Conversation with a Pediatrician: Vaccine Access and Keeping Kids Healthy

Which vaccines should kids get in the fall?

As a pediatrician, I recommend my eligible patients to stay current on their vaccine schedules and receive their routine vaccinations, as well as COVID and flu vaccines. We know that they are safe and effective, and they help prevent illness, severe illness, and hospitalizations in cold and flu season, which is really bad in many winters.

Will the average, healthy kid be able to get a COVID vaccine this fall?

Well, there is a lot of worry about that. This has never been an issue before. As we walk through things, we look at the science and the data, and then there's recommendations from FDA and then ACIP. 

This year's different. We saw FDA scientists being overruled, reportedly, in their recommendations. We are waiting for ACIP to meet. But in that context, we have resignations from the Centers for Disease Control and Prevention of people that were specifically worried about this ACIP meeting and that it was not going to follow the evidence. So that leaves all of us in this place of wondering what to do and who to believe.

Time and time again, we poll parents and ask, “Who is your most trusted source of information for the health of your child, for immunizations, and for public health information?” And it is their child's doctor. So, find that person, and talk to that person. Do not listen to social media, there is so much misinformation that parents are walking through. I will tell you that as I sit down and talk to parents about vaccines, I have never met a parent who is not just trying to do the right thing, and they are filtering through so much information. 

So, talk to your pediatrician. As a pediatrician, I would recommend, and the American Academy of Pediatrics recommends immunization against flu and COVID. We certainly saw deaths from COVID from healthy kids. In the past that has been disputed, but we did. Every year we see deaths from flu. So let's protect ourselves and protect our communities.

What should pregnant people do if they are worried about COVID-19 this fall?

I am the type of pediatrician that practices in a newborn intensive care unit. During the height of COVID, we had babies that were born preterm just because their mothers were so sick from COVID. That memory is still ingrained of me walking into delivery rooms with all the garb on because mom was COVID positive and sick, and the infant otherwise was healthy but had to be born preterm because mom was so sick. 

We know that vaccination in pregnancy protects mom and provides some protection to the newborn after they are born, too. So it's important, and the American College of Obstetricians and Gynecologists recommends it. So again, have a conversation with your obstetrician about the COVID vaccine. The research and the data support that it works.

Why is it so important to vaccinate newborns for hepatitis B?

It is to prevent transmission from mom to baby. We give it early on and we give it routinely. First off, it is very well tolerated, but it also reduces the risk that there is transmission from mom to baby or from communities. We know that infants are at much higher risk of developing chronic inflammation of their liver if they are infected. It is one of those steps where we can prevent a disease, so that is what we do.

What happens to community health if fewer children get vaccinated?

We have done such a great job of getting rid of diseases like polio that decimated communities not that long ago. And so, the worry is that we will have a resurgence of those diseases among children, which can have lifelong complications, and then it will spread to folks who are adults who have waning immunity. This is about protecting our kids, but it is also about protecting all of us. 

One thing I am mindful of is that there are many diseases my patients in the newborn intensive care unit cannot get vaccinated for because they are too young. There are other kids who cannot get immunizations because they have cancer, for example. The way we have approached this always in the past is having the mindset of getting vaccinated to not just protect me, but also to protect you. 

It is worrying that we are now in this place where we are being told all this misinformation, and that is beginning to erode the contract that we have with one another to be there for each other.

What can parents do to keep their families and communities healthy this fall?

First, talk to your family doctor or your pediatrician about vaccination and about specific risk factors you may have that would qualify you or your child for vaccination. 

Besides that, it is the general things we do to prevent disease spread:

• If your kids have a cold, a cough, or a fever, keep them at home.
• Wash your hands and have hand sanitizer around as you are going through this season.
• Maybe avoid big groups if there's high disease spread. 

I think one of the challenges we face right now is all the unknowns heading into the season. We are already seeing COVID in the community, and we do not really know as we approach the respiratory season what flu and COVID will be like this year.

What I worry about is not only the disease spread in communities, but the stress and strain it could put on our resources. Children's hospitals, for example, become very stressed during respiratory season. If we see a big resurgence like we have seen in years past, I worry about the stress that that can put on our systems.