The US Department of Health and Human Services (HHS) is recommending a reduction in the number of vaccines for most American children, according to health officials. The adjustment focuses on narrowing vaccination recommendations for certain diseases while maintaining guidance for others, reports BritPanorama.
Health officials will continue to endorse the measles, mumps, and rubella vaccines along with immunizations against polio, chickenpox, HPV, and others. However, recommendations for meningococcal disease, hepatitis B, and hepatitis A vaccinations are now limited to children deemed at higher risk for infections.
The recommendations suggest that decisions regarding vaccinations such as flu, Covid-19, and rotavirus ought to be based on “shared clinical decision-making,” indicating that families wishing to receive these vaccines should consult with healthcare providers.
HHS stated that its guidelines concerning immunizations for respiratory synctytial virus (RSV) remain unchanged, emphasizing that infants born to unvaccinated mothers should receive one dose.
The changes follow a notable surge in flu cases across the nation, with the US Centers for Disease Control and Prevention (CDC) reporting nine pediatric deaths from the flu this season. As a result of the adjustments, while all insurers will still cover the vaccines without cost-sharing, the modifications may complicate the process for parents seeking immunizations no longer recommended for healthy children.
Public health is not one size fits all
The new vaccination schedule aligns more closely with those of other developed nations, such as Denmark, which does not recommend childhood vaccinations against rotavirus, hepatitis A, meningococcal disease, flu, or chickenpox.
Initially, US health officials intended to announce these changes in December, following a presentation on the Danish vaccine schedule by Dr. Tracy Beth Hoeg, the newly appointed acting director of the FDA’s Center for Drug Evaluation and Research, made to the CDC’s panel of vaccine advisers. This panel, known as the Advisory Committee on Immunization Practices (ACIP), was reconstituted last year after Secretary of HHS Robert F. Kennedy Jr. dismissed all prior appointees.
These changes come as President Donald Trump ordered HHS to review the childhood vaccine schedule. In December, Trump publicly expressed his dissatisfaction with the current vaccine schedule, prompting his administration to expedite a comprehensive evaluation in alignment with international approaches.
In response, Kennedy tweeted support for Trump’s initiative, affirming that efforts were underway to adjust the schedule. Trump characterizes the new guidelines as a more reasonable plan, intended to shield children from the most serious diseases while still allowing parents the option to immunize their children against additional vaccines, which will continue to be fully insured.
However, multiple public health experts have cautioned that these alterations may lead to increased outbreaks of avoidable diseases. Dr. Caitlin Rivers from the Johns Hopkins Bloomberg School of Public Health expressed concerns that reductions in the vaccination schedule could jeopardize child safety and lead to a resurgence of preventable infections.
Experts in Denmark, such as Anders Hviid of the Statens Serum Institut, criticized the application of their country’s model to US vaccine policy, urging that public health strategies must reflect local contexts and healthcare access disparities.
Faltering information
In a statement, HHS reasoned that curtailing the recommended vaccines might help rebuild public trust in health agencies. However, the communication from the government has been significantly altered under Kennedy’s leadership, who has raised questions about vaccine safety.
Dr. Sean O’Leary of the American Association of Pediatrics warned that the recent vaccine recommendations create confusion among healthcare providers and families. He noted that they reflect a continued campaign by Kennedy to undermine the existing vaccination infrastructure.
Amid these changes, vaccination data collection has also suffered a setback. The Centers for Medicare & Medicaid Services (CMS) recently announced that it no longer requires states to submit childhood vaccination status, which some experts argue could diminish public confidence in immunization efforts.
The CMS has indicated that it may look for new measures to track vaccine uptake, including parental awareness on vaccine safety, though the potential decline in reported data from states may create a patchy understanding of vaccination trends moving forward.
Can’t ‘cowboy’ change
The revisions have elicited criticism from various quarters, including Louisiana Senator Bill Cassidy, a physician who had initially supported Kennedy’s position as health secretary after assurances of adherence to recognized safety protocols and ongoing monitoring for vaccines.
Cassidy has voiced his concerns that changing the vaccine schedule without robust scientific input could unnecessarily frighten families and healthcare professionals alike, especially against a backdrop of ongoing measles and whooping cough outbreaks.
While health officials assert they consulted reputable sources during the decision-making process, public health experts remain skeptical about the efficacy of sudden changes that deviate from consensus practices. Dr. Noel Brewer from the University of North Carolina emphasized the need for deliberation and consensus to frame any modifications effectively.
This evolving dynamic in the US vaccine landscape exemplifies the tensions surrounding public health policy, particularly as it intersects with broader societal attitudes toward immunization and preventive care.
