What parents need to know about childhood vaccines after CDC changes

S1: Welcome in San Diego. It's Jade Hindman on today's show here about the new federal guidelines for childhood vaccines and what local doctors are saying about them. This is KPBS Midday Edition. Connecting our communities through conversation. The US centers for Disease Control and Prevention released updated guidelines for childhood vaccines last week. That advice , however , runs counter to recommendations from California and San Diego County health officials. So what do parents need to know about the changes and which recommendations to follow ? I'm joined by Doctor Pia Raj. She is an infectious disease specialist with Rady Children's Hospital. Doctor Raj , welcome.

S2: Hi there. Thank you very much for having me.

S1: So glad to have you here.

S2: Last Monday , the CDC took away several of the vaccines and changed them to only for high risk groups or what's called shared decision making , meaning only after discussion with the doctor. Hmm.

S1: Hmm. So the recommendations for getting the hepatitis A and B vaccines were changed. Can you explain more about those diseases and what the previous recommendations were ? Sure.

S2: Yeah. They made changes to several vaccines , including hepatitis A and B , a meningitis vaccine , RSV vaccine , rotavirus , which causes diarrhea , and then the flu vaccine. Um , so hepatitis A and B , they cause diseases that affect the liver. It actually means Inflammation of the liver. Hepatitis B , in particular , can lead to a chronic infection that causes that can cause liver cancer. And so it's it's a we have a vaccine that's available that could prevent a cancer basically. And the changes to the vaccine recommendations makes it seem like it's an optional vaccine. Mhm.

S1: Mhm. What about changes to Covid 19 vaccines.

S2: So Covid 19 vaccine um is now by the CDC recommended just for those at high risk and only if they discuss families , discuss it with the with their physician. So the American Academy of Pediatrics recommends the vaccine for all children under two years of age , because we know that all children under two are at high risk just for being that young age. Um , they recommend the vaccine for high risk children two years to 18 and then the um. Other , um , the California Department of Health and other professional societies recommend the Covid vaccine for all adults just because there are still severe complications from Covid 19. Yeah.

S1: Yeah. You know , this news comes still , you know , with flu season in full swing. So I mean , can you tell us about the flu picture right now and how this CDC move could really impact kids in San Diego this winter , and especially as they head back to school ? Yeah.

S2: Um , definitely. Flu is hitting hard , especially on the East Coast. Um , we saw it hit hard in other countries , so we expected that it hit hard on the East Coast and it's making its way west. We're definitely seeing flu now. There's kids , um , having to stay out of school because of flu. And we're expecting this severity to hit in the next couple of weeks as well. And so , you know And that's with about 40 to 50% of our population vaccinated. So it's a little scary to think about what it'll be like if none of our nobody is vaccinated. Mhm.

S1: Mhm. Yeah.

S2: I mean flu is already circulating in San Diego County. Um , it takes about ten days to two weeks for the flu vaccine to work. But wolf flu will continue to stick around probably for the next couple of months. And so so , you know , getting the vaccine now is still better than not having it at all. Mhm.

S1: Mhm. You know , when talking about childhood vaccines , some of the debates around them are not always about which vaccines should be required but when they should be given. Can you explain that a bit more for us. Yeah.

S2: Yeah. The immunization schedule is made so that the timing of each vaccine is determined by when the child is most likely to get the disease , and when that child could have the most complications for the disease from the diseases. And so that determines when the vaccine should be given. So you don't want to give. You want to give the vaccine right in time to protect them when they're most at risk. You don't want to wait for it to be too late for them to have already been exposed to the disease , and then try to get the vaccine. It doesn't work that way.

S1:

S2: All of the original vaccine recommendations were made with a lot of thought and review of the data. That's both safety data and effectiveness data. And all of that is the same. It's what we've known from before. Nothing has changed to justify downgrading the recommendations. And so I think that's what's important for people to know. Um , pediatricians and providers know that. And , and even the California Department of Public Health knows that. And so here in California , we're all still giving the same vaccines as we always have , because the those vaccines work and they're safe and effective at those times that we recommend the vaccine.

S1: Um , so what should parents do about getting all this different advice from different places ? Um , you know , while the CDC's guidelines have changed , other health bodies , including here in San Diego County , as you mentioned , are sticking with what's what we've been doing.

S2: That's a great question. And that's that's really the key about all these changes it. It's leading to a lot of confusion. Confusion , unfortunately. So you know when when parents think about , you know , some of those changes said , well , you only need the vaccine if you're a high risk group. And I just want to point out that no one ever thinks they're in a high risk group. Just as an example , my family vacation to another country this over the winter break where seatbelts were not required in the back seat. And my children , who have always worn seatbelts and never questioned it for their safety , all of a sudden became very relaxed about wearing their seatbelts , you know , said , oh well , is this really necessary ? Oh , and that's the thing about , um , these new vaccine recommendations that say , oh , just get it. If you're high risk or only after discussion with your doctor , it makes people question what , um , what is always what has been known to be true , that these vaccines are safe and effective and all of a sudden now is safety a concern ? You know , it becomes a question. And do we need to discuss it with the doctor first ? It's always , you know , the doctors are always there and ready to answer questions. And so those discussions are always welcome. But I want to emphasize that it's it's important for people to know that all of that safety information , it's still there. Nothing has changed at all. And so your doctors are ready to have that discussion with you. But please know that those vaccines are still safe. Nothing's changed. Right.

S1: Right. And first , as for school requirements , um , do any of those change ? Nothing.

S2: Um , no. None of the school requirements have changed. Um , the vaccines that are recommended for school stay the same. You know , the idea is to prevent the infection from spreading within the schools where children Are close together. They share a lot of , uh , a lot of things , um , you know , touch the same door handles , um , share pencils and erasers. Even passed their phones around to each other. You know , it's really easy for diseases to spread in school. And that's why we have those vaccine recommendations. Yeah.

S1: Yeah. Um , earlier you mentioned this this idea of shared decision making , really navigating health care decisions. It can be hard. So do you have any advice for parents on how to best approach conversations with pediatricians ? Yeah.

S2: So shared decision making means that it's a decision with the doctor. And well , it sounds great on the surface. It unfortunately means the parents and families must now advocate for themselves. And that's not always easy. It's hard to get a doctor's appointment sometimes. The appointment is the time is limited. And when you're there with the doctor. So , um , but families definitely can ask questions if they're if they are concerned or are not sure about something , ask the pediatrician. Feel you know they should feel empowered to be able to bring up a question and have it answered in the with their pediatrician or their other health care provider.

S1: All right. I've been speaking with Doctor Pia Panerai. She is an infectious disease specialist with Rady Children's Hospital and professor of pediatrics at UC San Diego. Doctor Panerai , thank you so much for joining us today.

S2: Thank you so much.

S1: That's our show for today.

S3: I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.