Q&A: Expert Discusses Impact of New ACIP Member Changes and Vaccine Recommendations

The recent changes in the Advisory Committee on Immunization Practices (ACIP) have raised significant concerns among health care professionals about the future of vaccine recommendations and public health strategies. With new ACIP members potentially altering the approach to vaccine evaluation, Deanna Tran, PharmD, BCACP, FAPhA, associate professor of the department of practice, sciences, and health outcomes research at the University of Maryland School of Pharmacy, emphasizes the need for independent scientific assessment, relying on multiple reputable organizations, and maintaining patient trust. The potential impacts include slower vaccine approvals, complications in insurance coverage, and challenges in vaccine accessibility, prompting a call for proactive communication, community outreach, and strategic patient education to combat misinformation and preserve confidence in vaccination programs.

As concerns mount over potential shifts in vaccine recommendations, Deanna Tran, PharmD, BCACP, FAPhA, advocates for rigorous data assessment and patient-centered communication strategies. | Image Credit: Yuri Arcurs/peopleimages.com - stock.adobe.com

Drug Topics®: How will the trust of federal health entities be impacted for health care providers?

Deanna Tran, PharmD, BCACP, FAPhA: So the situation with ACIP really places us, I think, in a difficult situation. Historically, ACIP provided a uniform voice rooted in scientific literature regarding vaccines and its schedules, and oftentimes providers, including myself, as well as health care insurers, we just relied on those experts from ACIP and the CDC to help make those recommendations. So now, especially with these new ACIP members being of potential concern for the scientific community, I think that we have to be more diligent in assessing the data ourselves and making an informed clinical decision. It's honestly no different than how we've been assessing other evidence-based guidelines, let's say, for like a specific disease state. We still have to review the evidence behind it and make an informed decision for our patients, and so I also think about some of the organizations that nowt hey've continued to provide strong evidence-based data. So, like, we can rely on some of these other organizations to help supplement our clinical decision making. So this includes, like, obstetricians, the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). I also want to add that, for pharmacies specifically, many state regulations and scopes of practice regarding vaccinations follow ACIP and the CDC schedule. So this really just further complicates things; for example, to reduce liability, pharmacists may require patients to have a prescription for a vaccine if it's not aligned with the CDC vaccine schedule. This would ultimately cause a decrease in access to vaccines for patients, especially those who don't have easy access to our primary care provider.

Drug Topics: What will be the likely impacts of this change that pharmacists will need to communicate with their patients

Tran: Based on what we've learned so far about the new ACIP members, there may be more emphasis on long-term safety data and post-marketing surveillance, and this could slow down future vaccine approvals, including yearly vaccines and other scheduled updates. It's also important to help share with our patients how changes may also impact health insurance coverage for a vaccine.

Drug Topics: How can a pharmacist explain these changes to a patient worried about vaccine safety, especially if they heard conflicting messages?

Tran: Again, I think it's important to share the processes that ACIP typically takes to evaluate safety data when making our current vaccine schedule recommendations. This will hopefully help to instill confidence in the current schedule. It's also important to emphasize the safety data that we already know. So for example, COVID vaccines are actually one of the most studied vaccines to date and has substantial safety data to draw from some of the complexities in maintaining and regaining trust in some of this information and misinformation, including some of the statements by Secretary Kennedy, tangle truths with misinformation. So teasing out those truths can really be complex and difficult to explain to a patient, so I would recommend that pharmacists stay up to date on ongoing issues, be willing to hear out and even research what misinformation is circulating in order to strategize how best to educate our patients and then help them discern truth from misinformation. When discussing misinformation, studies have indicated that meeting patients where they're at so that means that agreeing with points that the patient makes that are true, can actually help to build rapport with patients when attempting to address the misinformation. This helps move patients from vaccine hesitant to vaccine acceptance, and in an age where a lot of people are kind of doing their own research, I think that it's important to talk through Google or AI. Some of those things may not be sufficient in helping them, so we want to take this opportunity as pharmacists to help patients get the most accurate, most appropriate science-based information, including those organizations that I mentioned earlier.

Drug Topics: How do ACIP recommendations affect broader aspects of vaccine access and utilization, such as insurance reimbursement or public health programs?

Tran: So changes in ACIP recommendations could impact health insurance coverage. Almost all payers are required to cover recommended vaccines that are tied to ACIP and CDC vaccine schedules at no cost. So therefore, if recommendations are narrowed or removed, payers are no longer required to provide no-cost coverage for a vaccine that's just not on the schedule. This reduces accessibility for patients who feel that maybe they would like to get the vaccine, but now it's not in the revised vaccine schedules that might occur in the future. Now I do know that some states, like Maryland, which is where I'm from, have enacted legislation to assist with this particular issue. So Maryland's legislation requires health insurers as part of the minimum package of child wellness services to cover ACIP recommendations as of December 31, 2024 so this would include what was previously already in the schedule before we've had the ACIP changes that have been coming, and it would include any new vaccines that are recommended after December 31, 2024.

Drug Topics: Is there anything else you would like to add?

Tran: I wanted to add that we have to also leverage our work directly with the communities going and outreaching directly in the communities, especially those in high vaccine-hesitant areas, can really help to move the needle, especially In the age of declining trust and vaccine fatigue.

READ MORE: Immunization Resource Center

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