61: Pediatric Vaccine Challenges

Dr. Marcus Plescia, ASTHO’s Chief Medical Officer, reacts to the decision to recommend approval of a pediatric COVID-19 vaccine; Dr. Nicole Alexander Scott, Director of the Rhode Island Department of Health, says Health Equity Zones have helped many...

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Dr. Marcus Plescia, ASTHO’s Chief Medical Officer, reacts to the decision to recommend approval of a pediatric COVID-19 vaccine; Dr. Nicole Alexander Scott, Director of the Rhode Island Department of Health, says Health Equity Zones have helped many communities in her state weather the pandemic; ASTHO publishes a new blog article about the tobacco industry’s assault on attempts to prohibit the sale of some or all flavored tobacco products; and Jim Blumenstock, ASTHO’s Senior Vice President of Pandemic Response and Recovery, appreciates public health workers with a “thankful” note.                      

CDC webpage: COVID-19 ACIP Vaccine Recommendations

Rhode Island Department of Health webpage: Health Equity Zones Initiative

ASTHO Blog Article: Despite Major Benefits, Flavored Tobacco Regulations Face an Uphill Battle Led by Big Tobacco

APHA webpage: Public Health Thank You Day

ASTHO logo



This is Public Health Review Morning Edition for Thursday, November 4th, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.



The proposed vote language is that the Pfizer-Biointech COVID-19 vaccine, acknowledging that it's 10 micrograms for this age, is recommended for children five through 11 years of age in the U.S. population under the FDA's emergency use authorization.


A panel of experts votes unanimously to recommend the CDC approval of the Pfizer COVID-19 formula for children.

Dr. Marcus Plescia is ASTHO's chief medical officer. We caught up with him for his reaction to the decision.

The president called this moment a turning point in the battle against COVID-19. How do you see it?


Yeah, this is a really, really important additon for us. Being able to now protect any child who's older than five years olds with this COVID-19 vaccine, I think, is going to really help us. It's also going to help kids, it's going to help families, have their kids back in school.

There's just a lot of benefit to it, but particularly the benefit of helping really slow down the pandemic and take us that extra step towards really moving to a different place.


For this moment to really matter, though, kids need to be vaccinated.

We still see polls that say two-thirds of parents are holding off for one reason or another. Do you think convincing them to have their kids vaccinated will be tougher than the actual process of developing this vaccine?


I think it may be a little more challenging because parents are a little bit more anxious or concerned about vaccinating their kids. They may be willing to get vaccinated themselves, but I think people have some concerns about the vaccination for a child.

I'm hoping that things like having the ACIP formally recommend the vaccine might help. We're thinking that a lot of these parents may go and check in with their doctor or pediatrician, and that may be very helpful as well, just give them that little bit of extra reassurance.

So, we're hoping that'll, you know—we think about a third of parents are going to be pretty enthusiastic and get this right away; we're hoping that middle third, with a little nudging from their doctor and a little reassurance, that they'll come along; and then, there's probably going to be a third there that I think are going to be tough to reach.


What do you think it will take to move parents in that middle group?


I think we're going to have to work hard on that middle third, and that's where I think that physicians—mostly family physicians and pediatricians—are going to make a big difference. So, states have been working really hard to get more family physicians and pediatricians enrolled as COVID-19 vaccinators, and we seem to be making progress there.

But I think that's going to be very, very important. It's going to be different than the vaccination for adults, where we did these big clinics, you know, where people would just come. I think a lot of people are going to go to the doctor and get some advice, get some reassurance.

So, that's going to be the challenge this time around.



Health equity zones promote community-led solutions to local public health challenges.

Dr. Nicole Alexander-Scott is the director of the Rhode Island Department of Health. She championed the concept when she was president of ASTHO and tells us how they've helped her communities during the pandemic. It's today's morning conversation.

Do you think your pandemic response would have been different or less effective had the health equity zones not been in place when all of this started?


Absolutely, absolutely.

We have said many times that we are moving at the speed of trust, particularly with the community's most significantly impacted; and the fact that we had a relationship in place in advance gave us a headstart in terms of that progress. Our health equity zones offered a ready-made infrastructure already in place to support immediate and longer term response efforts in the communities hardest hit by the COVID-19 crisis, and our HEZs did an amazing job in supporting the rapid response to the COVID-19 outbreak in so many different ways.

I have so appreciated how resilient and nimble and responsive and flexible our health equity zones have been. They've identified challenges and gaps in services or supports. They've informed the selection of testing treatments and vaccination sites in the core communities that need it most. They've shared culturally and linguistically appropriate information with their residents in the way that their residents need to receive it best. They've helped us in dispelling misinformation and fears that were promoted and needed to be addressed in order to achieve the high rates of vaccination and testing that we've been able to achieve. And they provided vital, real-time feedback to us at the state level to inform response efforts.

The ability for them to have that authentic voice and say, "You think that's going to work? This is what's going to work," or, you know, "It's going too much this way," or, "This is going well,"—we need more of that. That's critical, especially when things are moving quickly.


Well, let's talk about that for a minute.

We hope there won't be another pandemic, but everyone says there will be. Knowing how they performed this time, what do you want to change or improve for next time?


Yeah, one of the elements that they were clear about at the health equity zones level is making sure that they were even further engaged from day one so that we wouldn't move in quickly and come up with an idea and then, you know, just go to them for implementation, but really be those authentic partners. So, we would want to ensure going forward that we continue to build on that.

This was unprecedented and everyone was figuring it out, you know, as we go; but we are being very intentional now about taking the lessons learned and using that to transform how we operate so that we can do a better job serving them.

And one of those outcomes is ensuring that we don't, like, quickly build a system and then say, "Oh, we have to ensure that there's a health equity lens and that our communities hardest hit are incorporated," and then try to take steps back to get it to fit. But instead, have an ability to scale up, that has that health equity lens embedded within from the beginning, based on their input and community perspective.



In state capitals across the nation, groups are making plans for legislation they'll offer when lawmakers returned to work in January.

ASTHO says members need to keep an eye out for any proposals from tobacco companies looking to fight back against regulations limiting flavored e-cigarette products.

You can read a new ASTHO blog article on the topic—find it using the link in the show notes.


Finally this morning, Public Health Thank You Day is Monday, November 22nd. To celebrate, we're asking ASTO members, staff, and partners what they're thankful for this month.

This is how Jim Blumenstock, ASTHO's senior vice president of pandemic response and recovery, answers the question.


I'm celebrating 48 years in this profession; and every day I am just totally amazed over the talent, the skill, the devotion, the passion that my colleagues bring to the job and often take home with them.

So, it is my heartfelt thanks and voice of appreciation to all of them out there.



That'll do it for today's report.

Remember to visit the show notes to find links to all the stories mentioned in the newscast.


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And, if you have time, we'd be grateful if you could leave us a rating and a review.


Join us tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.

Nicole Alexander-Scott MD MPH

Director of the Rhode Island Department of Health

James Blumenstock

Former Chief Program Officer, Public Health Practice, ASTHO

Marcus Plescia MD MPH

Chief Medical Officer, ASTHO