by Vinay Prasad M.D., The Pulse:
On Thursday, the CDC’s advisory committee on vaccines voted unanimously—15 to 0—to add the Covid-19 vaccine to the country’s childhood immunization schedule.
This schedule of vaccines—which includes the vaccines for measles, mumps and rubella (MMR); tetanus, diphtheria, pertussis (Tdap); and inactivated polio—serves as the roadmap of routinely recommended vaccines for children across the nation. That’s among the many reasons the committee’s vote is consequential: State and local governments turn to the CDC’s guidance when deciding public health policy. The CDC has yet to adopt this guidance, but likely will in the coming weeks.
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I believe it was both bad medicine and bad policy to add the Covid-19 vaccine to this list. I come to that conclusion for four reasons:
1. Parents are frustrated with the CDC and its Covid-19 guidance. And for very good reason. During the pandemic, many parents believed that CDC recommendations—on quarantine, for instance—resulted in local officials locking kids out of school for too long or unnecessarily, which resulted in devastating learning loss. But when those parents complained to the schools, education officials said they were simply following CDC recommendations. So now, while the CDC may be technically correct that inclusion of the Covid-19 vaccine on the immunization schedule is not a mandate, it feels to many parents like more buck-passing from this influential agency.
Covid-19 and the question of when—if ever—to vaccinate kids has become among the most politicized topics in the country. Many municipalities, private schools, and day care centers in left-leaning areas will see the CDC’s imprimatur as an opportunity to institute mandates.
Mandates are concerning for two reasons. First, it is not clear they are ethical. The standard rule in medicine is simple: We do not intrude upon individual autonomy unless that intervention provides sufficient benefit to third parties. This means there must be a large benefit to others— enough so the loss of autonomy is acceptable. Given that the Covid-19 vaccine does not halt virus transmission, the prerequisite is not met.
The second reason is that mandates will harm vulnerable kids. As of July, the Kaiser Family Foundation found that in several states, black and Hispanic children under 12 years old were less likely to be vaccinated than white children, as the chart below illustrates:
If mandates become the norm, unvaccinated children will be displaced to virtual school, home school, or perhaps no school at all. The harm to kids from substandard education—after nearly two years of disruption—far exceeds any gains from compliance. And that harm will disproportionately hurt poor, black kids. The same is true for mandates that prevent kids from participating in school sports. Being sedentary is far more damaging for children’s health than not getting this shot.
