U.S. overhauls childhood vaccine schedule, recommends fewer shots

The Trump administration is overhauling the list of routine shots recommended for all babies and children in the United States, bypassing the government’s typical process for recommending vaccines and delivering on Health Secretary Robert F. Kennedy Jr.’s longstanding goals to upend the nation’s pediatric vaccine schedule.

Effective immediately, the Centers for Disease Control and Prevention will no longer recommend every child receive vaccines for rotavirus, influenza, meningococcal disease, respiratory syncytial virus (RSV), hepatitis A and hepatitis B, according to materials released Monday by the Department of Health and Human Services. Instead, smaller groups of children and babies should get those vaccines only if they are at high risk or if a doctor recommends it.

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Administration health officials said they were aligning U.S. recommendations more closely with vaccine schedules in other countries, citing decreased public confidence in vaccinations, especially following the covid-19 pandemic.

“We are aligning the U.S. childhood vaccine schedule with international consensus while strengthening transparency and informed consent,” Kennedy said in a news release. “This decision protects children, respects families, and rebuilds trust in public health.”

Children could still receive vaccines that are no longer broadly recommended by the federal government and insurers would still have to pay for them, officials said. Officials said coverage in private plans, Medicare, Medicaid and the Children’s Health Insurance Program wouldn’t be affected by the new recommendations.

Officials are dividing vaccines into three categories. The first category includes vaccines recommended for all children, such as to protect against measles and polio and whooping cough.

The second category encompasses vaccines recommended for certain high-risk groups or populations, such as RSV, hepatitis A, hepatitis B and meningitis. The third category includes vaccines that can be given under a designation known as “shared clinical decision-making” that allows children to get the shots after families consult with their health-care providers. Officials said they didn’t undergo a fresh assessment of who is considered high risk.

The new set of recommendations align the U.S. more closely with Denmark’s schedule, something administration officials had previously suggested.

Two of the vaccinations - for influenza and rotavirus - should only be given when a doctor recommends it, under the new CDC guidance. The CDC already shifted to this model for coronavirus vaccines in the fall.

The new guidance departs from the Danish schedule in two ways. The CDC will retain a recommendation for children to get the chicken pox vaccine, and it will recommend just one dose of the HPV vaccine, instead of two, as Denmark recommends. Officials cited research finding a single shot is as effective as two.

Medical associations and public health experts blasted modeling the U.S. vaccine strategy on that of other countries including Denmark, with a population of about 6 million and a universal health care system that is not comparable to the system in the United States.

Danish health officials also questioned the U.S. following its lead.

“Personally, I do not think this makes sense scientifically,” Anders Hviid, an official in Denmark’s Statens Serum Institute, which prevents and controls infectious diseases as part of the country’s ministry of health, wrote in an email to The Washington Post last month. “Public health is not one size fits all. It’s population specific and dynamic. Denmark and the U.S. are two very different countries.”

Under Kennedy’s leadership, federal health agencies have upended and scrutinized childhood vaccination policies. They have launched reviews of the cumulative health effects of the immunization schedule. The CDC eliminated a recommendation for all newborns to receive a hepatitis B vaccine shortly after birth, which researchers and health experts credited for a dramatic plunge in infections. Kennedy directed revisions to a CDC webpage that previously debunked a link between vaccines and autism to instead say health authorities have ignored evidence of a link and studies have not ruled out a purported link.

Ahead of his confirmation, Kennedy told senators he supports the childhood immunization schedule and would do nothing that “makes it difficult or discourages people from taking vaccines.”

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Graphics:

https://washingtonpost.com/documents/9e2cc53e-78c8-4c88-a1cc-84bf0730d367.pdf

https://washingtonpost.com/documents/5ad13f20-9349-4ad8-9f22-ca08f5d7c306.pdf

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