NMDOH Chief Medical Officer Dr. Miranda Durham addresses President Trump's executive order on childhood vaccines including MMR and more. Here is a transcript of her conversation with KC Counts:
KC Counts:
We have talked about vaccinations and state policy for childhood vaccinations in the past. And we find the need to clarify once again; President Donald Trump has signed an executive order to separate the MMR vaccine into three different shots. Am I understanding that correctly? And why is that?
Dr. Miranda Durham:
So, you are understanding it correctly. That is one of the things in the executive order. And it's really not clear why that that is, there's no science presented around that. And the MMR as a combo vaccine has been around for a long time. And in general, combo vaccines are awesome. You poke your child once instead of three times to get protection from these three diseases of childhood.
KC Counts:
And so just because the president has signed an executive order, it doesn't mean that states must follow that order.
Dr. Miranda Durham:
Exactly. So, a federal executive order really has no bearing on the states. What's really interesting about this one is it is not possible to get those vaccines as three separate vaccines. And I feel like that's really unfortunate, especially in the setting. I mean, we had a new measles case, but really across the US, we've had more measles cases this year than we've had in previous three decades. So, we really, for people who want to protect themselves from measles, especially, MMR is the only choice. There isn't a way to get those three separate shots.
KC Counts:
I was going to ask about that because I had heard a reference to that, we just don't make the vaccine that way. Now, is it possible that someone is working on creating three different shots for the people who do think that it's a good idea?
Dr. Miranda Durham:
It certainly is possible that, and I think that's really what the executive order was sort of directing federal agencies to start looking into that and having a plan. And choice is always good. But I think overall, in my years as a clinician, most of the time we just cheered when they got 3 vaccines into one poke for your child. It's less time at the doctor's, less time missing work, less time with your kid in tears, and just less volume of vaccine overall.
KC Counts:
Volume of vaccine. I think that's what the president said as part of justification for this, that he had seen a soda bottle size vaccine go into a little baby and then bad things often happen, I think, something similar to that was the quote. Does anyone know what he's even referring to?
Dr. Miranda Durham:
Yeah, I mean, again, I'll just speak from my experience as a clinician taking care of kids and sometimes, having to give the shots or co-giving the shots with a squirmy kid with the nurses. But yes, it's a tiny volume that each one of those shots is. And so, not quite sure.
KC Counts:
Okay. So you brought up a new measles case for New Mexico. And I think we were in arrangements to set a time for this very interview, that notification came from the New Mexico Department of Health shortly after. So, good timing for us to speak on that issue; tell us about the patient and where they are.
Dr. Miranda Durham:
They're in the southern part of New Mexico. But I think the point is here that travel anywhere in the United States really you can get exposed anywhere. So you can get exposed. I mean, fortunately, we've had, we haven't had a measles case since I think May was our last one and it was just a single one. So we haven't been in outbreak status. But everyone travels and it's out there. So especially unvaccinated people are at risk of picking it up and bringing it back to New Mexico.
KC Counts:
And you mentioned the southern part of the state was Eddy, was it Eddy County?
Dr. Miranda Durham:
Yes.
KC Counts:
Okay, so southeastern New Mexico, you know, not right in our immediate listening area, but so the patient was unvaccinated, is that correct?
Dr. Miranda Durham:
That is correct.
KC Counts:
And an adult.
Dr. Miranda Durham:
Yes.
KC Counts:
As the school year is here getting started, do you have any numbers in terms of what New Mexico's childhood vaccination rates are?
Dr. Miranda Durham:
So it definitely varies a little bit by vaccine, but overall we continue to have really good vaccination rates. So, and I can get you these specific numbers, but I think we've been hovering right around 95% for MMR for kindergarten across the whole state. And then there's sometimes, county by county, variation if you look at it.
KC Counts:
Now, tell parents what they need to know in terms of just heading into the new school year and getting vaccines.
Dr. Miranda Durham:
Yeah, and really the bottom line is the executive order doesn't change anything in New Mexico. So the school immunization requirements were, they get put out every year, they get published around March, well ahead of the beginning of the school year. And then the good news is, there's been no changes to vaccine coverage either. So Vaccines for Children is still covering the full usual slate of vaccines. New Mexico Medicaid, Turquoise Care, continues to cover all childhood vaccines, and private insurance in the state is also covering all childhood vaccines. So the access is there. If people want them, there should be no barriers. People should not be paying out of pocket for vaccines.
KC Counts:
Now, I remember speaking some time ago as well about covid vaccines and how that story has kind of changed a little bit over the last year and change. What is the current status for people who want to get a covid vaccine? I know we've got COVID circulating. Now we've got a bit of a surge going on, if you will, right?
Dr. Miranda Durham:
So just to be clear about COVID, it is not a required school vaccine, neither is flu. And the COVID story is we are just kind of waiting for that moment - our understanding is the manufacturers have them ready to go. They haven't shipped yet the new covid vaccine that will cover the XFG variant that was decided by the FDA back in May. So, it is a little different this year without usually kind of a trigger, is the Advisory Committee on Immunization Practices, or ACIP, issuing their recommendations and that's usually around the time that the vaccine ships. You know, we don't anticipate that we're going to get those recommendations from ACIP, but hoping that the vaccines will ship soon.
KC Counts:
That they could ship regardless of whether that comes. And you're just, so you're just still waiting, really. And there's, you don't really have, you know, nobody's saying what's going to happen.
Dr. Miranda Durham:
Exactly. We are not 100% sure.
KC Counts:
All right. Now, would it benefit anyone to get what covid vaccine is available at this time?
Dr. Miranda Durham:
It is. I mean, still the last, what we would consider at this point almost last year's covid vaccine is still available in limited places because, by and large, people have let their stock dwindle. I think in the right setting, I think this would be a discussion you'd have with your healthcare provider, get it now or wait. Some of that might depend on your risk, your travel, your previous immunization history. So it's hard to make a blanket recommendation there.
KC Counts:
Okay. Well, what do you think is important for people to know before I let you go?
Dr. Miranda Durham:
I think as always, our DOH nurse helpline, if you have questions about vaccines, where to get them, how to access them at the Department of Health, and that number is 1-833-796-8773.
KC Counts:
SW nurse, right?
Dr. Miranda Durham:
SW nurse, exactly.
KC Counts:
Alright, can we just talk briefly before I let you go about the mRNA technology and the new flu shot?
Dr. Miranda Durham:
Yeah, well, it's exciting. It's one of the first vaccines the FDA has approved in a couple of years. So, it's an mRNA flu shot. It was tested over last respiratory season, so 25, 26 in people 50 and over. And it just cleared its last hurdle of FDA approval on August 5th. So what we have heard is that it should be available for this coming respiratory season as an option. The initial studies do look like it's maybe a little bit longer lasting and a little bit more broadly, like sort of covers more strains.
KC Counts:
One of the things we know about previous flu shots is that it's kind of like the vaccine for COVID. It doesn't necessarily prevent you from getting the disease, and it can also vary by a lot from season to season, depending on how our predictions go for the strain of flu that we've got. Would the mRNA vaccine be, would its efficacy be greater or is it gonna be around the same neighborhood?
Dr. Miranda Durham:
It looked like in the study that was done that the FDA, it looked like when they were approving, that it's about 30% more efficacious. So that is exciting. And again, what they really looked at were those kind of medically attended flu, so visits, urgent care, hospitalizations.
KC Counts:
And one of the things that we hear people talk about who are skeptical of maybe vaccines in general, but especially the mRNA technology is there are claims that they weren't part of good clinical trials.
Dr. Miranda Durham:
Yeah, and I've forgotten the exact number of patients, but they did a robust study, again, last respiratory season. I think the other interesting thing about vaccines is they always track safety, side effects going forward, even after it comes out. So again, with COVID, you just can't say it enough. I mean, the millions and millions of doses that were given and the kind of endless number of studies that were done to show that they were, they are safe and effective.
KC Counts:
Well, Dr. Miranda Durham, thank you so much for talking with us today. I know that it's a bit of a roller coaster in recent years in terms of what happens regarding vaccines. It's certainly discouraging to see more cases of measles in the country than we've seen in decades. And we hope to see that turn around soon.
Dr. Miranda Durham:
Exactly. Thanks so much for having me.
