Still Here, June 25: Links and transcript

Summary

In this episode of Still Here: Reporter Laura Weiss covers the slew of COVID-19 vaccine policy changes that have occurred since Department of Health and Human Services Secretary Robert F. Kennedy assumed office.

Plus, in research, we’re looking at a study published in Pediatric Research that found pregnant people who were infected with SARS-CoV-2 during their first trimester were more likely to have smaller newborns.

Find our Long COVID news and commentary podcast on Spotify, Apple Podcasts, Pocket Casts, Amazon Music, iHeartRadio, or listen below and jump to the start of the podcast transcript. We’re currently experimenting with our format, so this is an episode sans COVID trends focused on just one top story.

Jump to a specific part of the transcript:

• Intro
• COVID-19 vaccine policy changes
• Research
• Outro

Still Here overlaps with The Sick Times’ newsletter, which publishes weekly.

Mentioned in this episode (in order of appearance):

• The Sick Times: The federal government is restricting COVID-19 vaccine access. Here’s what that means for the ongoing pandemic and people with Long COVID.
• Wall Street Journal: RFK Jr.: HHS Moves to Restore Public Trust in Vaccines (archive.ph link, free to access)
• Your Local Epidemiologist
• Vaccine Integrity Project
• Your Local Epidemiologist: Four ways to anticipate next week’s ACIP
• The Sick Times: Research updates, June 17
• The Sick Times: Research updates, June 3

Additional audio in this episode: 

• Rude Mechanical Orchestra: Which Side Are You On? (orig. Florence Reece) 

Transcript

Intro (0:00) 

[Instrumental snippet of theme song, the Rude Mechanical Orchestra’s rendition of “Which Side Are You On?” begins playing.]

James Salanga: Welcome to Still Here, a Long COVID news and commentary podcast from The Sick Times.

[Instrumental ends]

Miles Griffis: Hi, I’m Miles Griffis.

Betsy Ladyzhets: And I’m Betsy Ladyzhets. We’re the co-founders of The Sick Times. 

James: I’m James Salanga, and I’m Still Here’s producer.

Miles: Many institutions are ignoring the ongoing COVID-19 pandemic and trying to erase the Long COVID crisis.

Betsy: But here at The Sick Times, we’re not. We’ll continue to bring you the latest Long COVID news and commentary each week.

Miles: Without pandemic denial, minimizing, or gaslighting.

James: On our website, social media platforms, our newsletter and, of course, this podcast. We’re currently experimenting with our podcast format, and this episode is focused on just one story plus a short research update.

So in this episode, reporter Laura Weiss will break down the dizzying changes to COVID-19 vaccine policy that have happened over the past month ahead of an important Centers for Disease Control Advisory Committee on Immunization Practices meeting.

Miles: Alongside that, we’ll also share some other Long COVID research updates.

Today’s research update: We’ll look at a new study in Pediatric Research that found pregnant people infected with SARS-CoV-2 during their first trimester were more likely to have smaller newborns.

James: And after a quick musical break, we’ll get to our top story about the latest COVID-19 vaccine changes.

[instrumental segment of theme song plays]

The Sick Times: The federal government is restricting COVID-19 vaccine access. Here’s what that means for the ongoing pandemic and people with Long COVID. (1:29)

James: Last month, top health officials changed the COVID-19 vaccine policy essentially by decree.

They struck the recommendation for people under the age of 65 with no underlying health conditions to receive a COVID-19 vaccination.

Vaccinations for children and pregnant people are also restricted under the new policy. Since then, there have been a flurry of anti-vaccine policy moves that all go against established norms for transparency and vaccine approval processes.

Health and Human Services Secretary Robert F. Kennedy has stacked the Centers for Disease Control’s Advisory Committee on Immunization practices with allies ahead of its annual meeting on June 25.

And this is all happening amid unprecedented attacks on public health and health research in the United States.

Reporter Laura Weiss is sharing more about her story on COVID-19 vaccine policy changes, how they affect people with Long COVID, and what’s next for COVID-19 vaccines.

Laura, what are some of the biggest changes to vaccine policy since Robert F. Kennedy came on as Health and Human Services Secretary? How will those impact people with Long COVID?

Laura Weiss: When RFK Jr. was confirmed to be the head of HHS, there was a lot of concern about what he was going to do, particularly in regards to his anti-vaccine agenda.

And even though he made promises during his confirmation hearings that he would not change the process for vaccines and that he would not interfere, I think that when RFK was on the stand in the confirmation hearings, he was trying to placate people who were concerned about his anti-vaccine views. [He] kind of lied about his actual intentions, which I don’t think is surprising to anyone who’s been following this administration.

I will say that I do think that these changes kind of fall in line with other things that the administration has been doing, are happening kind of more quickly and more to an extreme than a lot of people anticipated.

There are a lot of questions. For example, there’s a really prominent scholar in legal vaccine research, Dorit Reiss, at UC Law in San Francisco, who I spoke with for the article.

And that conversation was more, is ACIP, Advisory Committee for Immunization Practices — is this [ACIP] meeting going to happen?

Just a few weeks before this meeting is to take place, he [RFK Jr.] abruptly fired the entire committee, 17 people, all experts in their field, people who have really served to guide vaccine policy for many, many years.

There could be some caveats there.

And I think things are even less clear because — so he fired the committee members, and he did so through a Wall Street Journal op-ed, which is a really untransparent way to do it.

Wall Street Journal’s paywalled. A lot of the public is not going to see this. He made a lot of changes last month restricting vaccine access.

But there has been some pushback.

He [RFK Jr.] said that the COVID-19 vaccine would no longer be recommended for children because he said that the potential side effects outweighed the benefits or that more research was needed to be done.

And this was announced on Twitter, X.

And alongside him were NIH director Jay Bhattacharya and FDA commissioner Marty Makary, who also share a lot of his views.

But in terms of the chaos and contradiction that all of this has sown, after he announced this — and he also announced it about pregnant people, which is kind of another caveat — he said the CDC is going to remove the recommendation for COVID-19 vaccines and children from their immunization schedule.

And they did not.

Instead, they kind of did something in between, where they said this should be a decision made between a parent and a doctor. They didn’t just comply with what he said.

Hopefully, in this case, kind of muddling the waters could be a good thing because what RFK Jr. is trying to do is so extreme.

And that’s where the recommendation for pregnant women comes in, because he said in his announcement on X, he said it would no longer be recommended for pregnant people.

But then in another announcement that he made saying that the vaccine would no longer be recommended for “healthy people” under age 65, there is a list of qualifying conditions that would make someone high risk for COVID that would allow them to still get a vaccine.

And one of those conditions is pregnancy.

So, very unclear what that means.

Are pregnant women allowed to get this shot? Are they not allowed to get this shot?

The kind of takeaway here is people were already not getting the COVID shot for a whole host of reasons.

There’s been a lot of discouragement around them. I think when they first came out, they were blocking transmission to a very large degree.

And there were so-called breakthrough infections.

But then subsequent shots, they’ve done a good job in terms of limiting hospitalizations, limiting death.

Although hundreds of people are still dying of COVID every week, which people don’t want to acknowledge.

But in terms of blocking transmission, I think it’s been a lot more varied. I think there’s some evidence that it temporarily lowers the risk of transmission. And then also evidence that it lowers the risk of getting Long COVID — doesn’t make it completely go away.

And I think under the Biden administration — a lot of health advocates are really critical of Biden’s actions to undo pandemic restrictions and the national state of emergency.

The CDC website long ago took away many, many, many of its references to masking, which I think anybody who has followed the research knows that wearing a good mask is the best way to prevent COVID.

The Biden administration was following the vaccine-only approach.

And now even that is being taken away.

Betsy: How are vaccines and changes to vaccine recommendations typically approved? How has this changed for COVID-19 vaccines throughout the pandemic?

Laura: So generally, for the past 60 years, there’s been a meeting — Advisory Committee for Immunization Practices that meets, I believe, quarterly.

It’s a panel of experts who all have published dozens of articles in their fields, are considered experts in vaccines, are medical professionals, are public health professionals, are PhDs, people with long histories of researching these subjects and who really have a lot of expertise on this subject.

And so people who are experts on these kinds of processes — which I am not, I would point to Your Local Epidemiologist Substack page by Katelyn Jetelina.

She’s really an expert on these issues. And I referred to her work a lot in this article.

I would also point to the Vaccine Integrity Project at the University of Minnesota. They’re doing a lot to try to counter what’s going on in the government right now and that kind of lack of information.

So people who are vaccine policy experts have been wondering since the moment that RFK Jr.was confirmed, what is he going to do when this advisory committee meeting happens?

And it is happening June 25th to June 27th.

So it’s not just the COVID shot [that they discuss].

Every year, they need to discuss different vaccines that are available, different health threats, and they decide what they’re going to recommend, who they’re going to recommend it for.

And then those recommendations are used by health insurance companies to determine what they’re going to cover.

Miles: Speaking of the ACIP committee, can you elaborate on some of the appointees and their policies just to give folks a better idea of who Kennedy has invited on?

Laura: So the meeting will happen if there’s a quorum. And it seems like that’s kind of unclear as well, because the new people that Kennedy appointed to the committee — there’s only eight of them, and they need 10 to run.

But the expert on this really is Dorit Reiss, who I spoke about earlier.

But the people he’s appointed, they’re the kind of people you’d expect.

They’re people who signed onto the Barrington Declaration. They’re people who have expressed anti-vax views throughout the pandemic.

And as Katelyn Jetelina published on June 20, she has this chart comparing the fired members to the new members and the number of scientific publications that they have.

And members who were fired had, on average, 49 published papers. And the new members have an average of 11. Only four of them have any publications about vaccines or vaccinations.

And it seems like this is within RFK’s rights to do something like this.

It’s very irregular. It doesn’t follow processes. It’s not democratic.

And it seems like by stacking the committee with his allies, he will be able to say, “Oh, I did follow the process. We did have the ACIP meeting, and they agreed with me.”

This is especially important to Louisiana Senator Bill Cassidy, who’s a doctor. And he was kind of the clinching vote for RFK Jr’s nomination.

And there was a lot of hope that he would do the right thing and vote against it, because he is a doctor, and he had a lot of concerns about it.

But he’s a Republican. And he ended up being the vote to confirm RFK Jr.

And he said, “I’ll only do this if you don’t change processes around vaccines. I’ll only do this if you consult with me on your decision-making.”

And it seems like he hasn’t. We don’t know what’s happening behind the scenes, but when RFK fired the ACIP members Cassidy tweeted, “I just hope the people that he replaces them with are legit.”

For the most part, it seems like they are not.

James: Summer has typically been a time where we see a rise in COVID across the United States due to travel and the weather in other parts of the country, just a lot of people moving around. So how might these changing vaccine regulations impact the broader landscape of COVID and public health now and in the coming seasons?

Laura: I mean, there’s already a measles outbreak due to this kind of anti-vax disinformation that’s been spread and popularized among a lot of people in the general public.

So we’re already seeing children dying as a result of this.

In the early days of the pandemic, we were told to do this sheltering in place to flatten the curve in order to prevent mass hospitalizations, mass deaths. I was in New York in March 2020. These were when morgues were filling up and they had to use army boats to make room for all of the people who were dying of COVID.

And when the vaccines came out — and granted, that was before, we knew a lot less then — that was before all of the new variants, and [before] Democrats also decided that they were done with COVID and done with COVID precautions.

But it’s just really interesting to go from this moment when everyone, or at least people in the center and on the left, were just waiting, waiting, waiting for this vaccine to come out so that they could get back to their “normal” lives.

And then now, even among those people, the uptake is so low, you can hardly convince people to get a COVID vaccine, hardly convince them it’s worth it.

And we’re going to see people who — “healthy individuals under 65” who would have gotten a shot, who now won’t.

And as a result, there will be more transmission.

There will be more COVID. There will be more Long COVID. There will be more hospitalizations.

There are real concerns about understaffing in hospitals and hospital overcrowding.

This is already a huge problem.

And if you look at this in the context of the rest of the Trump agenda, which is cutting off research into health and health prevention and health research, and you look at the cuts that they’re threatening with Medicaid and other really essential services that are also going to increase need for emergency services among a large swath of people …

And we’re going to see nurses and medical professionals just unable to meet this demand, particularly if they’re getting sick too.

Betsy: Looking ahead, where do you see potential roots of opposition to these policies? How do you expect the ACIP meeting starting on June 25th to go?

Laura: It’s really hard to anticipate, A, what will happen, and B, what the results will be.

I would say that there is a little bit of a potential hope that access to vaccines for “healthy people under 65” will still be covered by insurance, if insurance companies decide that it’s more cost-effective to them to cover the cost of a $150 COVID shot than to cover the cost of someone going in the hospital or cover the cost of somebody having long-term health issues.

And so I think even if ACIP does maintain the recommendations that RFK Jr. put forth, there is still some hope.

I mean, what does it say when our biggest hope is like, “Let’s hope insurance companies do the right thing.” But when doing the right thing might be profitable to them, they might.

So I guess we will see. We can hope that doctors and medical associations are still really, really advocating for the need for vaccines for kids and for everyone.

And I think maybe we’ll see those spaces open up as resources for information.

I know that the Vaccine Integrity Project is planning to kind of have — they’re not calling it this, but kind of like an alternative ASAP leader this summer with a lot of medical professionals.

So I think it becomes sort of a bit of a micro-issue of convincing different doctors and different medical associations and different practices to continue encouraging their patients to get vaccines if they can.

And if they can’t, the list of conditions that qualify someone to get one of these shots, to get a COVID shot with their restrictions, is pretty expansive.

And I would just add that one of the people I interviewed, Jessica Dye, was really, really concerned about her family’s ability to get COVID shots in the future because she has ME and she has long COVID, and her family members are her caregivers.

And so she was really, really, really concerned that they would have to choose one person in the family who would qualify for the shots, and that person would be her because she has underlying health conditions.

But fortunately, she did tell me that this week she was able to get vaccines for herself and for most of her family.

And I think part of that is because it’s not clear when these restrictions are meant to take place that RFK made about the vaccine only being recommended to people who are over 65 or people who have health conditions.

And so I think that’s another example of the confusion coming up from the top.

And so I think a lot of people will be able to say, “Oh, yes, I have one of these conditions.”

But only people who are quite motivated to get a vaccine will do that. If you can’t afford a shot without insurance, the Canada option [of getting a vaccine in Canada] is not really an option.

And again, so much of this is going to be under the discretion of whatever random pharmacy tech you end up seeing.

I spoke with spokespeople from CVS and Walgreens and Rite Aid, [the latter of which] did not respond to me about what the policy is now.

Did these restrictions apply now, or do they apply later? And how our individual pharmacists and pharmacy techs who don’t have a lot of training, necessarily going to do [this]?

And it seems like in some cases they might be willing to give more leeway or discretion, or they might have more updated information.

Like in the case of Jessica Dye and her family, they were all allowed to get the vaccine.

But then Lily, who’s one of my sources who I spoke to at the beginning, she has an underlying condition — she should still be able to get a vaccine, who’s not able to. And despite connecting her to the Walgreens spokesperson, she never got a response back.

And so I think we’re going to see a lot more confusion and chaos going forward.

And that is just not how public health is meant to be. Public health policy is meant to be consistent and clear. And this is anything but.

James: Thanks so much for sharing, Laura. You can read Laura’s story at thesicktimes.org and also find the link to that in our transcript. We also have a timeline in that story that recaps what those policy changes have looked like over the past few weeks.

And next we’ll get to a research update.

Research (17:51)

[Miles’ voice echoes the word “Research” accompanied with a sound excerpted from the theme song]

Miles: In this episode’s research update, we’re looking at a study that was published in pediatric research that found that pregnant people infected with SARS-CoV-2 during their first trimester gave birth to smaller newborns.

Scientists studied the birth outcomes of 544 newborns exposed to SARS-CoV-2 in utero and compared them with over 3,000 who weren’t exposed.

And these were happening between March and October 2020, so earlier in the pandemic.

Compared to newborns infected in their second or third trimester or unexposed to SARS-CoV-2 infection, they found that those infected during their first trimester had smaller body sizes. This is important because research has shown that babies who are smaller at birth may have worse developmental outcomes later.

This study, and a lot of the studies we looked at this week, were looking at the role of COVID-19, SARS-CoV-2 infection and Long COVID in children and newborns.

And this was a really interesting one.

There’s been a little bit of research about this before.

And yeah, this is interesting for this episode as well because looking at COVID-19 vaccines are now being restricted for people who are pregnant.

So it just sort of goes to show that this, the crisis of the vaccine committee and these new updates is going to, as Laura has talked about as well, just have very real implications for extending issues with COVID-19 and Long COVID.

These have broad outcomes.

So these are just sort of more concerning research showing the role of SARS-CoV-2 infection on newborns.

Betsy: Yeah, I mean, there was another study recently too that we covered in research updates showing that Long COVID can happen for infants and toddlers, which came out of the NIH RECOVER’s Pediatric Research.

And so I think just this continues to add more evidence that the outcomes of SARS-CoV-2 infection for the youngest humans really can be quite bad and quite, I mean, obviously more research I think is needed is going to continue to happen.

But what we know is already really, really concerning.

Miles: Yeah, one of our other research updates this week was looking at these different metabolic measures [in] children and adolescents who are infected with SARS-CoV-2 and there’s, it really sort of debunked the whole talking point that COVID-19 doesn’t affect children.

It was finding that the metabolic markers were like the same level of severity that they see in adults with severe COVID-19. Just a shocking week of research for Long COVID in children and COVID-19 outcomes in newborns.

Outro (20:38)

James: On that note, that is all we have for you for this episode. You can stay up to date with our newsletter and coverage at thesicktimes.org.

[Instrumental theme song excerpt plays underneath the rest of the podcast]

Miles: We’ll continue reporting the information you need to better practice care.

Betsy: Solidarity with everyone still here. 

James: This podcast and The Sick Times are supported by you. You can help us keep this work going by donating on our website.

Still Here is a production of The Sick Times, a nonprofit newsroom chronicling the ongoing Long COVID crisis. 

Our theme song for this episode is the Rude Mechanical Orchestra’s rendition of Which Side Are You On?, originally by Florence Reece. I’m James Salanga and I produced this episode. Our engagement editor is Heather Hogan. Our summer intern is Delfi Marchese. Sophie Dimitriou designed our podcast cover art. And Miles Griffis and Betsy Ladyzhets are your co-hosts and The Sick Times’ co-founders.

Thanks for listening.