In December, a memorandum signed by President Donald Trump directed the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention to align U.S. childhood vaccine recommendations with “best practices from peer, developed countries.”
Following an assessment of the immunization schedules in 20 other countries, Secretary of Health and Human Services Robert F. Kennedy, Jr. and Jim O’Neill, acting director of the CDC, directed the CDC to remove recommendations for several vaccines, reducing the number of targeted diseases from 18 to 11.
Dr. Andrew Pavia is an infectious disease epidemiologist and a pediatric infectious disease doctor at the University of Utah. He said the new recommendations aim to reproduce the vaccine schedule from Denmark, noting that he was speaking on his own behalf and not for his employer.
“There's no new data on any of these vaccines that suggest they're unsafe. There's really been no change in the data that led to the initial recommendations. We've just had a change in policy, not in the science,” Pavia said.
Dr. Ellie Brownstein is a pediatrician in Salt Lake City and vice president of the Utah Chapter of the American Academy of Pediatrics.
“So we've, over the years, developed a pretty robust immunization schedule based on science and how illnesses affect American children, because that's who our immunizations are aimed at," Brownstein said. "These changes essentially sidestepped all of the science involved and are trying to match those immunizations given in a different country. And, of note, that's a country that has universal health care. That's a country that has parental leave, which we don't have access to.”
Under the new CDC guidelines, RSV vaccines are now only recommended for high-risk groups. Rotavirus, COVID, and flu shots now fall under a category called “shared decision-making,” which indicates that parents should consult with a health care provider about whether to vaccinate their child. Vaccines for hepatitis A and B, as well as for two types of bacterial meningitis, are now recommended for high-risk groups only and fall into the shared decision-making category.
“All vaccines, all interactions between you and your provider are a form of shared decision-making," Pavia said. "Labeling them as requiring shared decision-making, I think, is simply a way to sow confusion and to suggest that the vaccines are risky and you ought to think long and hard about it.”
Both Brownstein and Pavia worry that, as anti-vaccination movements and vaccine hesitancy grow, vaccine-preventable diseases will become increasingly common.
“Vaccines are, in some ways, a victim of their own success, in that we have eliminated the diseases that we're vaccinated for, and so people are seeing that my kid's getting all these shots. Why?" Brownstein said.
“It's difficult for parents," Pavia said. "It's difficult when there's misinformation, and when there are these confusing messages. ... It's likely that fewer kids are going to get vaccinated, and that means more disease. We've already seen this resurgence in measles.”
Pavia said it's important for people to realize that the science hasn't changed, and to trust the people who know that science.
“The first thing to do is talk to your provider, your pediatrician, your family doc, your nurse practitioner; ask your questions," he said. "The second is to go to reliable resources that don't have a political agenda in that they’re really interested in the health of the population, particularly the health of kids."
"People should realize that a lot of what is happening today is driven by politics," Pavia added. "But I really want people to understand that there's nobody in the business of making, recommending, or using vaccines, who's doing it for any reason other than to promote the health of the population, and particularly children."
For more science-based information about childhood vaccines, Pavia recommends resources like Immunize.org, a web-based non-profit, and the American Academy of Pediatrics, the largest professional association of pediatricians in the United States.
