Jason L. Schwartz
LightNews LightNews
banner
jasonlschwartz.bsky.social
Jason L. Schwartz
@jasonlschwartz.bsky.social
1.3K followers 290 following 150 posts
Associate Professor of Health Policy and the History of Medicine, Yale School of Public Health. Vaccine policy, health policy-making, pharmaceuticals, FDA/CDC, etc. http://jschwartz.yale.edu
Posts Replies Media Videos
jasonlschwartz.bsky.social
Heartening results here www.theargumentmag.com/p/the-covid-...
November 23, 2025 at 8:54 PM
jasonlschwartz.bsky.social
The new approach adopted for COVID vaccine guidance this summer signaled we were likely heading in this direction, as I wrote in NEJM a few months back www.nejm.org/doi/full/10....
November 21, 2025 at 3:32 PM
jasonlschwartz.bsky.social
From today’s Politico Pulse. He’s talking about downgrading more (most? all?) CDC/ACIP vaccine recommendations from ‘routine’ to ‘shared decision-making’. Almost certainly starting with the Hep B birth dose next month and expanding from there.
November 21, 2025 at 3:29 PM
jasonlschwartz.bsky.social
So important to keep the actual landscape re: vaccine attitudes in mind. Broad support remains across party lines. Trust highest in one’s doctor, lowest in info from social media, RFK, podcasts. (From today’s www.politico.com/politicopulse/)
November 14, 2025 at 3:10 PM
jasonlschwartz.bsky.social
The first few paragraphs could have been written today (rather than late 2011). Plus ca change…
The current climate surrounding childhood vaccination in the United States is one of confusion and vitriol. Despite the well-documented achievements of vaccines and extensive efforts by the public health community to ensure their safety, vocal critics of vaccination proffer a growing list of theories that link vaccines to an array of medical conditions, most prominently autism. Others question the necessity of newer vaccines, seeing their arrivals not as triumphs of medical research but as overreaches by a profit-obsessed pharmaceutical industry and an accommodating, financially conflicted medical establishment. In response to these charges, physicians, scientists, and government public health officials are routinely on the defensive, refuting allegations of unconfirmed risks, justifying the value of recommended vaccines, and striving to preserve public trust in vaccination overall. While national data suggest that a strong foundation of support for vaccination remains, regional clusters of unvaccinated children and increases in nonmedical exemptions from state school-entry vaccination requirements are causes for alarm among advocates of vaccines. Even more worrisome is research suggesting that the safety of vaccines is a growing concern among many parents [1].
November 14, 2025 at 2:51 AM
jasonlschwartz.bsky.social
A great time talking vaccines and seeing old bioethics friends at ASBH this weekend! (My connecting flight on the way out to Portland, on the other hand, was a bit of an adventure.)
October 27, 2025 at 10:45 PM
jasonlschwartz.bsky.social
Latest eBay purchase: the 2005 Rolling Stone issue where RFK’s (later retracted) ‘Deadly Immunity’ was published. The very beginning of his two decades (and counting) spent challenging/rejecting the safety of vaccines. en.wikipedia.org/wiki/Deadly_...
October 9, 2025 at 9:33 PM
jasonlschwartz.bsky.social
No FR announcement, inside 15-days, and now meeting date updated to “TBD” on ACIP website.
October 8, 2025 at 12:49 PM
jasonlschwartz.bsky.social
If there’s really going to be another ACIP meeting on October 22-23, FACA requires a Federal Register announcement (with topics and potential votes) no later than this Tuesday, 10/7 (15 days ahead)
October 4, 2025 at 3:48 PM
jasonlschwartz.bsky.social
Our YSPH Communications office asked me to do a Q&A about the ACIP meeting. (Focusing on the actual outcomes and votes, not all of the process chaos and dubious scientific content.) A shortened version will be posted on our website sometime this week, but here it is now, all 1400 words of it:
Q1. First of all, how did we get here? Last week’s ACIP meeting was the latest installment in what’s been an incredibly busy and, frankly, confusing past few months for vaccine policy—and for COVID vaccines, in particular. To briefly recap how we got here: — In late May, HHS Secretary Robert F. Kennedy, Jr., announced on social media that CDC would no longer recommend COVID vaccines for pregnant women and healthy children. — A few weeks later, the entire membership of the ACIP was dismissed, an unprecedented action, and replaced with a new group a few weeks later. (Several more members were added this month.) — Over the summer, medical professional societies including the American Academy of Pediatrics and American College of Obstetricians and Gynecologists and many state public health departments issued their own vaccine recommendations that endorsed the continued, broad use of COVID vaccines, including for pregnant women and previously unvaccinated children. — Last month, the Food and Drug Administration (FDA) approved the updated COVID vaccines available this fall, but only for adults over age 65 and younger individuals with a condition that places them at increased risk of severe outcomes from COVID. The CDC has published a list of those conditions; notably, pregnancy is among those included. Q2. So what are the new ACIP guidelines for the fall COVID vaccine? The ACIP added still more complexity to the COVID vaccination story at their recent meeting. They voted to update the childhood and adult recommended immunization schedules to state that COVID vaccines can be administered to anyone 6 months of age or older based on individual decision-making that is informed by a discussion with a physician or another health care provider. As of this writing, this vote is awaiting adoption by the acting CDC director, upon which it would become an official CDC guideline. This “shared clinical decision-making” statement, as it’s also called, is a step down from the ACIP’s far more common, “routine” recommendations. It is used in situations where the committee wishes to highlight vaccination as an option for individuals (i.e., “may vaccinate”) without actively encouraging its use (i.e., “should vaccinate”). Importantly, it is still formally considered an ACIP recommendation for COVID vaccination, meaning that, if adopted, it will appear on CDC/ACIP immunization schedules and will therefore ensure continued no-cost coverage of COVID vaccines for all children regardless of insurance status and for all adults with private insurance, Medicare, or Medicaid. (Coverage of vaccines for uninsured adults remains an unfortunate gap in our health care system.) Q3. Can someone still get a COVID vaccine if they are not eligible under the guidelines? The population covered by this new ACIP recommendation—all individuals over 6 months of age (the earliest age at which any COVID vaccine can be administered)—is considerably larger than the groups for whom the vaccines are currently approved by the FDA. While it is not unprecedented for CDC/ACIP to endorse the use of a vaccine outside the margins of its FDA approval—what’s referred to as “off-label use”—it is quite uncommon and, unlike the widespread off-label use of pharmaceuticals, typically reserved for small populations in very limited circumstances. Here, ACIP has opened the door to off-label use of the vaccine for tens of millions of Americans, essentially all healthy individuals between 6 months and 65 years of age. Given the novelty of these circumstances, medical organizations, pharmacies, states, insurers, and other groups are currently sorting out the implications of ACIP’s recommendation, FDA’s narrowed approval of this year’s vaccines, and related implementation concerns. There is wide variation in state laws and regulations regarding where vaccines can be administered, by whom, and in what circumstances. Policy updates are therefore required in some states, several of which were being made even before this ACIP meeting. But when that work is completed, it’s quite likely that in most states, virtually anyone wishing to get a COVID vaccine this year should be able to do so, in most of the same locations—including pharmacies—where COVID vaccines have been available previously, and at no cost to them. Individuals seeking information regarding vaccine access and eligibility in their area should consult their health care provider, pharmacy, or state/local health department for more specific information. Q4. I’ve been vaccinated before. Do I still need to get a COVID vaccine this year? It depends, according to health experts. Even before all of this year’s tumult regarding vaccine policy, medical and public health officials had been signaling a move away from the prior practice of recommending annual COVID vaccines for virtually everyone regardless of age, health status, or prior vaccination history. In fact, the former ACIP had been working on updated, narrower COVID vaccine recommendations for this fall when they were dismissed. The current ACIP vote on COVID vaccination allows for broad use of the vaccine, but it doesn’t identify any priority groups for vaccination other than those 65 years or older. However, the other medical and public health organizations that released COVID vaccine recommendations this summer have indicated groups for whom COVID vaccines are especially important. Here in Connecticut, for example, COVID vaccination is specifically recommended for: — previously unvaccinated children — adults 65 years and older — pregnant women — individuals of any age who are immunocompromised or with underlying risk factors for severe COVID illness The Connecticut recommendations note that these groups should be vaccinated, while other groups—healthy, previously vaccinated children and adults under age 65–may be vaccinated if they desire. There’s significant alignment across the many (non-ACIP) COVID vaccine recommendations issued by medical and public health organizations this summer, largely echoing these same priority groups for vaccination. In all cases, the best source for information regarding personal vaccination recommendations and decisions is one’s health care provider. Q5. Did guidelines for the pediatric MMR vaccine change? Not for the MMR vaccine itself, but for a related vaccine, and only a minor change was made. Since 2005, a vaccine has been available that combines measles-mumps-rubella (MMR) and varicella (chickenpox) into a single vaccine known as MMRV. But for many years, the ACIP had recommended that children under age 4 receive the first doses of the MMR and varicella vaccines separately due to evidence of a slight increase in the occurrence of a rare vaccine-related adverse event in children receiving the combined MMRV vaccine. However, those prior recommendations gave parents of children in this age group the option to choose MMRV for this first dose if they preferred it, perhaps because it meant one fewer injection for their child. Only 15% of parents selected this non-preferred option. The new ACIP voted at last week’s meeting to eliminate that option and only recommend separate MMR and varicella vaccines in this very specific situation. No changes were made regarding recommendations for the MMR and varicella vaccines themselves, which have demonstrated extremely high levels of safety and effectiveness throughout their decades of use. High rates of MMR vaccine remain particularly important in light of the nearly 1,500 cases of measles in the US this year, over 90% of which occurred in individuals without evidence of vaccination. Q6. What about the Hepatitis B vaccine?
September 21, 2025 at 10:48 PM
jasonlschwartz.bsky.social
In short, it’s just a mechanism for providers/programs that streamlines vaccine administration for those who want it. No one is being ‘ordered’ to get the vaccine because of it! A nice 1-pager from Immunize.org www.immunize.org/wp-content/u...
September 21, 2025 at 1:40 PM
jasonlschwartz.bsky.social
Only two possibilities here, both of them mind-boggling: an ACIP member genuinely doesn’t know what a vaccine ‘standing order’ means (Vaccine Policy 101), or he does and has no problem spreading falsehoods.
September 21, 2025 at 1:35 PM
jasonlschwartz.bsky.social
Earlier this summer, I wrote about how a shift toward greater use of individual (‘shared’) decision-making recommendations from ACIP seemed likely given what we heard and saw from federal health officials all year long re: vaccines and their view of the role of government public health agencies…
September 19, 2025 at 7:44 PM
jasonlschwartz.bsky.social
Perhaps grading on a curve here, but not as bad as I was expecting? If passed, these would preserve coverage requirements and not totally undermine efforts by other entities to more actively encourage vaccination, especially for higher-risk groups.
September 19, 2025 at 6:15 PM
jasonlschwartz.bsky.social
An opportune time to promote this virtual event coming up in a few weeks, hosted by the folks at @busph.bsky.social. (Too bad there’s not much to discuss!) Details and registration: publichealthconversation.org/conversation...
September 18, 2025 at 8:51 PM
jasonlschwartz.bsky.social
One more…
September 18, 2025 at 5:49 PM
jasonlschwartz.bsky.social
As ACIP discusses doing away with the HepB birth dose, reminded of some papers I found in ACIP’s archives at NARA in the lead-up to the recommendation in 1990-91. US vaccination quite literally turning back the clock these days.
September 18, 2025 at 5:48 PM
jasonlschwartz.bsky.social
The panel includes people who say that COVID vaccines have harmed or killed many, even if that doesn't square with the evidence. "The idea that there have been dozens of deaths or other unacknowledged harms that were swept under the rug doesn't align with what we saw during the COVID pandemic, regarding the careful ongoing scrutiny of the vaccines throughout their introduction," says Jason Schwartz, associate professor of health policy at the Yale School of Public Health.
September 18, 2025 at 2:05 PM
jasonlschwartz.bsky.social
September 15, 2025 at 10:44 AM
jasonlschwartz.bsky.social
Setting aside the enormous consequences to public health, this is all just so sad. And it would have been literally unfathomable when I started studying ACIP ~20 years ago. (Or for that matter, unimaginable even just one year ago.)
August 31, 2025 at 10:37 PM
jasonlschwartz.bsky.social
June 26, 2025 at 10:35 PM
jasonlschwartz.bsky.social
June 26, 2025 at 12:15 AM
jasonlschwartz.bsky.social
Kudos to the AAP for taking this step and for speaking with such clarity. Exactly the kind of approach and focus I outlined in NEJM last week.
June 25, 2025 at 1:43 PM
jasonlschwartz.bsky.social
June 25, 2025 at 1:08 PM
jasonlschwartz.bsky.social
Apparently a reconstituted ACIP will be ready to meet on June 25. In normal times, identifying new members is a months-long process, with add’l steps to comply with the ‘balanced membership’ requirements of FACA. More details in this 2024 ACIP filing - gsa-geo.my.salesforce.com/sfc/p/#t0000...
June 10, 2025 at 2:05 AM