CDC reduces number of vaccines recommended for children

The new vaccination schedule recommends that all children be vaccinated against the following diseases:

• Diphtheria
• Tetanus
• Pertussis
• Haemophilus influenzae type b
• Pneumococcal disease
• Polio
• Measles
• Mumps
• Rubella
• HPV
• Varicella

The new schedule only recommends a single dose of the HPV vaccine rather than two.

Meningitis, hepatitis A and B, dengue, and respiratory syncytial virus vaccines will only be recommended for "high-risk groups." Currently, the dengue vaccine is only recommended for children who have had one previous dengue infection who live in a high-risk area like Puerto Rico and American Samoa.

Parents will be able to choose whether their children get vaccinated against rotavirus, COVID-19, flu, meningitis, and hepatitis A and B under "shared clinical decision-making," health officials said.

"After an exhaustive review of the evidence, we are aligning the U.S. childhood vaccine schedule with international consensus while strengthening transparency and informed consent," HHS Secretary Robert F. Kennedy Jr. said. "This decision protects children, respects families, and rebuilds trust in public health."

Vaccines for diseases that don't carry a universal recommendation will still be covered by federal health insurance programs like Medicaid, the Children's Health Insurance Program, and the Vaccines for Children program, officials added. Parents who wish to vaccinate their children against these diseases won't have to pay out of pocket.

States, rather than the federal government, have the authority to mandate vaccinations; however, CDC recommendations greatly influence state regulations.

Reaction

Some parents reacted positively to the decision. "Medical freedom and choice are so important and that's something we should have, especially with our children," said Brandy Bright, a Northeast Ohio parent.

However, vaccine experts said that CDC's decision could create chaos in pediatricians' offices around the country and discourage parents from using vaccines that are safe to protect their children against dangerous diseases.

"This is just one more example of the decisions coming out of HHS that are sowing confusion and making it harder for people to know what to do," said Daniel Jernigan, former director of CDC's National Center for Emerging and Zoonotic Infectious Diseases.

Jernigan added that pediatricians will have trouble meeting the demand for extra visits that a policy of "shared clinical decision-making" will require.

"By making these vaccines a shared clinical decision-making, it introduces one more barrier that prevents a child from getting a lifesaving vaccine," he said.

The change "puts the burden on pediatricians and parents to make these decisions without guidance," said Helen Chu, a physician and immunologist at the University of Washington and former ACIP member.

Chu also took issue with the claim that the change will increase trust in vaccines and improve immunization rates, warning that it will do the opposite.

A study published Friday in JAMA Network Open found that babies who didn't get their shots on time at 2 months were more than seven times more likely to not receive their first measles, mumps, and rubella shot by age 2 — months later than they're supposed to receive the shot.

"Already, parents are worried about what they are hearing in the news about safety of vaccines, and this will increase confusion and decrease vaccine uptake," Chu said.

The new vaccination schedule algins the United States more closely with Denmark's vaccination recommendations; however, experts noted that Denmark's recommendations are informed by a smaller population and a nationalized healthcare system.

"We're using the information from a country that is the size of one of our states to dictate what should happen to children. And that is just wrong," said Kathryn Edwards, a professor emerita of pediatrics and vaccine expert.

"The Danish approach to vaccination is relevant to the Danish population," she added. "The U.S. approach is appropriate for the U.S."

Kristian Andersen, a Danish-American professor in the immunology and microbiology department at the Scripps Research Institute, said the United States already has one of the best standards for vaccine recommendations.

"Their childhood vaccine programs covers almost everything it should," Andersen said, adding that the "Danish program does not" and noting that Denmark "has one of the most minimal vaccine programs among wealthy nations."

Some experts noted that Danish parents don't have a financial reason to wait and see if their child is sick enough to justify a trip to the doctor, given Denmark's nationalized healthcare system. That means children can be seen earlier, which could protect them from dangerous complications.

"The risk of severe consequences of an infection in the United States is much higher than in Denmark," said Lone Graff Stensballe, a professor of pediatric vaccinology at the University of Copenhagen. "That is why, on average, the Americans would need more vaccines."

"If not everyone has free access to hospitals, vaccines are even more important," Stensballe added. "It would be such a risk and such a potential waste of life not to be immunized if you don't have free access to healthcare."