Looking for COVID-19 Vaccine Guidance? Other Clinicians Are as Well

Like many clinicians, Jeremy Faust, MD, an emergency department clinician at Brigham and Women’s Hospital, and assistant professor, Harvard Medical School, is perplexed and uncertain by COVID-19 vaccine guidance and who is eligible for vaccines in 2025. 

“It went from out-of-date guidance, to just confusing guidance,” Faust said.

“I would say go talk to your clinicians, but I don't know how the clinicians can possibly know what to do, because they're hearing different messages from HHS [Health and Human Services] on a daily basis, and they're hearing different messages from CDC [Centers for Disease Control and Prevention].”

“It is a mess. You have RFK [HHS Secretary Robert F Kennedy] and his deputies out there saying that kids shouldn't get this on Twitter,” Faust said. “Then a few days later, the CDC said something different…We don't have transparency; We just have a stream of consciousness of competing ideas.”

In addition to a lack of well-constructed, consistent vaccine guidance is the backdrop of vaccine disinformation and misinformation, which leads to further mistrust and decreased uptake across all age groups. Faust says the myocarditis risk in teen boys and young men has diminished greatly with the latest version of boosters, yet the current federal agency leadership continues to discuss the risk of this adverse effect in an exaggerated context.

“The current FDA leadership is fanning those flames. They are out there talking about the myocarditis signal in young people, which is quite rare. They're talking about proxy outcomes, meaning they're not actually looking at clinical outcomes…And these are the same people who a year ago were telling us the proxy outcomes are garbage, and big pharma uses proxy outcomes to puff up their results all the time, and we shouldn't take those seriously. Now, they're using it to fan the flames of vaccine hesitancy…I am not okay with that.”

It is important to note, Faust believes in looking at individual patients’ medical histories for guidance around getting more boosters.

“I am not someone who thinks that a 5-year old child who's had COVID twice and got the COVID vaccine, needs a yearly COVID booster. I've never believed that,” Faust said. I thought that the booster rollout in the fall of 2021 was a mistake.”

Faust still believes people who are at a higher risk and some in the pediatric population should be getting vaccinated.

“I'll say what's very clear; high-risk people need to stay up to date. That is anyone who in my definition of high risk—not just the CDC definition—which has a laundry list of conditions. My definition is also that, but I would say anyone who's hospitalized on a frequent basis…If you're someone who gets hospitalized every time you get flu, I'd say you should get a flu shot, right? Same thing with COVID…People who are immunocompromised need to stay up to date… For children, especially kids who have never been vaccinated or infected before, that's a very high risk group. These infants and kids need a primary series.”

Check out the first installment of Faust’s interview, What to Make of Changing COVID-19 Vaccine Indications and Guidance.