VACCINES FROM WOMB TO TOMB - Part 2

May 2, 2024 - Health Freedom Institute - Part 2

After the 1986 Act, many vaccines were added to the childhood schedule. When the pneumococcal vaccine was added in 2001, it was licensed both for adolescents and adults. The promotion of adult vaccines picked up again for that moment in time. In 2002, the CDC unveiled its first official adult schedule. In short, healthy adults who had already been following the CDC’s childhood schedule were recommended annual flu shots, tetanus boosters every 10 years (generally at the time given in tandem with diphtheria as a TD shot), and the newly added pneumococcal recommendation for people who were 65 and over.  

Compare that to the Adult Immunization Schedule now. 

Note that right now COVID is recommended as “one or more doses,” which basically means there’s a blank check for how many shots will be recommended. The FDA and the CDC, along with their advisory committees (ACIP and VRBPAC respectively), have contemplated annual doses, but there’s also discussion of targeting strains. In other words, what will be recommended is yet to be seen.  

One thing we can say for certain is that back in 2002 when the adult schedule table was first unveiled, the dose counts recommended were a lot lower. 

Barriers to success for the adult schedule 

Simplification: The American Family Physician group says of the adult schedule, “The success of the childhood immunization program is partly because of the annual publication of the Recommended Childhood Immunization Schedule that summarizes the current recommendations and that it can be posted in the office for quick reference. We suggest that physicians post the Recommended Adult Immunization Schedule in the office as a quick reference tool and that it be used as part of a larger office-based program to improve adult immunization rates.” 

Access: A study published on February 4, 2014, in the Annals of Internal Medicinerecommended that physicians refer patients to get the vaccines they did not stock to a pharmacy or public health department to get vaccinated.12 The reason for referring patients outside their clinic was either “lack of insurance coverage for the vaccine (55% for general internists and 62% for family physicians) or inadequate reimbursement (36% for general internists and 41% for family physicians).” Dr. Laura Hurley, one of the authors of the paper,13 that improving the delivery of recommended vaccines to adults will require a concerted effort to resolve financial barriers, especially for smaller practices and for general internists who see more patients with Medicare Part D. 

In short, access comes down to whether a doctor is going to be paid enough to go to the trouble of stocking a shot.  

The current White House has been promoting increased uptake of immunizing agents in adults. And the CDC, the agency in charge of getting “shots in arms,” has increased both propaganda and financial incentives. The 2023 Inflation Reduction Act (IRA), for example, was14   

Conveniently, any American with Medicare or Medicaid can get any shot on the schedule at no cost to them. But some states did not require payment through their Medicaid for certain vaccines, and this federal law overrode their autonomy to decide how to spend taxpayer money. The new policy addresses that. 

Biden’s policy follows the footsteps laid by Obama’s Affordable Care Act in 2010, which expanded access to vaccines with cost-sharing. The Healthy People plan was mentioned in the Affordable Care Act four times.15  

The IRA law also highlights the importance of the schedule itself — insurance payments hinge on whether the vaccine is on the schedule, not simply whether it has been recommended. Not surprisingly, for the first time in history, the ACIP chose to update its annual schedule to a rolling schedule to keep up with all the anticipated changes and additional recommendations. For the first time in the history of the schedule, the ACIP left the last page blank so new recommendations could be quickly added through the year, rather than waiting for the annual update. This was done in the name of access.  

You may have also been hearing of calls for financing called Vaccines for Adults. This will have to be legislated through the budget.  

WHY THE SUDDEN PUSH FOR VACCINES FOR ADULTS? 

A review of 100 vaccines in development by “Vaccines Today,” found a staggering 80% percent are aimed at adults.16 A survey of the vaccines and immunizing agents approved for use by the FDA over the past five years shows 11 of 15 can be marketed to adults, nine of which are only approved for those over 18 years of age.17 This is a shift from around the 1960s where we saw an explosion in new vaccines aimed at children, especially after the 1986 Act removed liability for injury from manufacturers and providers for shots on the childhood schedule. 

THE NATIONAL ADULT IMMUNIZATION PLAN 

The U.S. government has a plan to increase adult immunization rates — literally. It’s called the National Adult Immunization Plan.18

One of the goals of the plan is to simply increase demand. In other words, the federal government wants you to want these products. The plan was launched in 2015, a year after the CDC announced it was collaborating with Pfizer and a company called CECity to increase adult immunization rates.19 We know Pfizer makes vaccines (and “immunizing agents”); CECity is a company that specializes in electronic health records and was brought on board to implement a cloud-based “Adult Immunization Registry.” The initiative was released during the World Health Organization’s “Decade of Vaccines,” where their “Global Immunization Vision and Strategy 2006-2015” expanded the target group for routine immunizations to include adults. 

The plan integrates health data transfer goals with calls for “interoperability” and “bidirectional exchange” of personal data between electronic health records (EHRs) and Immunization Information Systems (IIS’s).  

Can adults injured by vaccines sue the manufacturer? It depends. 

The 1986 Act and subsequent court cases removed liability from manufacturers and providers of vaccines if a person is injured or killed from vaccines. Does that apply to all vaccines? No, it only applies to shots that are on the childhood schedule. So if an adult takes a vaccine that is on the childhood schedule, like HPV or tetanus, they are bound by law to lose their right to a day in court and instead go through an administrative process many call “Vaccine Court,” which removes the right to a trial by jury. But if an adult takes the vaccine for shingles, which is not on the childhood schedule and therefore not under the umbrella of the VICP, an injured person can sue in court. It makes one wonder if those legal rights could be taken away and swept up into an amendment to the 1986 Act with a normalized Adult Immunization Schedule. 

REFERENCES

1. “Recommended Adult Immunization Schedule.” CDC. February 28, 2024. https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf. ↩︎
2. “Recommended Adult Immunization Schedule–United States, 2002-2003.” MMWR Morb Mortal Wkly Rep., (2003): 52(15):345. https://pubmed.ncbi.nlm.nih.gov/12418546/. ↩︎
3. “2020 National Vaccine Plan Development: Recommendations from the National Vaccine Advisory Committee.” Public Health Reports, 135(2):181–188. https://pubmed.ncbi.nlm.nih.gov/12418546/. ↩︎
4. MMWR Morb Mortal Wkly Rep., (1991): 40(RR-12). v “ACIP Recommendations 1969: Collected Recommendations of the Public Health Service Advisory Committee on Immunization Practices.” National Communicable Disease Center 18, no. 43. https://stacks.cdc.gov/view/cdc/818. ↩︎
5. “Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention.” Public Health Service 79-55071, U.S. Department of Health and Welfare (1979). https://files.eric.ed.gov/fulltext/ED186357.pdf. ↩︎
6. “The Evolution of the Healthy People Initiative: A Look Through the Decades.” J Public Health Manag Pract, (2021): 27(6):S225–S234. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478310/. ↩︎
7. “Current Trends Measles on College Campuses.” Morbidity and Mortality Weekly Report, (1985): 34(29);445-9. https://www.cdc.gov/mmwr/preview/mmwrhtml/00000581.htm.
   ↩︎
8. “Public Law 99-528.” Congressional Record, 99th Congress 132, (1986). https://www.govinfo.gov/content/pkg/STATUTE-100/pdf/STATUTE-100-Pg3009.pdf. ↩︎
9. Congressional Record, 99th Congress 132, part 15 (1986): 21399. https://www.congress.gov/bound-congressional-record/1986/08/13/senate-section?p=1. ↩︎
10. “Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention.” Public Health Service 79-55071, U.S. Department of Health and Welfare (1979). https://files.eric.ed.gov/fulltext/ED186357.pdf. ↩︎
11. “Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention.” Public Health Service 79-55071, U.S. Department of Health and Welfare (1979). https://files.eric.ed.gov/fulltext/ED186357.pdf. ↩︎
12. ”US Physicians’ Perspective of Adult Vaccine Delivery. Annals of Internal Medicine. Volume 160. No. 3. https://www.acpjournals.org/doi/10.7326/M13-2332?articleid=1819120 ↩︎
13. “National Adult Immunization Plan.” U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/nvpo/national-adult-immunization-plan/naip.pdf. ↩︎
14. “Several Changes to Adult Vaccine Access Enacted Through IRA.” Avalere, (2022). https://avalere.com/insights/several-changes-to-adult-vaccine-access-enacted-through-ira. ↩︎
15. “Compilation of Patient Protection and Affordable Care Act.” U.S. House of Representatives, (2010). https://housedocs.house.gov/energycommerce/ppacacon.pdf. ↩︎
16. Future of Immunisation: 100 Vaccines in the Pipeline.” Vaccines Today, Gary Finnegan (2023). https://www.vaccinestoday.eu/stories/future-of-immunisation-100-vaccines-in-the-pipeline/. ↩︎
17. “Biological Approvals by Year.” The Center for Biologics Evaluation and Research, U.S.FDA (2024). https://www.fda.gov/vaccines-blood-biologics/development-approval-process-cber/biological-approvals-year. ↩︎
18. “Adult Immunization Plans.” U.S. Department of Health and Human Services, (2019). https://www.hhs.gov/vaccines/national-adult-immunization-plan/index.html. ↩︎
19. “American College of Physicians, CECity, and Pfizer Collaborate to Increase Adult Immunization Rates.” Pfizer, (2014). https://www.pfizer.com/news/press-release/press-release-detail/american_college_of_physicians_cecity_and_pfizer_collaborate_to_increase_adult_immunization_rates ↩︎