In the classroom, optimism and concern raised over CDC vaccine discourse

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Just last week, the Advisory Committee on Immunization Practices (ACIP), an appointed committee under the Centers for Disease Control and Prevention, made changes to their recommendations for well-known vaccines for kids and adults.  

Pediatricians, pharmacists, public health and other doctors use ACIP recommendations to inform what vaccines they make available.  

Over the two-day-long meeting at the CDC in Atlanta on Sept. 18 and Sept. 19, the group voted to remove their recommendation for a combination vaccine that protects kids under four years old against measles, mumps rubella and varicella, or chicken pox.  

A vote on a whether to keep a recommendation for a hepatitis B vaccine that kids get soon after being born was pushed until the next meeting, because members were confused over the language being voted on. 

The result of a heated discussion on the safety of the COVID-19 vaccine between committee members and advising members was a recommendation that seniors, adults and kids at least 6 months old get the shot. The major change was in the language of the ACIP recommendation, which now includes “shared-decision making,” or a conversation between patient and provider about the vaccine’s risks.  

• RELATED: CDC vaccine panel adds new rules for getting the COVID vaccine in a tense meeting 

The ACIP’s decisions will have repercussions on access to well-known vaccines for kids and adults. 

Just a few miles away from the meeting making national headlines, people who study public health were having their own conversations. 

Rooted in science  

In assistant professor Robert Bednarczyk's epidemiology course, every week, they study a different disease and vaccine.   

“You think about the old sci-fi shows and each week there was a specific monster that they were battling or fighting,” Bednarczyk said. “And that's kind of what this is."

The course, Vaccines and Vaccine Preventable Diseases, is for students pursuing a higher education and research at the Emory University Rollins School of Public Health.  

They talk about diseases like polio, influenza, and Human papillomavirus, Bednarczyk’s area of expertise. They consider the results of vaccine trials, looking at hard numbers, what worked — and what didn’t. 

“A lot of the things that we focus on is just how can we most effectively use these vaccines,” he said. “And sometimes it's just how we talk about them, and sometimes it is about how do policies and systems work to make sure that people have access to these life-saving interventions.”  

While conversations outside the classroom have become increasingly inflammatory, in here, students and lecturers instead focus on years of data.  

“It’s to be nice to have that very concrete anchoring to what we're talking about, so that again, everybody is getting the good information that they need to be able to move forward in this field,” Bednarczyk said. 

During Friday’s class, student Alyssa Leal said she loves the deep dives. She wants to be able to talk about vaccines with anyone who asks.   

“So that I can then take and kind of like advocate and ease people's concerns for vaccines, because they're all valid, like, they're valid concerns,” she said.   

She’s worried about mistrust in science, and would like to see the increasing number people with concerns about vaccines addressed in an understanding way.  

The new crop of ACIP members, appointed by Health and Human Services Secretary Robert F. Kennedy Jr., say they want more studies on even the minor side effects of vaccines. New working groups will consider the benefits of vaccinating pregnant people and the schedules that vaccines are given.  

Public health experts warn the group is sowing confusion, ignoring scientific evidence and cherry-picking the studies they present.  

Andrew Hederman is studying immunology and microbiology as a post-doctoral fellow at Emory. He tries to be optimistic about the conversations happening in public health now.  

“For me, I'm excited about it,” Hederman said. “I think having people interested in public health and vaccines and, you now, more medicine in general, I think is always a good thing.” 

An unusual time for ACIP  

Ben Lopman, a professor in Emory’s Department of Epidemiology, said up until now, there has been no “historical precedent” that members on the CDC vaccine panel follow terms based on who is in the White House.  

That changed when all 17 members were removed in June.

Voting members of the ACIP serve four-year terms. That means by the end of President Trump’s second term, there may be a whole new group slated to start work.  

Lopman is an expert on diarrheal diseases such as those caused by rotavirus and norovirus. A former epidemiologist with the CDC’s Division of Viral Diseases, his research has been presented to the ACIP. Hundreds of thousands of children used to die from rotavirus every year before there was a vaccine.  

But even with their life-saving benefits, most every vaccine regularly given today has had its issues. Lopman’s presentation to the students of Vaccines and Vaccine Preventable Diseases emphasized the “classic hero’s journey” of the rotavirus vaccine which was pulled only a year after its introduction for causing a dangerous bowel blockage.  

The vaccine was then improved. The second-generation version shows a much lower prevalence of previously reported complications. It’s curbed thousands of annual hospitalizations and is routinely recommended for babies.  

Much of the Advisory Committe on Immunization Practices discussion last week on measles and hepatitis B vaccines rehashed old concerns about side effects, such as the chance of febrile seizures. But both vaccines are considered safe and effective, which was reiterated in presentations by CDC scientists to the group last week. 

“What I'm concerned about going forward is a focus on real, and sometimes perceived risks, that aren't taken into account with the really substantial benefits that come along with these vaccines,” Lopman said. “I think there's a lack of expertise on the panel.” 

The next meeting of the ACIP is scheduled at the end of October.