The United States took the unprecedented step Monday of dropping the number of vaccines it recommends for every child—leaving other immunizations, such as flu shots, open to families to choose but without clear guidance.
Officials said the overhaul to the federal vaccine schedule won’t result in any families losing access to or insurance coverage for vaccines, but medical experts slammed the move, saying it could lead to reduced uptake of important vaccinations and increase disease.
The change came after President Donald Trump in December asked the U.S. Department of Health and Human Services to review how peer nations approach vaccine recommendations and consider revising its guidance to align with theirs.
HHS said its comparison to 20 peer nations found that the United States was an “outlier” in both the number of vaccinations and the number of doses it recommended to all children. Officials with the agency framed the change as a way to increase public trust by recommending only the most important vaccinations for children to receive.
“This decision protects children, respects families, and rebuilds trust in public health,” Health Secretary Robert F. Kennedy Jr. said in a statement Monday.
Medical experts disagreed, saying the change without public discussion or a transparent review of the data would put children at risk. The unilateral change to the vaccine schedule by Jim O’Neil, acting director of the U.S. Centers for Disease Control and Prevention, marks a departure from the traditional process for changing it that has involved an independent panel of experts, the Advisory Committee on Immunization Practices, reviewing scientific data on shots and making recommendations that the CDC director then adopts.
“Abandoning recommendations for vaccines that prevent influenza, hepatitis, and rotavirus, and changing the recommendation for HPV without a public process to weigh the risks and benefits, will lead to more hospitalizations and preventable deaths among American children,” said Michael Osterholm of the Vaccine Integrity Project, based at the University of Minnesota.
The new vaccine schedule for American children now recommends routine immunizations against 11 diseases, down from 17, The New York Times reported. Vaccines against diseases including measles, polio, and whooping cough remain recommended for all children, while immunizations against other diseases—such as respiratory syncytial virus, or RSV—will be recommended for high-risk groups, the Times reported.
Shots that protect against meningitis, rotavirus, influenza, and hepatitis A and B can now only be administered to children after consultation with a health care provider—which the CDC calls “shared clinical decision-making,” STAT News reported.
The vaccine schedule takes effect immediately.
Today, all 50 states require that children entering child care, pre-kindergarten, and K-12 schools be immunized against polio; chickenpox; measles, mumps, and rubella; and diptheria, tetanus, and pertussis (whooping cough), according to the Immunization Action Coalition. Some have requirements for vaccinations against Hepatitis A and B, influenza, and human papillomavirus.
The new vaccination schedule from the CDC doesn’t change those state requirements. However, most states align their school vaccination requirements to the federal schedule, so state requirements could begin to change.
Already, there’s been a greater push by states in recent years to broaden exemptions to school vaccination requirements, making it easier for families to claim religious or philosophical cause to skip shots. In Florida, officials have announced plans to eliminate all vaccine mandates.
Immunization rates among kindergarteners nationwide have been slipping in recent years.
