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Medical and insurance organizations generally reacted favorably to the Senate’s Aug. 7 approval of the 

This week, the House of Representatives is expected to begin deliberating on the law, which has at least three national-level effects on health care:

Medicare will be allowed to negotiate drug prices.

Seniors’ out-of-pocket spending on prescription drugs will be capped at $2,000.

Subsidies will continue for patients purchasing health insurance through the Affordable Care Act Marketplace.

The American College of Physicians (ACP) praised the legislation to improve access to health care and improve health for all Americans, President Ryan, D Mire, MD, FACP, said in a 

“We are glad to see that the final version of the legislation still includes many of the important provisions that we 

 when the agreement was announced,” Mire said. “Subsidies for health insurance plans under the Affordable Care Act will be extended for three additional years, Medicare will now be allowed to negotiate lower drug prices with manufacturers, and the legislation will help to reduce carbon pollution and advance clean energy solutions. We are also encouraged that the legislation will cap insulin costs for Medicare beneficiaries, allowing our senior patients to more easily afford this life-saving medication. We look forward to the House taking up the bill and call on them to swiftly pass it.”

The Association of American Medical Colleges (AAMC) said the legislation will invest $64 billion for the ACA insurance subsidies.

“As the COVID-19 pandemic has highlighted many disparities in access to coverage and care, we commend senators for agreeing on a bill that will allow patients and families to maintain access to affordable coverage, empowering them to seek care before treatable conditions become more complicated and costly,” AAMC President David J. Skorton, MD, said in a 

. “Additionally, the high cost of prescription drugs often prevents patients from obtaining the medications they need. We support efforts to lower drugs costs and increase access to affordable medications.”

Louise Norris, health policy analyst for consultant 

“This is excellent news for the 13 million Americans who rely on premium subsidies to make marketplace health coverage affordable. Larger and more widely available subsidies have led to record-high marketplace enrollment,” Norris said. “Without action from Congress, millions of people will likely see their subsidies decrease or disappear in 2023, and 3 million current enrollees might lose their coverage altogether. The Senate’s vote to pass this legislation is a step toward ensuring these hard working Americans will still be able to afford their health coverage next year, and we hope to see it pass quickly in the House.”

The Endocrine Society issued a statement praising the IRA for addressing high insulin costs. More than 7 million people rely on insulin to manage diabetes and live, and the U.S. Centers for Disease Control and Prevention logged 37.3 million people with diabetes – 11 % of the nation’s population.

Insulin nearly tripled in price from 2002 to 2013, with the upward trend continuing.

The Endocrine Society noted the Senate missed an important opportunity to also help children and adults with type 1 diabetes when 43 Republicans voted against including a provision that would have capped out-of-pocket costs for individuals with private insurance, that the society supported.

, President Joe Biden led with the potential health care benefits, noting the IRA will lower the costs of prescription drugs and health insurance, along with other provisions of the bill. Biden said he ran for the post “promising to make government work for working families again, and that is what this bill does – period.”

 the new law will have a negative effect on innovation in the pharmaceutical industry, which in turn will have consequences for health of Americans.

Using “savings” from drug price controls to cover ACA insurance “would lead to a massive loss of life, due to foregone medical innovation, and a reduction in the quality of care, due to the government gaining more control over people’s insurance coverage,” former White House economic adviser 

This article was published by our sister publication Medical Economics.

Articles

Medicare drug prices, insulin costs affected by Inflation Reduction Act.

Medical, insurance groups praise Senate action on health insurance

Cybercriminals are taking advantage of all the connected medical devices within hospitals, and security for them is lacking, according to a report from 

Security experts have been warning health care companies for years that these devices are vulnerable to 

 because their security features are often outdated or inadequate, if they have security at all.

More than half of the respondents said senior management did not require assurances that medical or internet-connected device risks were properly monitored or managed.

In the report, 56% of respondents said internet-enabled device attacks resulted in longer patient length-of-stays, while 48% of respondents said they resulted in theft of patient data. In contrast, only 3.4% of hospital IT budgets are spent on device security.

Part of the problem is with the explosion in the number of these devices, they are often overlooked. The report found that 67% of organizations don’t even keep an inventory of them, and there is no clear ownership in many organizations about who is responsible for protecting them.

The report showed that 49% don’t measure the effectiveness of device security procedures, compared to 46% who take proper security steps. Of those organizations who reported a breach in the past two years, 88% said at least one connected device was a contributing factor to the 

Unfortunately, the only thing that may change these lackadaisical approaches for some hospitals is for a serious event to occur where hackers breach the hospital through a device that results in a loss of revenue or damage to relationships with clinicians or business partners, according to the report.

Security experts have been warning health care companies for years that all the connected medical devices are potential vulnerabilities

Cybercriminals using medical devices to hack hospitals

An increase in deaths by gun violence in children was observed during the COVID-19 pandemic. In the years of 2020 to 2022, the number of children killed by gun violence is of a similar size to those killed directly by the SARS-CoV-2 virus.

Data was taken from the Gun Violence Archive (GVA) to examine the rates of gun violence from January 1, 2014, to December 31, 2022. Investigators organized the data into periods of 28 days. Periods from the middle of March 2020 onward were compared with those prior. Subgroups were based on child age, household income, and percentage of Black or Hispanic population.

From March 2020 onward, an increase in child deaths by gun violence was observed. These deaths increased at an estimated rate of 1.12 children per day. During the study period, 733 child deaths were recorded. This figure compares to data from the US Centers for Disease Control and Prevention (CDC), which recorded 752 child deaths caused directly by COVID-19 in the same time period.

In the child deaths from gun violence observed, 22.3% were children aged 0 to 11 years, while 77.7% were aged 12 to 17 years. Moreover, 19.6% of these deaths were girls, while 78.8% were boys, while the gender of 1.7% of the children was unknown.

Deaths from gun violence were most often seen increasing in low median income households, or in an area with a higher percentage of Black or Hispanic population. Nearly 60% of the recorded deaths were from a high-minority area, meaning that more than half of the population in these areas was Black or Hispanic. The study investigators deduced that, “family and neighborhood socioeconomic conditions may be important mediators.” 

The authors also mentioned other factors which may have led to an increase in gun violence but have not been proven. These include the closure of schools and the increase in stress within families due to lockdowns. Economic strain could also be a factor in gun-related deaths.

Peña PA, Jena A. Child deaths by gun violence in the us during the covid-19 pandemic. 

 2022;5(8):e2225339. doi:10.1001/jamanetworkopen.2022.25339

Studies indicate that child deaths by gun violence were comparable to those by COVID-19.

Child death by gun violence increased during COVID-19 pandemic

Monkeypox has been declared a public health emergency (PHE) in the United States.

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra announced 

 Aug. 4 to “strengthen and accelerate the Biden-Harris administration’s response in recognition of the continued rapid transmission of monkeypox in the U.S. and globally, and to signal the seriousness and urgency with which the administration is responding.”

“Ending the monkeypox outbreak is a critical priority for the Biden-Harris Administration,” Becerra said in a news release. “We are taking our response to the next level by declaring a public health emergency.”

The same day, the U.S. case count reach 7,102 confirmed cases, according to the U.S. Centers for Disease Control and Prevention (CDC). More than 500 cases have been reported in New York, Georgia, Florida, Illinois, Texas and California, and just two states, Montana and Wyoming, have had no reported cases. Cities and states were quicker in their declarations than the federal government.

There were 26,864 confirmed cases in 88 countries around the world, with most of those in 81 countries that historically have not reported the disease. The World Health Organization on July 23 declared monkeypox to be a public health emergency of international concern.

 found some American believe it is a sexually transmitted disease. It is not, according to CDC, but can be spread through close, personal, often skin-to-skin contact, including sexual contact.

Along with the PHE declaration, the U.S. Food and Drug Administration (FDA) is working on new strategies to get vaccines to affected communities across the country, including a new dose-sparing approach that could increase up to five-fold the number of doses available, according to HHS.

As of Aug. 4, HHS announced it has shipped more than 602,000 doses of the Jynneos vaccine to states and jurisdictions, an increase of 266,000 in the past week. HHS has allocated 1.1 million doses to states and jurisdictions in total and is making more doses available as jurisdictions use their current supply. HHS has accelerated delivery of 150,000 additional doses to arrive in the U.S. next month instead of November.

So far, 51 jurisdictions have signed data use agreements to provide CDC with information related to vaccine administration. Declaring an emergency may provide the justification the remaining jurisdictions need to sign their agreements. The PHE provides authorities to the Centers for Medicare & Medicaid Services to collect testing and hospitalization data.

The developments came two days after the White House announced appointments of Robert Fenton, a regional administrator of the Federal Emergency Management Agency, as White House National Monkeypox Response Coordinator and Demetre Daskalakis, MD, MPH, director of HIV prevention for the Centers for Disease Control and Prevention (CDC), as White House National Monkeypox Response Deputy Coordinator.

“President Biden has called on us to explore every option on the table to combat the monkeypox outbreak and protect communities at risk,” Fenton said in the HHS announcement. “We are applying lessons learned from the battles we’ve fought – from COVID response to wildfires to measles, and will tackle this outbreak with the urgency this moment demands.”

White House ramps up efforts to fight outbreak.

HHS declares monkeypox a public health emergency in U.S.

Smoking tobacco while pregnant can lead to one’s child experiencing lower brain volumes and suboptimal cortical traits, according to a study by The Journal of the American Medical Association (JAMA).

Investigators conducted brain morphology in children aged 9 to 11 years. Over 2700 study participants had been exposed to maternal smoking during pregnancy, and a subsample of 784 patients had recorded DNA methylation. Magnetic resonance imaging (MRI) was used to examine brain volumes and surface-based cortical measures in patients.

Study participants underwent a brain MRI assessment, and it was found that those who were exposed to maternal smoking during pregnancy had a smaller total brain volume (TBV) than those not exposed. Specifically, children who were continuously exposed during pregnancy were observed to have lower TBV levels, and there was less gyrification observed in children exposed to maternal smoking. 

These changes in brain morphology were not found in children who were only exposed early in the pregnancy. Children exposed to maternal smoking in only the first trimester were found to have the same brain morphology as children not exposed at all.

Paternal smoking was shown to have effects as well, with both maternal and paternal smoking leading to a larger putamen in the child by the time they were 10 years of age. There were far more cases of brain morphology reported in cases of maternal smoking, however. No association was made between paternal smoking and changes in the cortical thickness, surface area, or gyrificationof the child.

No proof was found that DNA methylation at birth could mediate the effects of maternal smoking. However, it should be noted that all the children in the DNA methylation subsample were White, and the results cannot be assumed to be the same for other races and ethnicities.

Based on these findings, continuous tobacco use during maternal pregnancy will often lead to complications in the child’s brain developed by the time they are aged 10 years. These complications are seemingly not able to be explained by shared genetics or family factors.

These results are consistent with those of prior studies, which also showed smaller brain sizes in fetuses and children exposed to continuous maternal smoking. For favorable long term brain development in children, the authors encouraged ceasing maternal smoking before pregnancy starts or early in pregnancy.

Zou R, Boer OD, Felix JF, et al. Association of maternal tobacco use during pregnancy with preadolescent brain morphology among offspring. 

 2022;5(8):e2224701. doi:10.1001/jamanetworkopen.2022.24701

Smoking tobacco should cease during pregnancy, according to The Journal of the American Medical Association.

Smoking during pregnancy associated with smaller brain volume in child

The American Academy of Pediatrics (AAP) has announced revisions to the clinical guidelines for treating infants with hyperbilirubinemia who are born 35 weeks or more into pregnancy. Hyperbilirubinemia most often leads to jaundice, a condition where the skin and whites of the eyes take on a yellow appearance. However, symptoms are sometimes more severe, leading to complications in the brain.

Chair of the guideline authoring committee Alex R. Kemper, MD, MPH, MS, FAAP, discussed the importance of hospitals and clinicians having plans to help prevent hyperbilirubinemia in newborns.

One of these plans was to measure bilirubin levels in babies. High levels of bilirubin can lead to a permanent brain condition known as kernicterus, which can cause cerebral palsy and severe movement problems.

“This is why we need to make sure clinicians understand why it is important to test bilirubin levels and for families to understand their babies’ risk and recommended follow-up,” said Kemper.

If a case of hyperbilirubinemia is severe, exchange transfusion can be used as treatment instead. During exchange transfusion, the patient’s blood is rapidly replaced so that bilirubin levels may be lowered. One of the recent revisions made by the AAP suggested using this method less than before, raising the threshold for exchange transfusion along with phototherapy. This change came because of research published in 2004 that implied toxicity is caused in higher levels of bilirubin than initially thought.

“Fortunately, kernicterus is rare, but the impact on children and their families can be devastating,” said Kemper. “The guideline provides clinicians, birthing centers, and hospitals with strategies to prevent the worst-case scenarios and to help educate families so they recognize the signs of jaundice and know when to follow-up with their pediatrician.”

To cause more timely follow ups, the AAP revised the risk assessment approach to suggest the right times for measuring bilirubin levels. This approach is based on the difference between the infant’s bilirubin levels and the phototherapy threshold. The potential harm of phototherapy was a key factor in the development of the AAP’s guidelines.

These new findings were included in the “Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation,” which will be published in the September 2022 issue of Pediatrics. This issue was published online August 5, 2022.

American Academy of Pediatrics revises clinical guidelines for preventing, treating, and monitoring hyperbilirubinemia in newborns. August 5, 2022. Accessed August 5, 2022. 

http://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-revises-clinical-guidelines-for-preventing-treating-and-monitoring-hyperbilirubinemia-in-newborns/

Hyperbilirubinemia can lead to brain complications in rare instances, which the guidelines work to prevent.

AAP announces revisions to clinical guidelines for hyperbilirubinemia treatment in infants 

While unexpected, last Wednesday evening brought a deal between Senator Joe Manchin (D-WV) and Senate Majority Leader Charles E. Schumer (D-NY) on a bill touted as “Inflation Reduction Bill.” It was a surprising U-turn from Manchin, who reportedly previously vowed to block most of President Joe Biden’s bills that featured tax hikes. The new legislation looks to enact tax code reform, work against climate change, and cut healthcare costs.

If passed, it will be the largest tax increase in some time; the deal is intended to raise approximately $739 billion in accumulated taxes largely through eliminating loopholes. The revenue would be used to fund initiatives to support the goals of the bill, in addition to lowering the budget deficit. This would be processed as an investment of $400 billion over 10 years, with the remaining approximately $300 billion serving as a budget deficit reduction

So, what’s in the bill and how does it affect physicians? Let’s review some of the highlights of the bill:

 by imposing a 15% minimum levy on companies that had previously been eligible to pay very low taxes, or none at all, because of applied credits and deductions. Rather than the usual method of using income for tax calculation, this levy will be applied to the companies’ financial statement, or “book,” earnings.

Looking at the impact of the bill on individual taxpayers, a Joint Committee on Taxation found that for those earning under $400,000, the tax increase would initially be slight. However, by 2031, the various credits and subsidies may prove to be more of a boon to higher-income individuals; at that time, over than 60% of the projected revenue could be coming from those making under $400,000 annually, according to some Republicans on the Senate Finance Committee.

, though many Democrats had looked to continue the state and local tax (SALT) deduction. This currently allows taxpayers in higher tax states to deduct their local taxes from their federal tax returns. Unfortunately this was eliminated from the Bill. For those physicians who are self-employed, they should discuss paying state taxes from their owned corporations. This election is not automatically applied, and taxpayers must choose to do this. Not all states have these provisions, so it’s important to know what options are available currently.

, with the new legislation providing $80 billion to update technology, hire and train additional auditors, and improve customer experience. This is in line with Democratic legislators’ goal of modernizing the IRS and rebuilding its efficacy after losses to budget cuts over the past ten or so years. Because of the high rate of their earnings, physicians are more likely to be audited. The new provisions will give IRS auditors the ability to request detailed transaction information while making tax arbitration nearly impossible to win due to the increased time and cost of the proceedings.

An extension of the Affordable Care Act & Reforms to drug costs,

 continuing premium subsidies for insurance holders through the Act that were set to expire at the end of 2022. Instead, the subsides will extend to 2025, allowing millions of people who get their insurance through this method to pay a lower and more affordable price. The American College of Medicine applauded this provision, which will make healthcare more accessible to more people.

, up to $4000 for lower- and middle-income taxpayers for the purchase of used electric vehicles. The tax credits can be as high as $7500 for those purchasing new electric vehicles. For car companies who have shifted their attention to electric cars, this comes as a boon, as more people will look to those options when considering transportation.

 with several types of tax credits available to companies in the U.S. utilizing clean methods. There will be investment as well as production tax credits available to enhance U.S. research and production of wind turbines, solar panels, renewable batteries, and other green energy sources.

, with tax credits for consumers who enhance their homes with various improvements mentioned in the bill. These technologies include rooftop solar panels, electric water heaters and HVAC systems, and efficient heat pumps. For low-income taxpayers, the bill sets aside $9 billion in rebate programs for upgrades to make homes more energy efficient, with an additional $1 billion grant money for energy efficiency upgrades in affordable housing developments.

Removal of the carried-interest tax break

, which had previously been used by hedge fund and private equity managers to lower taxes. This had let the investment manager re-classify a share of income as capital gain, meaning it was taxed at a lower rate.

This is likely not the final form of the legislation, but these are the main points that the bill currently includes. Though a far cry from the initial Build Back Better proposal, it will still mean tax increases for individuals with an earned income over $400,000. The White House signaled Wednesday with a statement from President Biden that the administration fully supports this reconciliation bill, and Biden encouraged both the House and Senate to work to approve the bill before the upcoming recess.

Even before the legislation moves any further, physicians who are high-earners should prepare for potential changes and keep abreast of the situation as Congressional talks continue. To put themselves in the best position, physicians should speak to their financial advisors and CPAs to explore tax planning tools such as cost segregation, defined benefit plan establishment, and ROTH IRA conversions to lower overall taxes and be prepared to handle tax code changes in the future.

Syed has been regularly quoted in Medical Economics, Medscape, KevinMD, MedPage Today & Forbes. He can be reached on 

Securities are offered through Securities America, Inc., member FINRA/SIPC. Advisory services offered through Securities America Advisors, Inc. Wall Street Alliance Group and Securities America are separate companies. You should continue to rely on confirmations and statements received from the custodian(s) of your assets. Securities America and its representatives do not provide tax or legal advice; therefore, it is important to coordinate with your tax or legal advisor regarding your specific situation.

The sweeping legislation contains tax code reform, health care provisions and climate change action. What does it mean for physicians?

 Tax increases coming? What physicians need to know about the Inflation Reduction Act

Now more than ever, it’s essential for patients— particularly those who are at risk—to be vaccinated against influenza. Adults 65 and older, individuals with comorbidities, people of color, and individuals of lower socioeconomic status are at higher risk of illness. Getting vaccinated helps protect these vulnerable populations.

What strains have been chosen for this season’s vaccines?

On February 25, 2022, the World Health Organization (WHO) announced the strains selected for the 2022-2023 flu season vaccines after reviewing the data of circulating virus (see sidebar).

On March 3, 2022, the FDA’s Vaccines and Related Biological Products Advisory Committee voted to approve the strains selected by WHO.

What are the new recommendations for the current flu season?

At a meeting in June 2022, the Advisory Committee on Immunization Practices recommended that adults 65 and older receive high-dose influenza vaccines for better protection.3 These vaccines include quadrivalent adjuvanted inactivated influenza vaccine (aIIV4), quadrivalent high-dose inactivated influenza vaccine (HD-IIV4), or quadrivalent recombinant influenza vaccine (RIV4).

In May 2021, the FDA approved the cell-based vaccine Flucelvax (Seqirus).4 This extends the age of coverage of the vaccine to children 6 months and older. A phase 3 clinical study supported this approval, showing that the vaccine’s safety and immunogenicity was equivalent to that of other standard quadrivalent vaccines for children of ages 6 months to 5 years.4 “These data, presented at the Pediatric Academic Societies 2021 Virtual Meeting on May 1, 2021, represent the first US phase 3 study of a cell- based influenza vaccine in this population,” the press release noted.

Moderna is conducting ongoing clinical trials for its mRNA-1230 combination vaccine, which is designed to protect against influenza, COVID-19, and respiratory syncytial virus using the company’s mRNA platform. In a press release distributed ahead of the company’s annual Vaccines Day— held this year in March 2022—Stephen Hoge, MD, president of Moderna said, “We are pleased to add a combination respiratory vaccine candidate against 3 of the leading causes of respiratory disease in older adults, and a vaccine against all 4 of the endemic human coronaviruses as part of our strategy to address the substantial global burden of respiratory infections....Our goal is to develop vaccines to address respiratory infections and eventually combine many into a single annual booster vaccine, with the aim of reducing the significant morbidity and mortality caused by these viruses.”

On July 1, 2022, the FDA approved the license for Sanofi’s Fluzone High-Dose Quadrivalent, Flublok Quadrivalent, and Fluzone Quadrivalent influenza vaccines for the 2022-2023 season. Fluzone and Flublok are the only influenza vaccines proven by randomized controlled trials to prevent more cases in older adults, according to Sanofi’s press release.6 Sanofi said Fluzone has 10 years of evidence in protecting adults 65 and older from flu-related hospitalizations.

“In a clinical study, Flublok Quadrivalent is the first and only recombinant influenza vaccine for adults 18 [and older] that was proven to be 30% more effective than a standard-dose vaccine at preventing flu infection in over 9000 adults 50 [and older]. In adults 50 [and older], the most common [adverse] effects were tenderness and/or pain at the injection site, headache, and tiredness,” the press release stated.

Finally, Novavax, Inc, is developing a COVID-19–influenza combination vaccine. In April 2022, Novavax reported the vaccine was well tolerated and immunogenic, and that the phase 2 confirmation trial will begin toward the end of 2022.7 In the news release, Gregory M. Glenn, MD, president of research and development at Novavax, said the company is continuing “to evaluate the dynamic public health landscape and believes there may be a need for recurrent boosters to fight both COVID-19 and seasonal influenza. We’re encouraged by these data and the potential path forward for a combination COVID-19 influenza vaccine [and] stand-alone vaccines for influenza and COVID-19.”

This article was published by our sister publication Drug Topics.

1. Recommendations announced for influenza vaccine composition for the 2022-2023 northern hemisphere influenza season. News release. World Health Organization; February 25, 2022. Accessed July 5, 2022. 

https://www.who.int/news/item/25-02-2022-recommendations-announced-for-influenza-vaccine-composition-for-the-2022-2023-northern-hemisphere-influenza-season

2. Vaccines and Related Biological Products Advisory Committee March 3, 2022 meeting announcement. FDA. Updated March 25, 2022. Accessed July 5, 2022. 

https://www.fda.gov/advisory-committees/advisory-committee-calendar/vaccines-and-related-biological-products-advisory-committee-march-3-2022-meeting-announcement

3. ACIP flu meeting update: Flu vaccines worked better than reported & ACIP recommends specific vaccines for seniors. CDC. Published June 23, 2022. Accessed July 19, 2022. 

https://www.cdc.gov/flu/spotlights/2021-2022/specific-vaccines-seniors.htm

4. Seqirus receives FDA approval of its cell-based quadrivalent influenza vaccine, expanding the age indication to include children as young as six months. News release. Seqirus; October 15, 2021. Accessed July 5, 2022. 

https://www.prnewswire.com/news-releases/seqirus-receives-fda-approval-of-its-cell-based-quadrivalent-influenza-vaccine-expanding-the-age-indication-to-include-children-as-young-as-six-months-301401332.html

5. Moderna announces new development programs ahead of 3rd annual Vaccines Day. News Release. Moderna; March 22, 2022. Accessed July 5, 2022. 

https://investors.modernatx.com/news/news-details/2022/Moderna-Announces-New-Development-Programs-Ahead-of-3rd-Annual-Vaccines-Day/default.aspx

6. Sanofi flu vaccines licensed and approved for 2022-2023 influenza season, including CDC preferred higher-dose vaccines for adults 65+. News release. Sanofi; July 1, 2022. Accessed July 5, 2022. 

https://www.prnewswire.com/news-releases/sanofi-flu-vaccines-licensed-and-approved-for-2022-2023-influenza-season-including-cdc-preferred-higher-dose-vaccines-for-adults-65-301579875.html

7. Initial results from Novavax’ COVID-19-influenza vaccine trial are first to show feasibility of combination vaccine. News Release. Novavax Inc; April 20, 2022. Accessed July 5, 2022. 

https://www.prnewswire.com/in/news-releases/initial-results-from-novavax-covid-19-influenza-vaccine-trial-are-first-to-show-feasibility-of-combination-vaccine-839902859.html

Learn about the selected strains for this year’s flu season, flu vaccine recommendation changes, and newly licensed and forthcoming vaccine options.

 What's coming in the 2022-2023 flu season

August is National Immunization Awareness Month (NIAM), and the American Academy of Pediatrics (AAP) has urged parents to talk to pediatricians during this time about childhood and adolescent vaccines. As immunization rates in children decline, parents should find out if their children have fallen behind on vaccines. If so, they should catch their children up on vaccinations they may have missed.

With COVID-19 causing people to stay home, an estimated 25 million children missed their immunizations last year worldwide. This is the largest decline in immunization recorded in the last 30 years. A similar trend occurred in the 2021 to 2022 school year, leading to tens of thousands more children in the United States being unprotected against specific diseases.

With immunization towards diseases such as whooping cough, measles, and mumps falling, AAP President Moira Szilagyi, MD, PhD, FAAP, urged parents to take their children to a pediatrician for a checkup. At the same time, Szilagyisuggests children get caught up on their COVID-19 vaccine. Outbreaks of diseases may rise as more people travel. This makes it more important to protect children from these preventable disease outbreaks.

To help with this task, the AAP recommended different resources. One of these resources was “

,” an interactive immunization map which shows childhood vaccination rate per state.The data on this map, updated annually, comes from the Centers for Disease Control and Prevention National Immunization Survey. Updates will be made which add 

 on how to use the map. To obtain immunization data for a state, a user can hover their cursor over that state on the map.

Other resources were offered as well, such as 

, an interactive tool on HealthyChildren.org that allows parents to discover answers to questions they may have about vaccines. Answers to common questions about vaccines were also made into videos, which the AAP compiled into a 

The AAP reminded readers that COVID-19 vaccines have been recently approved for children under the age of 5 years. With this approval, the AAP urged parents to take their children to a pediatrician so they could be vaccinated. This could be a chance to get their children immunization against not only COVID-19, but other diseases as well.

As Child and Adolescent Immunization Rates Hit Historic Lows Due to Pandemic, AAP Urges Parents to Check on their Child’s Immunizations and to Vaccinate Against COVID. American Academy of Pediatrics. July 28, 2022. Accessed August 4, 2022. https://www.aap.org/en/news-room/news-releases/aap/2022/as-child-and-adolescent-immunization-rates-hit-historic-lows-due-to-pandemic-aap-urges-parents-to-check-on-their-childs-immunizations-and-to-vaccinate-against-covid/

As immunization rates fall in children, the American Academy of Pediatrics recommends a checkup with physicians. 

Amid decline in immunizations, AAP urges parents to keep up to date with child vaccinations

Care plans should be utilized in intentional, specific instances to suit individual needs, according to the American Academy of Pediatrics (AAP).

The AAP designed a set of principals which, when followed, will allow care arrangements to more effectively meet the needs of patients. Ambitious goals were set to improve population health, while also supporting the safety and experience of patients.

Improved networking was recommended for pediatricians who value quality care and specialist providers with niche focuses. Focus on unique needs was stressed for better treatment within communities.

Guidelines to support children with unique and complex needs when compared to adults were also discussed. Dedicated care manger services and partnerships with home health services were among the examples of methods through which this could be accomplished.

The APP suggested giving pediatricians a panel of primary care pediatricians (PCPs) from payer physician networks, with a willingness to broaden treatment teams in order to provide proper assistance. Further increased capacity and specialization would be needed for children who come from vulnerable populations.

When PCPs are not enough for a particular situation, pediatric specialist services were recommended. Preferably, these specialists would be certified by medical and surgical boards within their specialty.

All these care policies should be transparent, according to the APP. The clinicians’ participation should be made known to both the families and pediatricians, and families should be educated on the plan upon enrolling. Health insurance payment policies should also be made clear to providers.

Quality improvement was a key factor in the APP’s outline. Pediatricians, pediatric specialists, patients, and families would all participate in the process. Keeping in mind the previously outlined principles, managed care plans should help with research toward improved results and patient registry development. In order to support patients with health problems, early identification and treatment was recommended, alongside the promotion of preventative services.

To ensure quality during this process, the fundamentals of quality listed by the National Academy of Medicine should be followed. With attention given to early prevention, chronic diseases will be less burdening to children as they grow into adults. The APP concluded by saying, “Pediatricians need the tools and support of the health care delivery system to ensure the health and readiness of tomorrow’s adult population.”

Carlson KM, Berman SK, Price J. Guiding Principles for Managed Care Arrangements for the Health of Newborns, Infants, Children, Adolescents and Young Adults. 

 2022; 150 (2). doi:10.1542/peds.2022-058396

Health care is more effective when developed to support specific needs of children. 

AAP announces revisions to clinical guidelines for hyperbilirubinemia treatment in infants

Tax increases coming? What physicians need to know about the Inflation Reduction Act

What's coming in the 2022-2023 flu season

Amid decline in immunizations, AAP urges parents to keep up to date with child vaccinations

Managed care plans for children should follow guiding principles to be most efficient