The C.D.C.'s Vaccine Meeting: What to Watch For
One of them, Robert Malone, said on X that he considers the label 'anti-vaxer' to be 'high praise.' Mr. Kennedy named Dr. Malone a co-chair of the committee on Tuesday.
The panel's agenda on Wednesday includes some topics that are closely associated with the anti-vaccine movement and omits several others that were originally scheduled for discussion.
Here's what to watch for.
The panelists: Most of the seven new committee members are not vaccine experts, and a few have not publicly expressed their views on childhood immunizations. The meeting should offer clues about their opinions on the safety of various vaccines.
Thimerosal: A perennial target of the anti-vaccine movement, and of Mr. Kennedy, thimerosal is a mercury-based preservative that was falsely said to be a cause of autism. Most childhood vaccines in the United States have not contained thimerosal since 2001, even as autism rates have continued to rise.
Flu vaccine: The panelists are scheduled to vote on the only pediatric formulation that contains thimerosal, a multidose vial of the flu shot, which uses it to prevent microbial contamination. That formulation accounts for a small fraction of flu vaccines administered to Americans. In a twist, Lyn Redwood, a former leader of Children's Health Defense, the anti-vaccine group founded by Mr. Kennedy, is scheduled to present recommendations for the vaccine.
M.M.R.V. vaccine: This combination vaccine for measles, mumps, rubella and chickenpox is on the agenda under 'proposed recommendations' regarding its use in children younger than 4. It slightly increases the risk of febrile seizures, which can occur with any childhood illness but do not cause lasting harm. The C.D.C. already recommends administering the M.M.R. shot and the chickenpox shot separately in the first dose.
Maternal and pediatric vaccines for respiratory syncytial virus: It may turn out to be a straightforward vote on recommending clesrovimab, a new monoclonal antibody approved by the Food and Drug Administration earlier this month, as an alternative to protect infants. But a scheduled update on the safety of the maternal vaccine opens the door to restrictions.
The presenters: A dozen or more C.D.C. scientists typically present data to the panelists. This time, only a few senior scientists are scheduled to present most of the data.
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For example, if your child really enjoys taking a bath and they eagerly get in the bath every night, you wouldn't think to set up a reward system for taking a bath. However, if your child hates taking a bath and it is a fight every night, a reward system might be just what you need. Translation: Research suggests that you don't really have to worry about rewarding your child for the types of tasks you would typically set up a reward system for (that is, the tasks they aren't doing on their own). For activities your child isn't already doing on their own, rewards may help to 'jumpstart' intrinsic motivation. How this works is that rewards get the child to engage in something they may not have without the reward and eventually they start to see the intrinsic motivation. Going back to the bath example— your child may initially hate bathing and only take a bath to get a reward. Yet, when they start taking a bath every night, they may start enjoying the calming experience of the bath in their bedtime routine and the feeling of being clean. Eventually they love bathing for bathing's sake and, just like that, they have developed the intrinsic motivation to take a bath. Another example— your child may not be initially motivated to have a clean room but if you give them rewards for cleaning their room, they may start to realize that they like being able to easily walk around their room and find everything they need and they may start to enjoy the sense of accomplishment they get from cleaning their room. Ultimately, they become intrinsically motivated to keep their room clean. You can eventually fade out the rewards as the activity itself becomes intrinsically rewarding. There is also no doubt that rewards have other benefits above and beyond increasing intrinsic motivation such as encouraging persistence and improving children's control over their own behavior. In addition, parenting training programs that use reward systems have been found to have significant and long-lasting positive impacts on children's behavior and the parent-child relationship. An Important Exception… There is some evidence that providing tangible rewards for social behavior, such as helping others or sharing, may undermine intrinsic motivation (that is, make children less likely to want to help others or share in the future). This makes sense since these types of social behaviors should be rewarding in themselves. Intangible rewards such as praise or positive attention do not seem to have the same impact and parents should feel free to use praise and positive attention for any social behavior they would like to see more often ('I noticed that you shared your toys with your friend'). Bribes Versus Rewards Many parents have heard that they should not bribe their children. But what exactly is a bribe and how is it different from a reward? A bribe is when a parent promises a reward to stop 'bad' behavior. For example, if your child is hitting their sibling in the backseat and you say: 'If you leave your sister alone, then we can go get ice cream'. A reward on the other hand would be offered in the absence of 'bad' behavior . Bribes are a problem because they are actually rewarding the 'bad' behavior because your child may learn that if they engage in that behavior, you will reward them to stop doing it which indirectly rewards the 'bad' behavior. What About Children with ADHD? It is also important to note that reward systems may be particularly effective with children with ADHD. However, research also shows that children with ADHD may respond more positively to smaller, more immediate rewards than larger delayed rewards. Overall Translation Using rewards with children may have many positive impacts and we have no consistent evidence of negative impacts (with the very important exception of using rewards for tasks your child is already motivated to complete or positive social behavior like sharing or helping). More research is needed but the research we do have gives parents some guidance. Here are some evidence-based tips for using rewards with children in a way that does not decrease intrinsic motivation and may actually improve your child's behavior: Avoid using rewards for tasks your child already enjoys or is already motivated to do. For example, if your child is very motivated to be potty-trained and interested in using the potty, you may not want to use rewards. However, if your child does not seem motivated or interested, rewards may be essential. A good rule of thumb is whether they are doing the task without you asking them to do it. Avoid using rewards for any type of social interaction (such as sharing, playing nicely with siblings, or helping others). These activities should be enjoyable and motivating in themselves. However, praising and giving positive attention to these behaviors can be very effective and should not impact intrinsic motivation. Base rewards on the child's performance. Decide in advance which specific behaviors you will reward and only reward those behaviors. If rewards are given willy-nilly, they lose their meaning. Reward your child immediately and consistently after the behavior. Rewards need to be immediate and consistent or children will not link the behavior to the reward. Research also finds that immediate rewards tend to increase intrinsic motivation more than delayed rewards. Don't use bribes. In other words, don't use rewards to stop 'bad' behavior or your child may ultimately link the reward to that behavior. Find the system that works best for you and stick to it. Some parents prefer a sticker chart, some prefer tally marks on a piece of paper, some prefer apps (I personally love and use the app Stellar). Go through some trial and error to find out what system you can use consistently and seems to be the most motivating to your child. You may have to use concrete and immediate rewards for children who are three or younger (this is very important to remember if you are considering using rewards for potty training). Gradually stop using rewards when they are no longer necessary. There isn't research specifically informing when and how parents should fade rewards so pay attention to your child and notice when the reward seems less and less important and gradually phase it out. Solve the daily Crossword
