The Board of Health on Monday spent time discussing the town’s capacity to continue providing immunization services in the wake of changes at both the federal and state levels.

“We’re awaiting final guidance on all the vaccination schedules … how that’s changing, and how that affects what I can offer,” said public health nurse Simone Carter.

State and local health departments are awaiting word from the Centers for Disease Control and Prevention regarding the latest adult and childhood immunization schedules. The Advisory Committee on Immunization Practices (ACIP) is a federal advisory committee intended to develop vaccine use recommendations for the CDC. However, ACIP has undergone a shakeup in the last few months that leaves the fate of those recommendations in flux.

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. removed 17 sitting ACIP members back in June. Kennedy replaced those members with eight new individuals, some of whom have promoted misinformation about vaccines, according to a report from USA Today.

The turmoil, Health Director Shaun McAuliffe explained, has put his department in a holding pattern. “At this point, we’re just at the mercy of … the CDC,” he said.

McAuliffe and Carter also explained to the board that changes at the state level will impact how the Health Department can provide immunization services. Gov. Maura Healey recently announced requirements for insurance carriers to cover vaccines recommended by the Massachusetts Department of Public Health instead of relying solely on the CDC guidelines.

According to Carter, the groundwork laid by the state will allow the town to legally cover vaccinations without liability.

Chair Nasiba Mannan warned the board about the potential cost issues associated with the state guidance. “Until ACIP recommends them, insurance cannot consider them approved vaccines,” she said. “They consider it off-label, and they don’t pay off-label.”

Despite the uncertainty, Carter noted vaccination efforts in town will continue. A senior clinic for residents aged 65 and up is set for Oct. 15. Likewise, the Health Department is working on arranging a children’s clinic for Oct. 16.

When prompted by member Malcolm Smith, Carter explained that official word from the CDC would come sometime between October and December. “I think we will concentrate on COVID once we get actual guidance,” she added.

Sharps disposal issues raise concerns

During Carter’s nursing report, the Board of Health discussed ongoing issues with the town’s sharps disposal kiosk.

“What’s going on right now is not sustainable,” said Carter.

Both Carter and McAuliffe explained that the town’s single kiosk, which is stationed at the Hopkinton Police Department, has issues with overflow and improper disposal. “[Sharps] have got to be in an approved container,” said Carter. “You can’t just throw out needles.”

She went on to surmise that both issues with the kiosk may arise from an increase in community need for medications that require needles. 

McAuliffe reported to the board that he is working to obtain additional kiosks to place around town. At least two of them will remain inside, while another would be an exterior kiosk. Ideas discussed for kiosk placement included the Hopkinton Fire Department and the Senior Center.

When asked by Mannan about how soon the kiosks would be available, McAuliffe said he already was working with a vendor.

“For the interior ones, I’ve already signed the contract,” he said. “It’s just finding a house [for them].”

The cost of the kiosks will be covered through opioid funding provided by the state. “There’s plenty of funding to cover that, at no cost to the taxpayer,” McAuliffe explained.