‘Dangerous’: Changes in vaccine schedule worry healthcare leaders

The federal government is no longer recommending that all children get flu shots, and some doctors and medical groups are blasting the changes in federal guidance on childhood vaccines.

Saying it is complying with an order from President Trump, the Department of Health & Human Services announced Monday that it is revising its guidance to a host of childhood vaccines. The Health Department says it is no longer recommending influenza vaccines for all children, saying Americans should consult physicians on those shots.

The government is also changing its guidance for respiratory syncytial virus (RSV), meningococcal disease, hepatitis A and hepatitis B. Instead of broadly recommending those vaccines, the Health Department is now recommending them only to certain high-risk groups.

The Health Department continues to recommend that all children receive the measles, mumps and rubella vaccine, along with vaccines for polio and HPV. But the government is now revising its vaccine guidance into three categories: vaccinations recommended for all kids, those in high-risk groups, and vaccines based on “shared clinical decision-making.”

The American Academy of Pediatrics, which has clashed with the Trump administration on other recent changes in federal vaccine policy, said the changing federal recommendations run counter to scientific evidence.

Andrew D. Racine, MD, president of the American Academy of Pediatrics, said in a statement Monday that the announcement “to arbitrarily stop recommending numerous routine childhood immunizations is dangerous and unnecessary.”

“At a time when parents, pediatricians and the public are looking for clear guidance and accurate information, this ill-considered decision will sow further chaos and confusion and erode confidence in immunizations. This is no way to make our country healthier,” Racine said.

The government announced the changing guidance even as flu cases are rising nationwide, with 45 states reporting high or very high numbers of flu cases, according to data from the Centers for Disease Control and Prevention released Monday.

Federal health officials say insurance companies are still required to cover all childhood vaccines with no cost-sharing, regardless of the recommendations. But medical societies say the new guidance may lead to fewer people getting vaccinated, and they call the changes unprecedented and irresponsible.

Defense of vaccinations

The American Academy of Pediatrics continues to publish its own guidance on childhood vaccines, and continues to recommend all kids get vaccines for the flu, COVID-19, RSV, and hepatitis B, among others.

The Health Department’s changing guidance comes after it recently announced it was no longer recommending the Hepatitis B vaccine for all babies. The White House also directed the Health Department to look at vaccine schedules in other nations, pointing out that Denmark recommends vaccinations for 10 diseases, while the U.S. suggests 18.

Critics note that Denmark’s population of 6 million is far smaller than America’s. Nineteen states have populations surpassing Denmark.

“The United States is not Denmark, and there is no reason to impose the Danish immunization schedule on America’s families,” Racine said.

Jennifer Mensik Kennedy, president of the American Nurses Association, told Chief Healthcare Executive® in a December interview that she doesn’t want to see changes to the childhood vaccine schedule.

“It's imperative that we make sure kids get their vaccinations, on the schedules that we have created, because we've shown how effective we are at decreasing horrible illnesses, diseases and death,” she says.

R. Shawn Martin, CEO of the American Academy of Family Physicians, told Chief Healthcare Executive® in a recent interview that he is very concerned about changes in vaccine recommendations and the prospect of fewer people getting vaccines.

“This isn't a hypothetical,” Martin says. “I mean, we see what happens when vaccination rates drop, and I worry that we'll see the return of largely eliminated, if not eradicated, infectious disease in populations in this country. And I think that should worry us.”

Matthew Cook, CEO of the Children’s Hospital Association, said the group supports access to vaccines and encourages families to talk to doctors about vaccine options.

“Vaccinations have long been our strongest defense against preventable childhood illnesses, public health tragedies, and are a critical tool to help children grow into healthy adults,” Cook said in a statement. “Any changes to the childhood vaccine schedule should be guided by the best available evidence for the long-term health of children.”

Lacking transparency and rigor

Health Secretary Robert F. Kennedy Jr. said the revised guidance reflects the vaccine schedules of other peer countries. President Trump issued his order calling for a review of the vaccine schedule Dec. 5.

“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,” Kennedy said in a statement. “This decision protects children, respects families, and rebuilds trust in public health.”

Racine countered that the health department’s changes run contrary to how the government has typically examined and weighed changes to the childhood vaccine schedule.

“For decades, leading health experts, immunologists, and pediatricians have carefully reviewed new data and evidence as part of the immunization recommendation process, helping to keep newborns, infants, and children protected from diseases they could be exposed to in the United States as they develop and grow,” Racine said. “Today’s decision, which was based on a brief review of other countries’ practices, upends this deliberate scientific process.”

Sandra Adamson Fryhofer, MD, a trustee of the American Medical Association, said she was troubled by the changes and the lack of appropriate review in revamping the childhood vaccine recommendations. The AMA continues to back the vaccine recommendations of leading medical groups.

“Changes of this magnitude require careful review, expert and public input, and clear scientific justification,” Fryhofer said in a statement from the AMA. “That level of rigor and transparency was not part of this decision. When longstanding recommendations are altered without a robust, evidence-based process, it undermines public trust and puts children at unnecessary risk of preventable disease.”

Ronald G. Nahass, MD, president of the Infectious Diseases Society of America, said it is irresponsible "to haphazardly change vaccine recommendations without a solid scientific basis and transparent process."

"Upending long-standing vaccine recommendations without transparent public review and engagement with external experts will undermine confidence in vaccines with the likely outcome of decreasing vaccination rates and increasing disease," Nahass said in a statement. "Making these changes amid ongoing outbreaks of vaccine-preventable diseases shows a disregard for the real confusion families already face."

U.S. Sen. Bill Cassidy, R-Louisiana, is a physician and chairman of the Senate Health Committee. Cassidy cast a critical vote that helped ensure Kennedy’s confirmation as health secretary, but the senator said on X that he opposed the changes.

“The vaccine schedule IS NOT A MANDATE,” Cassidy posted on X. “It’s a recommendation giving parents the power. Changing the pediatric vaccine schedule based on no scientific input on safety risks and little transparency will cause unnecessary fear for patients and doctors, and will make America sicker.”

The American Academy of Pediatrics, the American Public Health Association, and other groups have filed a lawsuit challenging the Health Department’s changes in guidance on vaccines. Medical societies have repeatedly criticized the department’s changes in vaccine policy and guidance under the leadership of Kennedy, a longtime critic of vaccines.

Doctors and health systems say they are seeing more patients with vaccine hesitancy.