Healthcare leaders fear possible changes to vaccine schedule

President Trump’s order to evaluate and possibly revise the childhood vaccine schedule worries healthcare leaders, especially after other changes in vaccine policy over the past year.

Trump issued an order directing Health & Human Services Secretary Robert F. Kennedy Jr. to review vaccinations schedules in other peer countries. In a post on Truth Social, Trump said kids are getting more vaccines than other nations and “far more than is necessary.”

Now, CNN and other media outlets have reported that the Health Department may soon announce revisions to the childhood vaccine schedule, which could mirror the schedule in Denmark, which calls for fewer shots.

The president’s order comes after changes in guidance on the hepatitis B vaccine. Following a federal advisory panel’s recommendation, the Centers for Disease Control and Prevention said last week it is no longer advising that all babies receive the hepatitis B vaccine. The CDC is advising parents to discuss the vaccine with doctors, and also says it shouldn’t be given to babies under two months of age. The CDC continues to recommend the vaccine to mothers testing positive for hepatitis B or those whose status is unknown.

Healthcare leaders have expressed concerns about the new vaccine review, and recent changes in vaccine guidance, given Kennedy’s long record of vaccine skepticism. And they fear other changes in the vaccine schedule could raise the risk of more children developing diseases that could be easily prevented.

Jennifer Mensik Kennedy, president of the American Nurses Association, tells Chief Healthcare Executive®, says 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.

She points to the vast reduction in hepatitis B infections because babies have been getting vaccinated. Since the federal government began recommending a hepatitis B vaccine at birth in 1991, infections among infants and children have dropped from 16,000 to less than 20, according to the American Academy of Pediatrics.

As Mensik Kennedy says, the infection rate has dropped so dramatically “because of the work we have done over the last several decades to drive that down, and the evidence is there.”

‘This isn’t a hypothetical’

R. Shawn Martin, CEO of the American Academy of Family Physicians, tells Chief Healthcare Executive® that he is very concerned about the changes in vaccine policy as well as the lack of clear guidance on the value of vaccines. He pointed to the uptick of measles cases in South Carolina.

“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.”

Dr. Sean O’Leary, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases, said moving to a vaccine schedule similar to Denmark’s would lead to more fatalities.

“They’re going to bring back suffering and death,” O’Leary said in a statement from the AAP. “I don’t say that with any hyperbole, that’s exactly what’s going to happen.”

Dozens of medical groups have opposed the change in guidance for the hepatitis B vaccine. Medical societies say they continue to call for newborns to get the hepatitis B vaccine, and some states (including New York, Pennsylvania, Maryland and others) said they will continue to offer that guidance.

Public health leaders have also criticized Kennedy for firing all the members of the Advisory Committee on Immunization Practices, a key advisory panel on vaccine policies, and blasted him for stacking the committee with members who are less qualified, including other vaccine skeptics.

The American Academy of Pediatrics, the American Public Health Association, and other groups have filed a lawsuit in federal court challenging the Health Department’s changes in guidance on vaccines. The groups appeared in federal court last week in a hearing to assess if they have standing for a legal challenge.

Richard Hughes IV, an attorney for the health groups, said in a statement that the organizations are fighting to prevent “unfortunate, unsupported changes to the adult and pediatric immunization schedules.”

Susan Kressly, president of the American Academy of Pediatrics, the lead plaintiff in the suit, said families need clarity on vaccines.

“They deserve thoughtful, deliberative guidance grounded in medical evidence,” Kressly said in a statement. “They deserve access to immunizations for their children without confusion and chaos."

The prospect of the Health Department changing the vaccine schedule to one that is similar to Denmark comes after the White House pointed to Denmark as an example of a country employing fewer vaccinations. Denmark recommends vaccinations for 10 diseases, while the U.S. suggests 18, the White House noted in a fact sheet.

While Denmark is a high-income nation, the country boasts a population of less than 6 million. New York City alone is home to more people, and 19 states have populations larger than Denmark. The U.S. boasts a more diverse health population, and critics note that Denmark also offers universal health care.

The government is seeking to dismiss the lawsuit challenging the changes in vaccine policy, and the plaintiffs say a decision is expected in early January.

Sowing doubt in vaccines

After the federal vaccine advisory panel met earlier this month, the Infectious Diseases Society of American and 40 other groups issued a joint statement saying the committee aims “to sow doubt in vaccines rather than advance sound vaccine policy, and we will all pay a price for that.”

“This is a significant departure from the historic role ACIP has played in shaping vaccine policy in the United States,” the groups said. “Previously, we could expect science to drive decisions, experts to debate evidence, and consensus to lead to shared, clear recommendations. That is not the case with the current committee, and this change puts Americans’ health at risk.”

Healthcare leaders such as Mensik Kennedy say they want to see qualified experts making decisions that could affect vaccine policies and guidance.

She also says she would like Congress to make sure changes in vaccine guidance reflect evidence-based science and the recommendations of leading experts.

“We always need to make sure that we have the most informed, most educated, most experienced individuals who are on those panels,” she says.