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Young girl gets vaccine

AAP working with White House on COVID vaccine commercialization concerns

November 18, 2022

Editor’s note: For the latest news on COVID-19, visit

The AAP recently brought its concerns about COVID vaccine commercialization directly to the White House, where officials pledged to continue working with pediatricians.

AAP President-elect Sandy L. Chung, M.D., FAAP, and AAP CEO/Executive Vice President Mark Del Monte, J.D., met with Ashish Jha, M.D., White House COVID-19 response coordinator, in the West Wing in October. They discussed issues such as single-dose vials, low vaccine uptake among children, vaccine counseling and payments and the Vaccines for Children (VFC) program.

“As pediatricians, we know that giving vaccines is a complex process from ordering, purchasing, storage, scheduling, administering, tracking, billing and inventory management,” Dr. Chung said after the meeting. “It is critical that the White House and the decision-makers understand what is necessary in order to ensure adequate access to COVID vaccines for infants, children, adolescents and young adults.”

The meeting came shortly after AAP President Moira A. Szilagyi, M.D., Ph.D., FAAP, wrote a letter to Dr. Jha urging federal officials to reduce the burdens of administering COVID-19 vaccines.

“Commercialization of COVID-19 vaccines now — when most adults have received the vaccines but most younger children have not — has the potential to leave children behind,” Dr. Szilagyi wrote in the letter.

If commercialization happens soon, clinicians could have to pay for some vaccines upfront with no guarantee they will recoup the costs. They also are grappling with administrative burdens such as time for counseling, ordering logistics, vaccine labeling, storage space and rules on waste.

In the letter, the AAP laid out numerous actions the administration could take to help address these hurdles:

  • Purchase enough vaccines for children now so they can be provided at no cost to pediatricians.
  • Lower the number of minimum vials per order.
  • Adopt single-dose vials or pre-filled syringes to reduce waste.
  • Improve labeling of COVID-19 vials.
  • Simplify the dosing schedules so Pfizer and Moderna vaccines can be interchangeable.
  • Continue weekly supplies of COVID vaccines.
  • Allow flexible returns once commercialization is in effect.
  • Allow longer invoice and payment schedules.
  • Ensure insurers upload vaccine codes and are ready to pay before commercialization is initiated.
  • Encourage pricing guidelines for manufacturers so the cost is not exorbitant for pediatric practices.
  • Ensure payment for vaccine counseling for both COVID vaccines and routine immunizations whether vaccine is administered or not.
  • Continue to provide COVID vaccines at no cost to patients.
  • Increase funding for a public health campaign to promote the need for routine immunizations.
  • Allow COVID-19 vaccines to be distributed through the VFC program.
  • Relax rules on storage of public and private vaccines in separate refrigerators.
  • Ensure adequate payment levels for VFC providers.

“Simply put, the nation’s pediatricians need to be supported as we attempt to vaccinate our nation’s youngest citizens against COVID-19,” Dr. Szilagyi wrote. “If there are too many financial and practical disincentives for pediatric clinicians to purchase, stock and administer COVID-19 vaccines, we will fail to meet the challenge.”

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