NBC News
Instability in Centers for Disease Control and Prevention (CDC) and the fact that states are beginning to assume greater control over their own decisions about vaccines threaten to fracture the consensus that previously existed nationally around vaccination, and could rethink the vaccination recommendations system throughout the United States.
These changes, together, point to a growing division around vaccination in the United States, with some states led by Republicans who have begun to reduce or eliminate mandates, while states led by Democrats distance themselves from CDCs to elaborate their own vaccination guidelines.
On Wednesday, California, Oregon and Washington announced a public health alliance to provide reliable information on the safety of vaccines in response to the recent dismissal of the CDC director, Susan Monarez, the resignations of outstanding scientists after their dismissal and the new and controversial guidelines of the Food and Medicines Administration (FDA) about who must be vaccinated against COVID-19.
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Last week, the New Mexico Health Department announced that it would order pharmacies “to eliminate possible barriers and guarantee access to vaccines against COVID-19”. Colorado did the same on Wednesday.
Also on Wednesday, the Director General of Health Services of Florida, Dr. Joseph Ladapo, announced that the State will eliminate vaccination mandates, even in public schools. Other states have also considered the possibility of reverting the mandatory vaccination, especially Texas, where dozens of bills against mandates have submitted.
This division occurs at a time when false statements, discredited for a long time, about vaccine health risks have found great attraction and have been adopted by the Trump administration.
“Repeatedly listening to vaccines cause autism or that an RNM vaccine alters DNA can erode public trust,” said Dr. Peter Chin-Hong, an expert in infectious diseases at the University of California in San Francisco, referring to two of the most common cases of misinformation about vaccines.
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For decades, the Federal Government, in close collaboration with experts in infectious diseases, has prepared guidelines on who should be vaccinated and when. The states and medical organizations used these guidelines to administer vaccines to millions of people, and insurers were based on them to determine the payment. The recommendations were based on clinical studies and sought to minimize individual and social risk.
But as the reluctance to be vaccinated has shot after the Covid-19 pandemic and the internet misinformation campaigns, vaccination mandates have become a point of political conflict.
A divided country
The distrust of vaccines has created a division that threatens to divide the country into two different areas, delimited not by borders or geography, but by the positions of state governments on the right of the medical system to dictate who should be vaccinated and who does not.
In an opinion article published on Tuesday at The Wall Street Journal, the Secretary of Health and Human Services (HHS), Robert F. Kennedy Jr., described measures such as “the use of fabric masks in young children, the arbitrary distance of 1.8 meters, the reinforcement dose for health The suppression of low -cost therapies in favor of experimental and ineffective medicines “as” irrational “policies that had a devastating impact on Americans.
The confinements and the closure of schools certainly had economic and mental health inconveniences, and the data suggests that people vaccinated and not vaccinated can transmit the virus to similar rates because they have comparable viral loads (or quantities of viruses in their respiratory tract), according to an article of 2022 published in The Lancet Infectious Diseases.
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However, vaccines were effective in reducing hospitalizations and the number of serious COVID-19 cases, two factors that collapsed health systems at the beginning of the pandemic and precipitated confinements in the United States and throughout the world.
Once Vaccines against COVID-19 were available at the end of 2020, after the intense investment of Trump’s first government, the states began to make confinement and social distancing measures more flexible.
What did not decrease, and still does not decrease, was the fear of the alleged dangers of the new vaccines against COVID-19, developed through a new type of vaccine technology, known as MRNA, which was both revolutionary and difficult to understand.
The novelty aggravated the uncertainty about the long -term repercussions for the health of a previously unknown virus and the general feeling of loss generated by the pandemic, including the loss of personal freedoms. This created the perfect conditions for the division around vaccines, said Chin-Hong, and Covid-19 vaccines became an easy scapegoat.
“The vaccine is something that one could focus, instead of a general feeling of loss,” he said.
Kennedy, one of the most outstanding figures of the once small anti -vacussion movement, was confirmed as HHS secretary after adopting a more moderate tone about vaccines, which he later abandoned.
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In June, Kennedy dismantled an independent advisory committee on vaccines from 17 people at CDC. He replaced the members with a group that included skeptics of immunization and people criticism of vaccines against COVID-19. At the beginning of August, he also cut 500 million dollars in contracts for RNM vaccines.
After the FDA approved a new version of the COVID-19 vaccine in May, Kennedy announced that the CDCs would recommend that doctors manage vaccines only to adults over 65, as well as people with certain pre-existing conditions. Previously, COVID-19 vaccination was recommended more generalized.
After that change, the American Pediatrics Academy made the unusual decision to issue its own vaccination recommendations; The first time in 30 years that their guidelines differed significantly from those of the Federal Government.
“It will be somewhat confusing. But our opinion is that we must make the right decisions to protect children,” Dr. James Campbell, vice president of the Infectious Diseases Committee of the Academy told NBC.
That could have been the first visible fracture in the growing vaccination gap in the country.
“Protected by science, not by politics”
The governors of California, Oregon and Washington follow those steps, stating that they work to provide unified recommendations to “ensure that residents remain protected by science, not by politics.” They warned that there will be serious consequences if the CDCs become “a political tool that promotes more and more ideology instead of science.”
“The mass dismissal of doctors and scientists of the CDC by the president, Trump, and his flagrant politicization of the agency, is a direct attack on the health and safety of the US people,” said the statement.
In a statement, HHS criticized the states governed by the Democrats for pandemic policies that “undermine the confidence of the US people in public health agencies.” He also defended the Advisory Committee on Immunization Practices for CDC.
“ACIP remains the scientific organism that guides immunization recommendations in this country, and HHS will ensure that policies are based on rigorous evidence and reference science, not on the failed policies of the pandemic,” said the statement.
The press release announced by the Health Alliance of the West Coast on Wednesday criticized the dismantling of the CDC, pointing out the absence of consistent federal leadership and with a scientific basis in public health. He added that the shared principles of the alliance will be finalized “in the coming weeks.”
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Without clarity by the federal government, each State could begin to prepare its own public health orders.
The New Mexico Department of Health announced last week that ordered pharmacies “to eliminate possible barriers and guarantee access to vaccines against COVID-19” after some pharmacies reported that they could not administer the new versions of vaccines against COVID-19 until the CDC advisory panel met and issued its official guide.
Insurance companies, which resort to the federal government to obtain guidance on the coverage of health plans, will also analyze the changing panorama in the coming months.
The vaccines recommended by the Advisory Committee on Immunization Practices are usually free thanks to the provisions of the Asequible Medical Care Law (Obamacare) and the Inflation Reduction Law of 2022.
Tina Stow, AHIP spokesman, a group of the medical insurance industry, declared that the organization was reviewing the announcement of the FDA and that, together with its members, it would closely follow the next recommendations of the CDC on considerations related to coverage.
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“Individual health plans and their sponsors will be prepared to make coverage decisions based on science, the most recent medical evidence and the most recent data,” he said. “This process will be based on evidence, will evaluate multiple data sources, including, among others, the ACIP, and will be based on the needs of customers.”
Decisions on vaccine coverage may also depend on the recommendations of medical organizations such as the American Pediatrics Association.
Chaos for recent layoffs
In recent days, greater chaos was unleashed in the CDC after the White House announced the dismissal of Monarch as its director after her refusal to resign. Monarch’s lawyers affirmed that “he refused to automatically approve little scientific and reckless directives and to fire health experts” and that “he preferred to protect the public instead of serving a political agenda.”
His dismissal caused a massive exodus of senior CDC officials. Nine former Directors and functions accused Kennedy of jeopardizing Americans in an essay published Monday at The New York Times.
“During our respective mandates in the CDCs, we do not always agree with our leaders, but they never gave us reasons to doubt that they would be based on information based on data for our protection, or that they would support public health workers,” they wrote.
The signatories urged Congress to exercise their supervision authority on HHS and urged state and local governments, as well as philanthropic entities, to cover the deficiencies as much as possible.
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Kennedy defended his decisions, including the dismantling of the CDC, in essay published on Tuesday at The Wall Street Journal. He accused the CDC of Mursing public trust for decades.
He wrote that the organization should focus on infectious diseases – its original mission – and that other programs focused on chronic diseases, such as diabetes or heart disease should be decentralized.
“CDC must restore public trust, and that restoration has already begun,” Kennedy wrote.
