Vaccine Fellows Share Updated Recommendations, Insights
Aug. 23, 2024, David Mitchell — The CDC’s Advisory Committee on Immunization Practices recommended updated COVID-19 vaccines for everyone ages 6 months and up during its June meeting, and more than 40 states recently reported high or very high levels of COVID activity, according to wastewater data updated by the CDC on Aug. 15.
Unfortunately, COVID vaccine uptake was low in 2023-24 — 10% in young adults, 14% in children and 41% in those 75 and older.
“We, as family medicine physicians, have some work to do,” Anne Schneider, D.O., FAAFP, of Naperville, Ill., said during the Aug. 8 episode of the Inside Family Medicine podcast.
Schneider, who was an was an AAFP Vaccine Science Fellow from 2021 to 2022, discussed the ACIP’s new recommendations and tips for dealing with vaccine hesitancy during the podcast. She noted that during the 2023-24 season, less than one-third of parents reported that their children’s clinician recommended COVID vaccination.
“Our statement of recommending a vaccine is vital to that uptake of the vaccine,” said Schneider, who is medical director for the Student Wellness Center at North Central College and chair of her health system’s vaccine committee. “This is a team effort and includes all staff being prepared to answer questions.”
As a new school year begins, the percentage of kindergarten students up to date on recommended vaccinations has not rebounded to pre-pandemic levels. Schneider said it’s important to remind parents that vaccines protect not only the individual patient, but also family, friends and the community by reducing the spread of the disease.
“There’s a lot of vaccine fatigue since the pandemic, so it’s really vital for physicians to paint that picture for families of new kindergartners just how much exposure to potential illness they may have at school,” she said. “Physicians can help explain to families that diseases spread through the air, can live on surfaces, and get them to really think about how many tiny hands are touching everything and all the sneezing and coughing that occurs at school.”
Other new recommendations also are covered (in greater detail) during the podcast:
A new 21-valent pneumococcal conjugate vaccine is an option for adults 19 and older. PCV21 covers more than 80% of the most common pneumococcal serotypes, compared to less than 60% covered by PCV20.
The ACIP reaffirmed its recommendation for annual flu vaccinations for people ages 6 months and older who do not have contraindications. There is a nuance for solid organ transplant recipients ages 18 through 64 years taking immunosuppressive medication regimens. The committee now recommends high-dose and adjuvanted inactivated flu vaccines for that population.
Vaxelis, a combined diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, and Haemophilus influenzae type b vaccine, is now included in the preferential recommendation for infants of American Indian and Alaska Native descent, who are at increased risk for Hib.
An updated recommendation for respiratory syncytial virus vaccine calls for all adults 75 years of age and older to receive a single dose, while adults 60 to 74 years of age should receive a single dose if they are at increased risk of severe disease. The previous recommendation called for adults 60 years and older to receive one dose based on shared clinical decision-making.
AAFP News delved deeper into the latest ACIP updates this week.
Also this week, Inside Family Medicine posted an episode featuring recent Vaccine Science Fellowship graduates Neha Chande, M.D., M.H.S., of Santa Monica, Calif., and Llewellyn Mensah, M.D., M.P.H., FAAFP, of Gastonia, N.C.
Chande said she was specifically looking for a vaccine training program for physicians. Fellows attend vaccine-related meetings (including ACIP meetings), develop a self-study project, participate in monthly calls, and work with mentors throughout the year.
“I came across this and I couldn’t believe it,” said Chande, a health sciences assistant clinical professor in the Department of Family Medicine at the David Geffen School of Medicine at the University of California, Los Angeles. “There is literally a program combining my passion for family medicine, and for vaccines and public health. I’m just so grateful that I’ve been able to participate. I don’t think (family medicine) is always recognized for the wide range of clinical medicine we do (or) how much public health policy and recommendations we have to constantly filter through and make sure that we implement it for our patients. This is a way to get involved in the behind-the-scenes aspect of it.”
More than two dozen family physicians have participated in the fellowship since its inception in 2009. Chande said the experience connected her to “an amazing network of alumni who are passionate about family medicine, and vaccine science and policy.”
Mensah, who practices at a federally qualified health center, said learning more about the science involved in the process of vaccine development, production and policy has helped him better communicate with vaccine-hesitant patients and parents.
“Using the right language is so important,” he said. “I’m spending a lot more time talking about vaccines and boosting patients’ confidence to receive these vaccines. If you are interested in family medicine and public health, this is fellowship is for you.”