A federal vaccine advisory panel voted on Friday to recommend people talk with a clinician before getting a Covid vaccine, while voting against a motion to require prescriptions for the shot.
All 12 members of the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC) voted unanimously to update COVID-19 guidance so coronavirus vaccinations for all people should be based on “individual-based decision making.”
For people between six months and 64 years old, the recommendation advised that vaccinations be based on individual-based decisionmaking along “with an emphasis that the risk-benefit of vaccination is most favorable for individuals who are at an increased risk for severe COVID-19 disease and lowest for individuals who are not at an increased risk, according to the CDC list of COVID-19 risk factors.”
ACIP Chair Martin Kulldorff said it was his understanding that this recommendation they voted on would mean that SARS-CoV-2 vaccines would still be covered by insurance. Insurers look to the board’s recommendations to inform their coverage.
The ACIP voted against a motion which recommended that states and local jurisdictions require prescriptions for COVID-19 vaccines. The panel does not have the purview over whether to require prescriptions. States and local jurisdictions make those rules, not the CDC.
The vote was split evenly 6-6. With Kulldorff voting ‘no’ to break the tie, the motion failed.
The questions they were to vote on were not publicly disclosed until the very end of the meeting.
ACIP member Retsef Levi, professor of operations management at the Massachusetts Institute of Technology’s Sloan School of Management, led the panel’s discussion on the COVID-19 vaccines.
Levi, a known COVID-19 vaccine opponent and skeptic, was selected to lead the CDC’s COVID-19 working group in August. During the pandemic, Levi called for all COVID-19 programs to be stopped immediately, claiming there was no proof of efficacy and that the vaccines were behind the deaths of children and young people.
Levi presented four questions for the committee to vote on: to recommend the CDC promote six risks and uncertainties he cited in his presentation on Friday; to recommend requiring prescriptions for COVID-19 vaccines; that patients should be informed of the risks of COVID-19 and its vaccination before receiving the shot; and to update the current guidance so that coronavirus vaccinations for all people should be based on “individual-based decision making.”
All questions except for the one recommending a prescription for COVID-19 vaccine were passed by the committee.
Members of the working group that Levi leads gave a presentation strongly supporting the continued availability of COVID-19 vaccines, especially for pregnant women, children and seniors.
“In summary, Covid-19 vaccination matters for pregnant women, pediatric patients — especially those less than two years of age — people 65 years and older, those of any age with a weakened immune system or chronic medical conditions and anyone who feels they want protection for themselves or their families,” said Henry Bernstein, a member of the COVID-19 working group, on behalf of himself and two other members of the working group who he described as being in the “minority.”
During the committee’s discussion on Friday, ACIP members spent time speculating on whether the COVID-19 vaccine rewrote human DNA after being administered, whether it could cause lung cancer; of it could cause birth defects.
The debate over requiring a prescription, though outside the powers of the committee, was prolonged as several members strongly believed that requiring a prescription was creating a barrier to access. Members noted that people who are uninsured or underinsured don’t have the ability to easily go to a healthcare provider to receive a prescription.
Prescriptions aren’t normally required for seasonal vaccines like the flu shot and COVID-19, being available to the demographics for whom they are recommended. Still, Levi argued that COVID-19 vaccines were being treated essentially like over-the-counter drugs, adding that he believed they offered “questionable benefits for a lot of people.”
Fellow ACIP member Hillary Blackburn, pharmacist and director of medication access and affordability at Ascension Rx, who was appointed just this week, spoke out strongly against a prescription requirement.
“Well historically, at least 19 states have required pharmacist authorization to be tied to ACIP recommendations,” Blackburn noted. “And so, a lot of the states have been making their own recommendations to help clarify some of the confusion, which has been limiting some of the access, as we’ve seen with CVS and Walgreens pulling their COVID-19 vaccines for the season.”
Kelly Goode, president of the American Pharmacists Association, added on to this argument, telling the committee, “Pharmacists are the most successful healthcare providers who embrace the relationships with patients, and are well equipped to determine risk based on medications and health histories.”
“Furthermore, pharmacists are the healthcare providers who have the most experience with covid 19 vaccines. Claims data show that 90 percent of COVID-19 vaccines have been given in pharmacies,” she added.
