Under updated guidelines from Health and Human Services Secretary Robert F. Kennedy Jr. and the Food and Drug Administration, healthy children, pregnant women, and most adults under 65 are no longer routinely recommended to receive the COVID-19 vaccine. The change is raising concerns among some San Diego doctors and public health experts, who said the move could widen health disparities, especially for low-income families and communities of color.
The announcement brought back memories of what it was like before COVID-19 vaccines were available for Dr. Marsha Spitzer, a pediatrician with Family Health Centers San Diego.
“It was awful,” she said. “My first thought was that we can't go back,”
Spitzer is worried the updated recommendations could leave vulnerable families confused about their eligibility for the vaccine and at greater risk.
“No doubt the communities were not all equally affected. And our most marginalized or under-resourced communities are the ones that were hit hardest by COVID,” she said.
In San Diego County, vaccine uptake remains uneven. The latest vaccine data show 8% of Latinos and 11% of Blacks are up to date with their COVID-19 vaccine, compared to 16% of whites.
The new policy could deepen health inequities, said Cheryl Anderson, an epidemiologist and dean of the Herbert Wertheim School of Public Health & Human Longevity Science at UC San Diego.
“We'll find that those who are in more vulnerable positions, whether it's economically or socially, are the ones who will have the greatest hurt or the greatest impact based on lack of availability.”
Latinos make up 55% of California’s frontline workers, putting them at higher risk of exposure. In San Diego County, they died from COVID-19 at a higher rate than whites.
“So all policies around vaccines really need to be thoughtful about the different environments that people have in the context of their lives that could then impact whether or not they're going to be likely to get an infection or not,” Anderson said.
Research shows Black and Hispanic communities were hit harder by vaccine hesitancy, partly due to past medical mistrust and a history of racial discrimination.
Community clinics will play a vital role in educating the community about their options under the new guidelines, Spitzer said.
“I'm talking to families about vaccines,” she said. “I will continue to have those conversations, and I will tell them what my recommendation is based on the science.”
The policy shift could also lead some insurers to stop covering the vaccine, said Mayra Alvarez with The Children’s Partnership.
“It's almost $200 to pay out of pocket for a vaccine,” she said. “That $200 can help pay their rent, to pay for childcare costs, to pay for food.”
Adults without insurance or with incomes below the poverty level were much less likely to get vaccinated than those with coverage or higher earnings, according to CDC data.
A new NIH-funded study shows that 1 in 7 children under age six who got COVID-19 developed long COVID. Anderson said the risk remains.
“This policy should not leave anyone thinking that COVID is no longer a public health concern,” Anderson said.
Experts stress this policy could deepen gaps in care unless public health agencies step up efforts to ensure access, especially in the communities hit hardest by COVID-19 from the start.
