Title: Vaccine Status and Other Public Health News

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Brigid Bergin: It's The Brian Lehrer Show on WNYC. I'm Brigid Bergin, senior reporter in the WNYC and Gothamist newsroom, filling in for Brian. Today. Shanah Tovah, Happy New Year to all who are celebrating. Coming up on today's show, our election series, 30 Issues in 30 Days, is on Issue Number 2, the housing-related ballot questions that will be on New York City ballots this November.

My guest will be WNYC and Gothamist housing reporter David Brand. Plus, for Climate Week NYC, which happens every year in conjunction with the UN General Assembly, we'll talk about how countries around the world are dealing with the climate-related challenges now that the United States under President Trump has fully deprioritized combating climate change.

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We'll wrap today's show with a conversation about the cold cultural significance of saris. This is connected to an exhibition at The New York Historical, and we'll want to hear from those of you who wear saris on their importance to you and your community, but first, we're starting with the health portion of Health and Climate Tuesday on The Brian Lehrer Show. Once again, we look at policies coming out of RFK Jr.'s HHS. Yesterday, there was a press conference at the White House.

President Trump: Today, we're delighted to be joined by America's top medical and public health professionals as we announce historic steps to confront the crisis of autism. Horrible, horrible crisis.

Brigid Bergin: At that lengthy evening event, the President made claims linking the use of acetaminophen during pregnancy as a cause of autism. Acetaminophen, of course, is the drug in Tylenol. There was considerable pushback from the medical and scientific community on the interpretation of the data. The President also weighed in on the number and volume of childhood vaccinations.

Plus, at the end of last week, the CDC's Advisory Committee on Immunization Practices, or ACIP, met and made some changes to vaccine guidelines. To try and clarify yesterday's announcements and what's changed and what hasn't in recommendations for pregnancies, for childhood immunizations, for doctors' offices and pharmacies, we're joined by Chelsea Cirruzzo, Washington correspondent for STAT News. Chelsea, welcome to WNYC.

Chelsea Cirruzzo: Thanks so much for having me.

Brigid Bergin: Let's start with that press conference. The biggest news was probably this from the President and his recommendation that people avoid Tylenol while pregnant.

President Trump: Fight like hell not to take it. There may be a point where you have to, and that you'll have to work out with yourself, so don't take Tylenol.

Brigid Bergin: Chelsea, sorry for our little miscue there, but I wanted to hear that recommendation coming from the President. Now, he did acknowledge that "they're waiting for certain studies," but went on to make it sound like there's evidence that acetaminophen, the active ingredient in Tylenol, causes autism to develop in the fetus. Does the data show that direct a link?

Chelsea Cirruzzo: They were referring to a Harvard review of about 46 studies. This wasn't a new study; this was a review of existing studies. That review found an association between long-term use of acetaminophen, so we're talking four weeks or longer, and developmental disorders. Now, to be clear, the researchers from Harvard did say that further research is needed to say that Tylenol does cause autism or other developmental disorders. They just concluded the study with saying caution is needed, and they would recommend scaling back acetaminophen, but they didn't make a direct link.

Brigid Bergin: My understanding is the FDA sent a letter to physicians saying to minimize the use of acetaminophen based on some of that data during pregnancy because of this association between its use and autism and ADHD, but said there was no evidence that it actually caused autism or ADHD. What else could be going on there? Is that whatever was leading to the use of these drugs during pregnancy that might actually be the problem?

Chelsea Cirruzzo: It's hard to say. Of course, this review did find this association, but there's still more work to be done to establish an exact link. I think what's really significant about this move is that acetaminophen is really the only drug that pregnant people can take to reduce pain or fever. Calling to scale it back is a pretty significant change in the wellness of pregnant people who are experiencing pain.

To be clear, the President said during his conference, "Do not take Tylenol." That's not exactly what the FDA said. The FDA added a safety label to say people should take the lowest dose for the shortest amount of time in consultation with their doctor.

Brigid Bergin: Just to put a fine point on it, how does that guidance differ from the advice pregnant women were being given for use of acetaminophen before, up till yesterday?

Chelsea Cirruzzo: Prior to this safety label, acetaminophen was used to reduce fever or reduce pain during pregnancy. Again, it was one of the only drugs that, if you're pregnant, you can use that is considered safe. Tylenol, the makers of Tylenol, have continued to say that it is safe, that it's safe for pregnancy, that their view of it has not changed.

Brigid Bergin: Now, the FDA letter also said that the acetaminophen is the safest way to break a fever, which can have really serious consequences for someone who's pregnant and certainly for their fetus. Is the advice at this point that it sort of is dependent on the severity of the fever? If it's a low-grade fever, should they just sort of let it ride?

Chelsea Cirruzzo: It's hard to say. With the President's comments yesterday, it sounded like if you can tough it out, as he said, tough it out, just don't take Tylenol. Of course, the President said that's his opinion. If you have a high fever, maybe you have to take it, but I think that the real answer there is, "Talk to your doctor," right? Certainly, the FDA label doesn't say, "Don't use it at all." I think it would really depend on what your doctor thinks is best. If they think the best thing to do is to take the Tylenol, I believe they would recommend that.

Brigid Bergin: Of course, to state the obvious, the President is neither a scientist nor a doctor. Listeners, do you have a question for my guest on the latest health advice coming from the White House? We're also going to be talking about vaccine access in a bit. You can also call or text to report how it's going with getting your fall vaccine so far. The number 212-433-WNYC. That's 212-433-9692.

Chelsea, at the press conference, they also announced a label change for a vitamin B-based drug called leucovorin. That is something that is used to treat autism. What do we know about the drug and its effects on autism symptoms?

Chelsea Cirruzzo: That drug was reapproved, as you said, by the FDA. It had stopped being marketed a little over 20 years ago, I believe, and it's being reapproved as an autism therapy. It was originally used to treat toxicities related to another drug. According to the FDA, there's some evidence that it could treat cerebral folate deficiency, which has been linked to some developmental disorders.

It's worth noting that the FDA saying this has been reapproved, and you can use it, Dr. Oz, who runs the Centers for Medicare and Medicaid, was also there, and he announced that given that at least half the children in the United States are on some kind of federal health insurance program, be that Medicaid or the Children's Health Insurance Program, they will ensure that parents have access to that drug.

Brigid Bergin: They also talked about a change in direction for autism research, shifting from looking at genetic causes to environmental ones. What will that entail? Do you have a sense of that?

Chelsea Cirruzzo: That really goes along with what Secretary Kennedy has been a huge proponent of for quite a while. He has really linked a lot of health conditions in children, chronic disease, including autism, to environmental toxicities. What that could mean is again, a shift away from looking at genetics, which is sort of what we understand to be driving autism, or at least one of the drivers of autism, towards looking at things like food, like vaccines, and medicines.

Secretary Kennedy, when he took his position as the head of HHS, has promised to leave no stone unturned. We could see, really, a lot of revisiting science that we have done many years ago, including on vaccines, that found there was no link between vaccines and autism, and re-litigating that and bringing that back to the forefront.

Brigid Bergin: Chelsea, a listener, texted a question, and I'm not sure if you know the answer to it, but the listener writes, "Isn't it true that autism was first diagnosed decades before acetaminophen came on the market?" Is that something that you've reported on?

Chelsea Cirruzzo: I have not. That is a great question. That is certainly something to ask. I actually don't know the answer to that one, but I do think that's an interesting question.

Brigid Bergin: Yes, there's definitely lots to unpack here. We appreciate all of our listeners' questions, even the ones that stump us, because as a reporter in my day job, it always gives me something to do when I'm off the air. In the meantime, let's go to Elmo in Englewood, New Jersey. Elmo, you're on WNYC.

Elmo: Hey, good morning. How are you guys? One of my favorite shows, even when Brian is not on the air. I got a question for you. The last bit of medical advice that the President gave us, well, let me say this. I'm a doctor. I lost 38 patients to COVID, and one of my receptionists that worked for me for over 20 years to COVID. His advice was to use bleach. No one confronted him with his expertise. No one in the press corps. No one confronted him with that. I don't understand it. I don't understand. Are we at the end of science?

Brigid Bergin: Elmo, thank you for the question so much. Really, the comment, Chelsea, which, going back to the previous Trump presidency during the height of the COVID pandemic, that was one of the suggestions that came out of the White House. Was there much pushback that you saw from the press corps about these recommendations? Was there really even much time for it?

Chelsea Cirruzzo: Not really. The President did take questions, and some of the questions were for some outlets that he's more familiar with, more conservative outlets that also did ask important questions, as well, but not so much pushback. There was pushback to his comments on vaccines, which I know we will get into. Of course, there was also a question about if Medicaid, which, again, covers about half the children in the United States, is going to cover this therapy that they believe can help treat symptoms of autism.

How does that track with the Big Beautiful Bill that just passed and was signed by the President, that cuts Medicaid? The President did call that a nasty question and said that it should not impact access.

Brigid Bergin: Well, as you mentioned, Chelsea, I do want to get into some of the issues surrounding vaccines. The President pointed to vaccines in the way they're administered as one of the environmental risks associated with autism. As you said, that's come up and debunked, but it's something RFK Jr. has really held onto. The President made some claims about the volume of vaccines children receive. What can you tell us about those claims and what research has actually shown?

Chelsea Cirruzzo: Yes, they were some pretty extraordinary claims, and it's not something we haven't heard from the President before. In fact, when the President and Secretary Kennedy first connected, and this was before Kennedy had agreed to endorse President Trump when he was running again, Trump did say to him over the phone, this is a recorded conversation, that children are being given shots equivalent to the amount you would give to a horse.

Now, of course, we understand there is a vaccine schedule for children. Most schools do require this, and that's done over a few years of a child's life and typically from when they're born up until they enter school. Then, of course, there are shots that they get updates on later on in their teens or early adulthood. His claims that they are being pumped full of shots, it doesn't quite track with what we know about the span of childhood vaccination schedule.

Of course, kids do get quite a bit of vaccines to prepare them for school and for socialization, but it is spread out, and there are recommendations to make sure that it's done in the most appropriate way.

Brigid Bergin: We have several listeners who've called in with questions about the Harvard study and then also questions about some of the claims made by the President during the press conference. Let's start with Lauren in Cranford, New Jersey. Lauren, welcome to WNYC.

Lauren: Hi. Yes, aside from that women need to tough it out and that kind of stuff, when you were reporting and you said that this was based on Harvard studies or a number of Harvard studies, they're suing Harvard. They say that Harvard's not a great place. They're cutting funding to Harvard. Was this study or these studies funded by the government through Harvard? How are they going to follow up on this? Is the CDC going to follow up on it with its own research? They've villainized Harvard to such a great degree, and now all of a sudden, that's all they're relying on.

Brigid Bergin: Lauren, thanks for that question. I want to build on that with another text that a listener wrote, Chelsea, that just asks some more questions if you had any other information about that Harvard study, any of the authors, and if you knew whether or not there was going to be any follow-up on it.

Chelsea Cirruzzo: Yes, that's a great question. The Harvard Review, again, it's a review of 46 other studies. Harvard didn't necessarily do its own study. It was NIH-funded. They did receive government funding to do this study. One of the authors is the dean of the Harvard Public Health School. Yesterday, the NIH director, Dr. Jay Bhattacharya, announced that there will be more studies coming, not necessarily just from Harvard.

We still need to look into who those people will be, but there will be more studies and reviews in this vein of research on autism. Certainly, the administration is funding what it sees as its priorities, and this was considered one of them.

Brigid Bergin: I want to get back to some of the recommendations we saw coming from the Advisory Committee. The Advisory Committee met last week, looking at the timing of childhood vaccines. I want to talk more specifically about the meeting, but in terms of what the President is recommending, how big of a change would it be to take those vaccinations and spread them out as he was suggesting? Just go to the doctor multiple times, as he suggested.

Chelsea Cirruzzo: Yes, let me put those in context. He was talking specifically about the MMR vaccine, which is the measles, mumps rubella vaccine. That is a combined shot. It is a shot that you get over several visits as well. What he was saying is separating out the measles shot, the mumps shot, the rubella shot. Part of the reason why they're combined is, it just makes things easier for parents and doctors to be able to get that crucially important shot.

Measles, mumps, and rubella can be very harmful to children, could have really drastic effects on the community. He was suggesting spreading that out. The other thing he was talking about was hepatitis B. Now that is a vaccine we give to newborns. It's universally recommended because hepatitis B can cause a lot of health conditions down the road for a child who is impacted by it.

It's spread from the mother to the baby and can also be spread through contact, as well as through needles and things like that. A lot of what the President was saying is that it's a sexually transmitted disease. That can be true, but of course, there are other ways you can get it. For that reason, given that it can be so harmful, it is universally recommended that it's given at birth.

Now, I will say, last week, the vaccine advisors were considering delaying the shot, but they weren't considering delaying it as much as the President had suggested. They were only saying up to delaying it for one month for parents who are determined to be negative for hepatitis B. The President was saying it should be delayed up to age 12. That would be far beyond what they were considering.

They ended up tabling that discussion, and they will likely return to it in forthcoming meetings. He was talking about things that they had been discussing at this meeting, but definitely beyond the questions that they had in front of them.

Brigid Bergin: If you're just joining us, this is The Brian Lehrer Show on WNYC. I'm Brigid Bergin, senior reporter in the WNYC and Gothamist newsroom, filling in for Brian today. I'm speaking with Chelsea Cirruzzo, Washington correspondent for STAT News, about yesterday's announcement on autism and the vaccine advisory committee meeting last week. We have much more to talk about. We're going to take more of your calls coming up right after a short break. Stay with us.

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Brigid Bergin: Good morning again. This is The Brian Lehrer Show. I'm Brigid Bergin, filling in for Brian today. My guest is Chelsea Cirruzzo, Washington correspondent for STAT News, as we cover Part 1 of today's Health and Climate Tuesday's selections. Stay tuned for Climate later in the show. Chelsea, let's talk about this newly reconstituted vaccine advisory group now. Who makes up this committee, and how has its membership changed under RFK Jr.?

Chelsea Cirruzzo: Right. Historically, this has been a committee of vaccine experts, people who have invented vaccines, people who have administered them, pediatricians, epidemiologists, but earlier this year, Secretary Kennedy ended up dismissing everybody on the panel, saying that they had been bought in by corporate interest, specifically the pharmaceutical company, and that reconstituting the panel was needed to restore trust.

What he ended up doing was hand-picking new advisors. Those include people who have had anti-vaccine or vaccine-skeptical views in the past. That includes people who have questioned the safety of mRNA shots, which is the technology that powers COVID-19 vaccines, as well as people who have served as expert witnesses in lawsuits questioning the safety of vaccines. Those folks have since met twice, and they most recently met last week.

Brigid Bergin: From the coverage I've seen, it seems like there are some problems stemming from the members' unfamiliarity with the panel itself and how it's supposed to work. Can you give us a sense of how the meetings were conducted?

Chelsea Cirruzzo: Yes, there certainly was some confusion. The way the meetings work is, they have questions that they are deciding whether or not to vote on, and these create recommendations. The question should be, "Should we delay the Hepatitis B vaccine one month from birth, as opposed to giving it at birth?" and then they vote on that. Of course, with the newness of this committee, there were some hiccups.

For example, at one point, the committee agreed to recommend that the MMRV vaccine, which is measles, mumps, rubella, and varicella, that's a combined shot, to recommend that children, young children under the age of four, receive an MMR and a varicella shot separately. That has always been an option, but they are specifically recommending that you do them separately.

Now, the next step of that would have been to vote to align this recommendation with the Vaccines for Children Program. This is a CDC program that provides free shots to low-income children, and doing so would have prevented the program from covering the shots entirely, therefore, basically taking away the option of taking the combined MMRV from those children.

At first, they were surprised by that. They voted not to align that recommendation and had an uneven coverage recommendation until they did another vote the second day. That really was emblematic of the experience level that they brought to the table. Of course, it is complicated. It took me a long time to understand it, [crosstalk] but when you're voting on it, it is very important you understand it.

Brigid Bergin: RFK Jr. is a well-known vaccine skeptic. Is that the case across the board for the committee now?

Chelsea Cirruzzo: I wouldn't say for everybody. There are certainly people who, again, have had vaccine-skeptic views. They've written papers. They have been public on social media about vaccine skepticism. Again, that's not true for everybody of the panel, but of those leading it, it certainly is something that they believe in. Of course, they will say you're not anti-vaccine.

In fact, the chair, Martin Kulldorff, opened up his remarks by saying that he is not anti-vaccine; he is focused on vaccine safety. In fact, he invited former CDC officials who have criticized him to debate him publicly and told the public that they refuse to not trust them. Certainly a lot of fiery rhetoric there.

Brigid Bergin: Wow. Let's bring some callers in. Let's go to Alex in Philadelphia. Alex, you're on WNYC.

Alex: Hi. Thanks so much. I just wanted to point out that lately, it has really sounded like this conversation around the hepatitis B shot, now around Tylenol, it's sounding like we're going to start putting the blame and the onus on anything related to childbirth right back onto the mother. It sounds like just like when we're having the conversation around abortion and birth control, "Oh, women, you got yourselves pregnant, so it's your own consequences to keep."

Now, if you have a baby and let's say the kid is born naturally, there is a risk of hepatitis B if it's something related to the mother, so it's going to just all start being put back on parents. "Oh, is your child born somewhere on the autism spectrum? Well, your mom probably took Tylenol when she was pregnant with you." I just feel like the blame is going to start going back onto women in the same way that we've been putting it for abortion and birth control and IUDs and things like that.

I'm just wondering if that conversation is happening at all, or if this has sort of felt like it's living in a different world than the conversation around abortion and women's sexual reproductive rights. I'll take my answer off the air. Thanks so much.

Brigid Bergin: Thanks for that question, Alex, a really interesting point, and one that textures are also raising, Chelsea, some framing it as really an issue of misogyny. What kind of conversation is happening in this space related to kind of who's at fault? Do you see the shift that Alex was just describing?

Chelsea Cirruzzo: Yes, that's a great question. Absolutely, there are some people who share that view that they feel like mothers are being blamed for choices that they made during pregnancy or during childbirth that have led to things happening to their children. That has been brought up quite a bit with some of Secretary Kennedy's rhetoric. Interestingly, during the press conference, I believe both the President and the Secretary said that they are doing this for moms, that moms have wanted answers forever.

They want to know how they can best help their children, and that this is about helping moms. Of course, they also had two mothers of autistic children speak and thank the President for really focusing on them and giving them the answers that they felt that they wanted. Again, there's certainly both sides to that, and there's, it seems, a lot of emotion surrounding that question of who's to blame and, of course, some moms feeling like they're being blamed, and some parents feeling like this is what they wanted.

Brigid Bergin: Chelsea, a listener texts, "If the current vaccine schedule works for the overwhelming majority of children, why so suspicion about it? Please discuss the bigger issue here. This administration wants to replace medical and scientific expertise with quackery, rumors, and superstition." That larger question about the fact that the schedule did seem to be working for the majority of children, is that something that's being discussed among pediatricians within the health field, as you report this out?

Chelsea Cirruzzo: Yes, and it has been for quite a bit. Again, some context here. The reason we have this childhood vaccine schedule is so that 95% of children in a community are vaccinated against certain diseases. That's the threshold that we need to ensure there's herd immunity to ensure that an outbreak doesn't happen. In recent years, those numbers have dropped for certain diseases.

That includes measles in certain communities below that 95% threshold, which really creates the risk for outbreaks. Now, pediatricians, public health experts have been concerned about this for a while, and they continue to be with these conversations about potentially changing the childhood vaccine schedule that we will continue to drop below that threshold and continue to introduce the potential for outbreaks.

Brigid Bergin: Chelsea, on the issue of COVID shots, at the end of August, the FDA had approved COVID boosters, but the guidelines were for people over 65 or with underlying conditions, which meant, depending on what state you lived in, getting a shot in your neighborhood pharmacy might get kind of complicated. If you weren't high risk, did you need a prescription? A lot of that got sorted with states like New York giving their own advice. Did ACIP make the same recommendations as the FDA?

Chelsea Cirruzzo: Yes, there was A little bit of confusion there. I can say as a reporter in the room, we all were looking around like, "Okay, what does this mean exactly?" They ended up recommending that people should ask their doctor about the risks and benefits of the COVID shot before getting it. This was not necessarily outside of what the FDA had said, but it does maintain coverage for everybody to get the shot, whereas the FDA had said only people over the age of 65 and those with health conditions or health risks should get the shot.

In a way, it sort of expanded who could get the shot, but it does create this sort of confusing framework. You mentioned New York. There's, of course, also some Western states that have also made their own coalition. Then there's also states like Florida that are taking away mandates, school mandates for children. It creates this very confusing patchwork of, depending on what state you live in, how you can get a shot if you want to get one. What they ended up doing, again, was maintaining access for everybody, but that is different from what the FDA said.

Brigid Bergin: I want to bring in one of our callers. Let's go to Ted in Staten Island. We'll get a report from the field about how easy or difficult it is to get a COVID shot in New York. Ted, you're on WNYC.

Ted: Hi. Thanks, Brigid. Yes, I got the new COVID shot last week. Let's see which one it was. This Pfizer community, 25, 26, blah, blah, blah.

Brigid Bergin: You didn't have much trouble getting the shot when you were trying to find it, it sounds like.

Ted: No. Initially, I had called my local neighborhood pharmacy a couple of weeks ago, and it sounded like they weren't going to be able to get it until the end of September. Then I went to a chain and I was able to snap get it right away. Now, I say this maybe because I'm over 65. I did have a friend of mine who's under 65 who wasn't able to get it when he went in, but that was before this new guidance from the state that would allow a person to get it just based on consulting with the pharmacist.

Chelsea Cirruzzo: Great.

Ted: As far as I know, anybody else could do the same thing I did is just go online, make an appointment, and go in and bada bing, bada boom, get the shot.

Brigid Bergin: Ted, thank you so much for that field report. He got his COVID shot in Staten Island. Chelsea, a listener also texted that President Trump gets a lot of credit for Operation Warp Speed and the development of the COVID vaccines. Is he turning his back on that as an accomplishment, and how does RFK Jr. refer to that?

Chelsea Cirruzzo: That is such a great question because that has been something that we as reporters have been asking for the past few weeks. There is a bit of a weird thing happening here, where Secretary Kennedy has questioned the safety of mRNA shots, again, the technology that was used in Operation Warp Speed to create COVID vaccines. A few weeks ago or this summer, Secretary Kennedy announced that HHS would end a lot of funding for mRNA research, saying it doesn't protect you against respiratory illnesses like COVID.

Of course, studies will dispute that. At the same time, he has also agreed, and he appeared before Congress a few weeks ago and agreed with senators that the President deserves a Nobel Prize, excuse me, for developing Operation Warp Speed. The President has also made some confusing comments around Operation Warp Speed. He has sort of congratulated himself on it.

Again, it was a pretty significant accomplishment. They got vaccines out the door to millions of Americans very quickly. At the same time, on Truth Social, for example, he's questioned whether or not it was as good as the vaccine makers say it was, and he has urged those makers, that includes Pfizer and Moderna, to give him information proving that their products work. It creates a patchwork again. Once again, a very confusing situation.

Brigid Bergin: Sure. Just another text from a listener. In terms of reporting from the field, the listener writes, "When I picked up an unrelated med at Duane Reade Walgreens by Times Square yesterday, they proactively asked if I wanted to schedule vaccines, and now I've got both COVID and flu vaccines." It sounds like getting them or finding them here in the New York City area seems easier than potentially other parts of the country, that patchwork you were referring to.

Just to fact-check, one of the questions a listener called in with earlier, Chelsea, Tylenol was introduced in 1955. Autism was diagnosed long before that. However, we know that the issue of the definition of autism has changed over time and is more expansive now. How much is the thought that thought to be part of why we are seeing an increase in autism diagnoses?

Chelsea Cirruzzo: Yes, that certainly plays a role. Again, to just put this in context, we have seen a rise in autism rates recorded across the United States, and it varies by state. That said, the definition has changed. The way it's diagnosed has changed. A lot of researchers, a lot of people with autism, a lot of doctors will say that they recognize it differently now, and the way it's diagnosed is different now.

More people are being diagnosed, which could contribute to these rising rates. For example, we know from these studies that women were less likely to be diagnosed. We know that children of color were less likely to be diagnosed. Now that has changed or shifted in the direction of diagnosing people earlier. That, again, is one of the things that could be driving this increase. That isn't to say that-- there's other questions. A lot of autism researchers will say, "Yes, sure, we do have other questions here, but we don't want to lose sight of the fact that we do diagnose this better now."

Brigid Bergin: I'm going to take another field report from Bob in Brooklyn. Bob, you're on WNYC.

Bob: Well, thank you for taking my call. Long time, long time. Love the show. My field report is kind of different from the one that you just aired. In my case, we discussed the federal guidelines, and they said, "You can't qualify." I said, "Hey, man, I'm going to be locked in a room with voters for 12 hours a day for like 2 weeks. I kind of need this shot." They're like, "We can't help you."

I said, "Well, what about the New York State guidelines?" They said, "Oh, no, that's not going to help at all. That really doesn't affect, in one way or the other, the federal guidelines." Finally, we decided. Well, it was like, "What's your height?" I gave them the height. They said, "Well, what's your weight?" I said, "Well, I don't know at the moment, but I'm usually around X."

They said, "Oh, well, I can't be sure, but let me just run the numbers. Let me help some customers, and I'll run the numbers." Finally, they ran the numbers, and they said, "Okay, that makes you either overweight or obese." I think the numbers were like 5, 11, and 225. They said, "Yes, okay, now I can give you the shot, but these people from the Fed, they're checking."

Brigid Bergin: Wow.

Bob: "I got to have a reason that I show on paper, or else I'm in trouble."

Brigid Bergin: Bob, this was just a chain pharmacy, or where were you trying to get this shot? Thanks for being a poll worker. We appreciate you.

Bob: Oh, sure. Thank you very much. Doing God's work one voter at a time. Yes, that was my local pharmacy, which has been getting better and better at getting these, with the availability of getting these shots out to the public.

Brigid Bergin: Interesting, Bob.

Bob: That's it.

Brigid Bergin: I want to get Chelsea to weigh in on that, because, Chelsea, I think we are just hearing, here on the air, the patchwork that you referred to in terms of people's ability to find the kinds of boosters and vaccines that they need, depending on the guidance that their pharmacy appears to be following, whether it takes the state guidance or the federal guidance.

Chelsea Cirruzzo: Yes, and I think, again, that's emblematic of what I was talking about with this patchwork. It's more than just, "This panel makes this recommendation, and suddenly it works across the country." You do need to educate providers on what that looks like. They need to prepare to work with their patients on that. They need to prepare to have the vaccine available to administer to their patients, so just the recommendation alone is really just one part of this whole system. When you have this confusing set of standards across different states, across the federal government, it's really hard to get that to trickle down to you going into your pharmacy and getting a shot.

Brigid Bergin: Just final question, because obviously there's a lot to continue to uncover here, but when it comes to who has the final word, is it states, is it the CDC, is it the President, and then ultimately, what guidance are insurance companies following?

Chelsea Cirruzzo: That's a great question. I think I will say first of all that the Kennedy's administration, his folks would say the person has the final word is the patient, and that's what they want to really emphasize here. Of course, in practice, that looks a lot different, right? These recommendations that are made by the panel for last week, the ACIP, those do impact insurers.

If they say everybody should get the COVID vaccine, then insurers are then required to cover it. If they say only people over the age of 65 should get it, then they will only cover it for people over the age of 65. Again, confusion here because the AHIP, which is a large group of insurers, has said that they will insure COVID shots no matter what. Again, just another sign of how this system is sort of breaking down.

Where it typically would be the FDA would authorize a vaccine, this panel would recommend who gets it, the CDC would tell insurers to cover it, insurers would cover it, it would be in your pharmacy; now we're seeing different parts of that system break down or decide to go their own way.

Brigid Bergin: Ooh. Chelsea Cirruzzo, Washington correspondent for STAT News. Chelsea, you're going to be really busy for a while, I think. Thank you for coming, joining us, fact-checking, and explaining what happened yesterday and last week. We're going to leave it there for Part 1 of Health in Climate Tuesdays. We really appreciate you joining us.

Chelsea Cirruzzo: Thank you so much for having me.

 

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