Dr. Miranda Durham explains changes to federal vaccine guidance and how the state is responding by maintaining its recommendations. Here is a transcript of her conversation with KRWG's KC Counts:
KC Counts:
Let's begin with the recent shift in the childhood vaccination schedule from the Health and Human Services Department. The New Mexico Department of Health came out after that, saying that the recommendations remain the same. For people who are just confused about what they should be doing or what they'll be able to do, what advice do you have?
Dr. Miranda Durham:
Well, the good news is on what they'll be able to do, is they'll be able to do the exact same thing that they've always been able to do in New Mexico, and that is get childhood vaccines at no cost. So all insurances will continue to pay. New Mexico Medicaid will continue to pay. And we have a really robust Vaccines for Children program, which covers kids who don't have insurance. So that's the good news in all of this. The confusing part is really how the schedules are put together. We endorse the American Academy of Pediatrics. We have for years. We decided to stick with that schedule because it offers the broadest access to vaccines. It's also the one our providers have been using for years. And so, I think it's just a great starting place for having conversations with pediatricians and other healthcare providers taking care of kids.
KC Counts:
Can you explain the changes from the federal level?
Dr. Miranda Durham:
Yeah, so broadly, what the schedule that we had for years basically had the 16 vaccines that were recommended for all children. And what the recent changes is kind of took those, that same set of vaccines and divided them into 3 buckets. So, the one bucket is ones that are recommended for all kids. Another bucket is those recommended just for high-risk kids. And the third bucket is ones for shared clinical decision-making. Our point is vaccines have always been something that parents talk about with providers. So, it's always shared clinical decision-making, not really necessary to stick it in, stick some of these vaccines in a bucket that makes it look like maybe they aren't as important. There's also a handful of vaccines that are, sometimes you see the numbers differ because there are some vaccines that have always been on the AAP schedule only for high-risk children. And those also are on the current federal schedule for high-risk kids.
KC Counts:
Are you concerned that, you know, a lot of people might welcome this change and that we could see impacts in the general population as a result?
Dr. Miranda Durham:
We're in the business of public health, trying to preserve the health of individuals and communities. So, yes, we are concerned. And I think in New Mexico, we've seen, we had a big measles outbreak. We had a fantastic response from people and providers across the state stepping up and getting vaccinated and really got our measles outbreak under control quickly. So, my worry is really more about the confusion this causes and people just not doing anything because they don't know what to do. And I know there are people who don't want to vaccinate their kids, and that has always been a choice in New Mexico as well through the exemptions. But I worry the confusion's the bigger problem.
KC Counts:
Well, and no doubt some amount of misinformation or even disinformation as well.
Dr. Miranda Durham:
Yes.
KC Counts:
Where to go for more information on those childhood vaccinations?
Dr. Miranda Durham:
Number one, I think, are providers taking care of kids. That's nurse practitioners, pediatricians, family docs all across the state. I think our pharmacists in New Mexico also do a lot of vaccinating and are really good at talking through vaccines with parents. We've got school nurses who are good at vaccines, and we have our Department of Health nurses in 40 offices across the state. also love to talk about vaccines. And then we have our Department of Health helpline. There are nurses on that line that will also be happy to talk through vaccine decisions with parents.
KC Counts:
All right. Well, I want to move on to a different topic briefly. We recently spoke with the deputy epidemiologist about flu season and vaccines, but I want to touch a little bit more on that because I think since then we've really seen an uptick in flu cases. Are we seeing in New Mexico what seems to be happening around the rest of the country?
Dr. Miranda Durham:
Absolutely. And it really was like an overnight, you know, one week we were looking okay and the next week we were off the charts. And what we are seeing is a real uptick in emergency room visits. The highest uptick is in kids under 18. So, it really is much higher than last year. Unfortunately, our vaccine rates are lower than last year and we're dealing with a pretty tough flu strain. So yes, now is the time. It's not too late for parents, kids, grandparents, everyone to go get your flu vaccine. It's not a perfect vaccine. It doesn't always stop people from getting the flu, but it has been shown even in the environment of our super flu to keep people out of the hospital.
KC Counts:
This does happen, you know, from time to time. I think maybe the year that swine flu was really bad. Somewhere in the neighborhood of 60,000 people died of swine flu. And it was a similar situation where the strain that became the dominant strain was not the one that, you know, forecasters were working with and when they were creating the vaccine.
Dr. Miranda Durham:
Right. And it's probably not as big a mismatch, but and fortunately, we do have some early data showing that it is still providing protection against hospitalization, which is really the important thing.
KC Counts:
Well, I have a confession, even though I've talked with folks like yourself for many years now about the importance of your flu shot, I first got my first one this year.
Dr. Miranda Durham:
Congratulations!
KC Counts:
First one, didn't even feel it. Didn't even have a sore arm. So, I think one thing that folks want to know is, well, we know it's not super effective, but in what ways does it help?
Dr. Miranda Durham:
Really helps keeping, preventing hospitalization and death. And so the CDC had a great campaign last year, wild to mild. So again, of course, we'd all love to think that it would 100% protect us from getting sick and it doesn't. There's also just a lot of other winter viruses that make people sick with similar symptoms. So sometimes what you're sick with, we call everything the flu. It's not the flu. But the flu is a really bad virus, and it does cause a lot of deaths every year, even among children. And so yeah, that is what we're really looking for this vaccine to do, protect against hospitalization and death. And for some people, it really will prevent them from getting sick at all. So Good news there.
KC Counts:
Right. Well, my next one is shingles because that terrifies me.
Dr. Miranda Durham:
So here is the thing that motivated me on the shingles is there's all this interesting data about shingles vaccine. It's associated with lower dementia risks.
KC Counts:
I saw that.
Dr. Miranda Durham:
So, what this very interesting and actually the flu shot also, there's more data coming out about how some of these adult vaccines of additional benefits. It's really fascinating. But I take a few days of a sore arm for a lower dementia risk any day.
KC Counts:
And shingles just looks nasty anyway.
Dr. Miranda Durham:
That's actually the number one reason to get your shot.
KC Counts:
We all know it doesn't care! So, all right. Dr. Miranda Durham, thank you so much for joining us today. And we hope to stay in touch as the flu season progresses. Hopefully, it will get better rather than worse as time goes on. But we'll stay in touch. Thank you so much for joining us.
Dr. Miranda Durham:
Thanks for having me.
The New Mexico Department of Health's Helpline is:
