Waiting for the midterms

But pharmaceutical executives don’t appear comforted by the pushback. “Today it may be childhood vaccines or mRNA, but tomorrow it’s everything,” Noubar Afeyan, co-founder and chairman of Moderna, maker of mRNA vaccines, said. “We have to say not just ‘why is this happening?,’ but ‘Where will it stop?’”

As a bad flu season is underway, Dean Li, president of Merck Research Laboratories, noted that the anti-vaccine rhetoric is hitting seasonal flu shots. “With the pressure on vaccination, I cannot foresee flu vaccination increasing in this country over the next three years,” he said in a presentation.

Sanofi Chief Executive Paul Hudson had a similarly pessimistic outlook. “It’s clear this administration has a particular sensitivity around vaccination, and indeed pediatric vaccination,” Hudson said. “I’m asked all the time ‘what are you going to do to fix this?,’ and the truth is we just need to stay extremely objective and continue presenting the evidence. There’s really very little else we can do,” except wait for the midterm elections, he said.

“We will have to maintain a steely focus on the long-term future of vaccines and deal with any uncertainty around vaccine coverage rates in the short-term based on misinformation, Facebook posts, and statements from the top,” he said.

Bourla also worried about the conditions Kennedy is creating to attack drug makers. Kennedy, who is an environmental lawyer with no scientific or medical background, has profited from lawsuits against vaccine makers, as have many of his allies and advisors. “There is also a lot of plaintiffs’ playbook there,” Bourla said. “Everybody will start litigating.”

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“It’s clear that we’re in a different place in the pandemic than we were four or five years ago in terms of risks to healthy older kids,” Sean O’Leary, chair of the AAP Committee on Infectious Diseases (COID) said in a statement. However, “the risk of hospitalization for young children and those with high-risk conditions remains pretty high.”

According to CDC data, the rate of COVID-19 hospitalization in children under 2 is the highest among any pediatric group. Further, the rate of hospitalization among children 6 months to 23 months is comparable to that of adults ages 50 to 64. Critically, more than half of children aged 6 months to 23 months who are hospitalized for COVID-19 have no underlying medical condition that puts them at high risk for severe infection.

For children 2 to 18, the AAP recommends COVID-19 shots for children who have a medical condition that puts them at high risk, are residents of care facilities, have never been vaccinated, or have household contacts who are high risk of severe COVID-19. All other children and teens should also have access to updated seasonal shots if they desire them, the AAP says.

“The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children, and adolescents,” Kressly said. “Pediatricians know how important routine childhood immunizations are in keeping children, families, and their communities healthy and thriving.”

Coverage questions

With school starting, COVID-19 cases ticking up around the country, and cold-weather respiratory virus season looming, the question now is how the conflicting recommendations will be interpreted by insurance companies. Insurers are required to cover vaccines recommended by the CDC. But there is no such obligation for recommendations from medical groups.

AAP has been holding meetings with insurers to press for continued coverage of evidence-based vaccine recommendations.

O’Leary told The Washington Post that insurers are “signaling that they are committed to covering our recommendations.” The Post also noted that AHIP, the major insurance lobby, released a statement in June saying its members are committed to “ongoing coverage of vaccines to ensure access and affordability for this respiratory virus season.”

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