safety and effectiveness of vaccines. And we've seen it most recently with the expert advisors to the cdc. That advisory committee on immunization practices that met recently, that's for 60 years been really the gold standard source for shaping national vaccination policy. The entire membership of the committee was dismissed several weeks ago by the Secretary of Health and Human Services, replaced with a new group of members who are deeply skeptical, deeply doubting of the evidence supporting the safety and effectiveness of vaccines. They made that loud and clear at their initial meeting and they've signaled an agenda that will continue to emphasize their views regarding the value and benefits of vaccines that they appear to think have been overstated and the harms of vaccines that they appear to think have been understated. So I think we're getting a signal of a major shift in how we talk about and hear about vaccines from our federal government continuing in the months ahead.
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Ping Huang
Dr. Svjanovic, has anything actually changed so far in terms of what kids and adults have access to in this moment?
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Dr. Alexandra Svjanovic
No, it has not changed on a street level at this point.
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Ping Huang
There's definitely a lot of uncertainty right now around where the policies of Vaccines are going to. But the actual CDC recommendation for kids and pregnant women to get Covid vaccines has gone from a universal recommendation. You know, everyone should be getting it to I believe it's changed to like a shared decision making recommendation. Is that, is that your understanding of it?
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Dr. Alexandra Svjanovic
Yes, that is my understanding. That is correct.
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Ping Huang
Can you talk a little bit about shared decision making? Like, how is that different than the recommendation for just everyone to get it?
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Dr. Alexandra Svjanovic
The shared decision making is a trend, which in some cases is. I think it's an important thing to do. As a pediatrician, I talk to my families about the need for vaccines and they ultimately have the final decision. But when the recommendation is not a universal recommendation that every child and all pregnant women should get the vaccine, it. It does allow for more discussion in terms of is it truly safe? Like, why is this no longer a universal recommendation? Why are we being told that not everybody has to get this? So I think the shared decision making option ends up sowing doubt in terms of the need for vaccines for these patient populations. So I think it further complicates the picture.
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Ping Huang
Jason, you've studied how public trust in vaccines has gone up and down in the past, and I'm wondering from those past experiences what has improved it and are things heading in that direction right now?
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Jason L. Schwartz
Sure. I think what we've seen when individuals have doubts or concerns or questions or a lack of trust in public health recommendations or vaccines in particular, what moves the needle is not a public service announcement or a snazzy website from a, a public health organization. But it really is the kinds of recommendations and clarity and empathy from a healthcare provider, a pediatrician, or another physician, for example, who a family knows, can relate to, can talk to, can try and seek clarity. So I think that will. If there is a path to overcome all of this turbulence that we've been speaking about, it will really come from the frontline healthcare providers who can sit down and can try and help sort through the noise, help see what the evidence points to, and can help little by little try and reverse, I think, the confusion that we're seeing here. But that is a long and challenging hill, particularly in the face of so much attention being given in many cases to see their long refuted or discredited vaccine safety hypotheses or inaccuracies regarding the benefits of vaccines. There's a megaphone coming that is amplifying, I think, questions about vaccines that it will be very challenging to undermine, but I think it will begin those frontline healthcare providers.
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Ping Huang
Dr. Spionovich, I'm wondering if you can describe a situation with a patient who is confused. How would you direct them in this particular time and place?
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Dr. Alexandra Svjanovic
Yes, I can bring up a specific conversation I had with a family just a couple of weeks ago where this is a family who has not been immunizing their now toddler. And at the 12 month well child check we generally do a few vaccines and one of the vaccines we traditionally do at this checkup is the measles vaccine. And I know this family and I said, you know, I understand that you haven't been vaccinating your child until now, but I do think that I would like you to consider the measles vaccine very seriously because we are seeing measles in our community and it is an extremely dangerous disease that can cause long term effects and we know that the vaccine is effective and it has been around a long time and I would really appreciate it if you considered protecting your child against the measles virus. And the parents said, well, I absolutely do not want that vaccine because I don't want any MRNA vaccines. And I explained that currently the COVID vaccine is the only MRNA vaccine that we use and that the measles vaccine is not an MRNA type vaccine. And the father said that's not true. That's not what I've read. And you don't know that they haven't changed the measles vaccine into an MRNA vaccine. And so I am battling this type of information and it is a very challenging thing.
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Ping Huang
Jason, what do you make of Dr. Spionovich's example? Do you think that this is what you're talking about in terms of how trust can be restored?
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Jason L. Schwartz
Exactly that often we think that folks who have doubts or questions of vaccines may be really committed opponents or critics, the kinds of folks that we sometimes see on the news or protesting vaccines. And while those represent a portion of individuals who have reservations around vaccines, it's far more common for individuals like the family we just heard about who have questions or concerns. Maybe there's some confusion, maybe there's some factual misunderstanding. And by and large we know from research that families who have reservations around vaccines overwhelmingly are trying to figure out what to do for their children, how to best take care of their children, and providing a venue where hopefully doubts and questions and concerns can be clarified is exactly the kind of setting that can can address concerns. Maybe not all the time, but certainly.
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Dr. Alexandra Svjanovic
Sometimes I do feel like when I talk to my families who are hesitant about vaccines, the best part of my job is watching their child grow up and be a healthy, successful person. And there is so much information out there. And one of my jobs that I take extremely seriously is making sure that I am always current on vaccines and current safety profiles of all the vaccines. And I do stress with these families that, you know, you trust me to take care of your child when they're sick and at their most vulnerable. I take that trust very seriously. So when I tell a family that I believe that this vaccine is safe for your child to take, that is not a sentence I say lightly. I feel responsible because they are placing their most treasured possession in my hands, literally and figuratively.
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Ping Huang
That's pediatrician Dr. Alexandra Svjanovic in Albuquerque, New Mexico, and Professor Jason L. Schwartz from the Yale School of Public Health. Thank you both for joining us.
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Dr. Alexandra Svjanovic
Thank you.
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Jason L. Schwartz
Thank you.
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Ping Huang
This episode was produced by Michelle Aslam and Avery Keatley. It was edited by Timbit Ermias. Our executive producer is Sami Yenigun. It's CONSIDER this from npr. I'm Ping Huang. You're listening to the NPR Network.
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Dr. Alexandra Svjanovic
Live from NPR News. I'm Lark Schmies.
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Ping Huang
A living, breathing record of your neighborhood, the country, the world, told by thousands of local journalists who live in the places where stories unfold, backed by a national newsroom that puts it all in perspective. Hear the whole country's story. Hear ways of thinking that challenge your own. Hear the bigger picture with npr. At Planet Money, we know that economic jargon can sometimes feel like speaking another language. Yeah, like arbitrage, Alpha, Odarchy. That's just what's in the news these days. There's also absolute advantage, aggregate demand, aggregate supply. And this is just the A's.
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Jason L. Schwartz
Oh, animal spirits.
- [13:53]
Ping Huang
That's a pretty good one. Planet Money from npr. We help you translate the economy so you can understand the world wherever you get your podcasts. Want to hear this podcast without sponsor breaks? Amazon prime members can listen to Consider this sponsor free through Amazon Music. Or you can also support NPR's vital journalism and get consider this plus@plus.NPR.org that's plus.NPR.org.