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 long-standing 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, the agency will recommend smaller groups of children and babies should get those vaccines only if they are at high risk or if a doctor recommends it.

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.

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.

Medical associations and public health advocates and experts condemned the revisions to the vaccine schedule, arguing they endanger children and are built on faulty assumptions. They said comparisons to other countries are misleading because they differ sharply in population, access to universal health care and disease burdens.

President Donald Trump in early December ordered the review of the childhood immunization schedule to align with other countries, calling the U.S. an “outlier” that recommends far more shots than necessary. The changes also delivers a win to anti-vaccine groups that have long sought to drastically curtail the number of recommended childhood vaccines.

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.

Under the new shared clinical decision-making recommendation for annual flu shots and RSV immunization, insurers are still required to pay. Coronavirus vaccines for all age groups are now recommended this way. (Source: The Washington Post)