Confused about the COVID-19 booster? Here's what children, pregnant women in Kentucky need to know

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The guidance about who can and should receive COVID-19 vaccines and boosters is shifting.
Health and Human Services Secretary Robert F. Kennedy Jr. said on May 27 that the COVID-19 vaccine will no longer be included in the Centers for Disease Control and Prevention's recommended immunization schedule for healthy children. Instead of lumping it in with recommended vaccines, doctors will utilize a shared decision-making model with parents or guardians to determine whether a child should be vaccinated. The same day, the CDC also rolled back its recommendation that pregnant women receive the vaccine, which clashes with previous guidance.
These changes are unprecedented in the sense that the CDC's Advisory Committee for Immunization Practices traditionally meets and votes on changes to the immunization schedule, or recommendations on who should get vaccines. From there, the director of the CDC typically makes a final call ― but the committee did not vote on the changes Kennedy announced on May 27.
There have been reports, too, that this fall U.S. Food and Drug Administration may limit vaccine availability for healthy adults.
With all this in mind, The Courier Journal sat down with Dr. Steven Stack, the commissioner for the Kentucky Department for Public Health, who guided Kentucky through the COVID-19 pandemic. We also checked in with Dr. Kristina Bryant, who serves as associate medical director for Louisville Metro's Department of Public Health and Wellness, as well as UofL Health's Dr. Valerie Briones-Pryor, who treated patients on frontlines of the COVID-19 pandemic and was one of the first five people in Kentucky to receive the vaccine.
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All three experts stressed that the most important thing a person can do amid these changes is consult your primary care physician or your child's pediatrician about what's best for your household.
But there are still many question marks about what these changes could mean for the public.
If you're confused by the recommendations coming out of federal government regarding the COVID vaccine and booster availability, you're not alone. Here's what a few Kentucky medical experts have to say on the topic:
COVID-19 has largely shifted from a deadly pandemic to a virus that doctors are able to control, Briones-Pryor said. There are more than 200 different kinds of respiratory viruses in humans, and even the common cold can be deadly when it hits a person who is immunocompromised. In many cases, the treatment is the same whether the virus is COVID-19 or not. Patients usually need rest, fluids and time to heal.
'It's evolved to such a way that now I don't ask if they're vaccinated anymore, because they all come in with respiratory viral illnesses and and there's really no treatment for it,' Briones-Pryor said.
COVID-19 remains a serious respiratory disease, and it still kills far more people than influenza does, Stack said. People who keep current with their immunizations are less likely to end up in the hospital with complications from COVID-19.
Adults, in general, are more likely than children to get sick from COVID-19, Stack said, but children often become sicker from COVID-19 than they do from most other regular viral respiratory illnesses.
'The thing that has changed is we've had a federal election, and the administration has changed,' Stack, the commissioner for the Kentucky Department for Public Health, said. 'And with that change in administration, (there's) a new approach to messaging related to infectious diseases, immunizations and public health in general, so that that's what's changed.'
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The COVID-19 vaccine is safe for pregnant women and it protects the mother and the unborn child from the disease, Stack said. While federal agencies have stopped recommending the COVID vaccine for pregnant women, the American College of Obstetricians and Gynecologists has not. Stack cited a statement the college released on May 27.
'ACOG is concerned about and extremely disappointed by the announcement that HHS will no longer recommend COVID-19 vaccination during pregnancy,' said Dr. Steven J. Fleischman, president of the American College of Obstetricians and Gynecologists. "As ob-gyns who treat patients every day, we have seen firsthand how dangerous COVID-19 infection can be during pregnancy and for newborns who depend on maternal antibodies from the vaccine for protection. We also understand that despite the change in recommendations from HHS, the science has not changed.'
The COVID-19 vaccines will still be available for children, under a shared decision-making model, Bryant, with Louisville Metro's Department of Public Health and Wellness, said. The language and approach doctors use are the primary difference between a shared decision-making model and the recommendation that existed up until this point.
With a recommendation from the CDC, the COVID-19 vaccine would be offered as readily as immunizations for tetanus, diphtheria and pertussis, Bryant said.
With a shared decision-making model, the doctor would tell a parent the vaccine is available and offer some education about why they might want to consider it, Bryant said. Then the doctor would ask if the parent has questions, and if they'd like their child to have the vaccine.
Bryant also stressed that even with this change, the CDC has not advised against the COVID-19 vaccine for children.
'I would say to parents that, as a reminder, the COVID-19 vaccine is safe and effective,' Bryant said. 'This vaccine underwent the most rigorous safety studies In U.S. history ... and there have been multiple studies that have shown that the vaccine is safe and effective in children and adults.'
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Stack isn't worried about COVID-19 overwhelming hospitals in its present form. The virus would have to mutate in an unexpected way to cause the chaos it did in 2020.
It's still too early to know whether insurance companies will continue to cover the COVID-19 vaccine for pregnant women, children and healthy adults.
In general, insurance companies have followed the federal recommended vaccine schedule, Stack said.
However, Stack said, the companies follow those schedules 'in the confidence that a rigorous and transparent scientific process makes recommendations for what should or should not be on that schedule, and who should or should not get certain types of immunizations depending on their risks of harm from the diseases.'
That hasn't been the case because the CDC's Advisory Committee for Immunization Practices didn't meet and vote on this guidance.
'I think there's a lot of concern in the scientific community and in the medical community about whether these recommendations are based in sound science,' Stack said.
Overall, Stack said, if vaccines are discouraged or not recommended, it could create confusion for commercial and public health insurers about what they are required to cover.
'It really does throw into uncertainty 'will Kentuckians and will the American people continue to have access to immunizations that have clearly protected countless numbers of people and saved an enormous number of lives over the years?'' Stack said.
It can be difficult to keep up with changes and advancements in science, Briones-Pryor said, so it's important to talk with your primary care physician to figure out what's best for you and your household. She noted that throughout her career, she's seen several medicines go off the market and frequency of preventative screenings, such as pap smears and colonoscopies, shift overtime.
'Change is hard, especially in medicine,' Briones-Pryor said. 'We don't do change well as a society. ... We continue to learn about the things that we do (in medicine), and hope that we can find things that are better and safer. It's been an interesting ride.'
Practicing good hygiene can help prevent the spread of COVID-19 and other respiratory illnesses. Briones-Pryor recommended washing hands frequently for the full-length of the 'Happy Birthday,' avoiding touching your face, carrying hand sanitizer and trying to cover all coughs and sneezes.
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The CDC recommends that anyone who may have COVID-19 or another respiratory virus stay home and avoid in-person contact with other people. A person can return to their normal activities when your symptoms have improved overall and you've been fever-free for at least 24 hours. Symptoms typically include fever, chills, fatigue, cough, runny nose and headache.
The CDC encourages added precautions during the first five days of normal activities such as physical distancing, keeping good hygiene and wearing a mask.
Information from the Courier Journal's sister paper, USA Today, was used in this report. Reach Courier Journal reporter Maggie Menderski at [e-mail].
This article originally appeared on Louisville Courier Journal: Is the COVID vaccine necessary now? Read what Kentucky experts say