ARI SHAPIRO, HOST:
Now that the federal government has stopped recommending the COVID vaccine for healthy children and pregnant women, will those shots still be available to people who want them, and will insurance cover it? Health and Human Services Secretary Robert F. Kennedy Jr. did not answer those questions in the one-minute video where he announced the new guidance yesterday.
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ROBERT F KENNEDY JR: I couldn't be more pleased to announce that as of today, the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC recommended immunization schedule.
SHAPIRO: Dr. Peter Jay Hotez is here to help us understand what this means for people's access to the shots. He's dean of the National School of Tropical Medicine at Baylor College of Medicine, and he was part of the team that worked to develop a low-cost COVID vaccine. Welcome to ALL THINGS CONSIDERED.
PETER JAY HOTEZ: Oh, thanks for having me, Ari.
SHAPIRO: What's your initial reaction to the new guidelines?
HOTEZ: Sort of shock and disappointment because we know how important COVID vaccinations were both for pregnant women and for children, although for different reasons. In the case for pregnant women, first of all, you know, as anyone who was working in an intensive care unit between 2020 and 2023 knows, pregnant women did not do well with COVID the virus. On average, they had much higher rates of severe illness requiring hospitalizations or even intensive care unit monitoring, and sometimes they didn't survive. The data that we have so far suggests that if pregnant women were vaccinated against COVID, it had multiple benefits, predominantly including, you know, by one analysis, suggesting a 90-, 94% reduction in hospitalization for pregnant women who got vaccinated.
SHAPIRO: So that's pregnant women. On the question of healthy children, FDA commissioner Dr. Marty Makary said most countries have stopped recommending these vaccines for kids. Is that true? And if so, does it make sense for the U.S. to follow?
HOTEZ: You know, I think one of the problems with the way the current leadership of the FDA looks at COVID vaccines is very much the way they portrayed it when they were talking heads on Fox News, which is they were only looking at one parameter, which was case fatality rates or infection mortality rates, which of course are much lower in children, although a significant number of children do die annually from COVID. But here's the part that they really missed the ball on, which is the impact of vaccinating children for long COVID. There was, last year, a very important study showing significant benefit for both children and adolescents, in both the delta wave in 2021 and the BA.1 omicron wave in 2022, of preventing long COVID. So in their calculus, it doesn't look like the FDA at all is considering the impact of long COVID.
SHAPIRO: If somebody still wants the shot, despite the federal government's recommendation, is insurance likely to cover it?
HOTEZ: So this is where I'm going to give you a pretty I-don't-know-the-answer-to-your-question answer, a pretty long one, which is I don't think we know. First of all, you know, usually it's not the FDA signing off on the public health use of a vaccine. This is why we have a Centers for Disease Control. This is why we have an Advisory Committee of Immunization Practices - known as ACIP - to make those recommendations. So the decision on how the vaccines are used are typically made in collaboration between ACIP and the CDC director. And that's often the basis for recommending the vaccine for the vaccines for children's program, for the insurers. And all of that now has been bypassed. So I think we're in kind of an unknown territory now. What does it mean that the FDA has skirted all of that - or Health and Human Services - and just kind of made this unilateral decision, which on top of that, is not evidence-based?
So question one, what do the pharmacy chains do? Do they continue to offer vaccines for pregnant women or for kids? What do the pediatric practices do? That's question one. The next question is going to be, will the insurance companies cover it? And then, if that weren't confusing enough, if you remember, the leadership of the Food and Drug Administration - Dr. Makary, the FDA commissioner, and the head of CBER, the Center for Biologics Evaluation Research, Dr. Vinay Prasad - issued a guidance document where they specifically said that pregnancy is, quote, "a risk factor" for warranting vaccinating individuals who might not otherwise qualify.
SHAPIRO: And just to be clear, if it isn't covered by insurance, it's pretty expensive, right?
HOTEZ: Well, it certainly can be. I know I was not very happy when Pfizer and Moderna, after they took a lot of U.S. taxpayer dollars, they jacked up the price. I think at last look, it was around $130 a dose. So that is a significant expense for a lot of people.
SHAPIRO: So bottom line, what is your advice for people who want to be as protected as they can be?
HOTEZ: Certainly, if it were my daughter or loved one who was pregnant and there was a lot of COVID transmission, I would strongly suggest that they get vaccinated to protect themselves and protect their soon-to-be newborn infant. For an adolescent or a child, if you're concerned about long COVID, I would also recommend keeping up with annual immunizations.
SHAPIRO: That is Dr. Peter Jay Hotez, codirector of the Texas Children's Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine. Thank you.
HOTEZ: Thank you. Transcript provided by NPR, Copyright NPR.
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