The U.S. took the unprecedented step Monday of cutting the number of vaccines it recommends for every child — a move that leading medical groups said would undermine protections against a half-dozen diseases.
The change is effective immediately, meaning that the U.S. Centers for Disease Control and Prevention will now recommend that all children get vaccinated against 11 diseases. What’s no longer broadly recommended is protection against flu, rotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV. Instead, protections against those diseases are only recommended for certain groups deemed high risk, or when doctors recommend them in what’s called “shared decision-making.”
Trump administration officials said the overhaul, a move long sought by Health Secretary Robert F. Kennedy Jr., won’t result in families who want the vaccines losing access to them, and said insurance will continue to pay. But medical experts said the decision creates confusion for parents and could increase preventable diseases.
States, not the federal government, have the authority to require vaccinations for schoolchildren. While CDC requirements often influence those state regulations, some states have begun creating their own alliances to counter the Trump administration’s guidance on vaccines.
The change comes as U.S. vaccination rates have been slipping and the share of children with exemptions has reached an all-time high, according to federal data. At the same time, rates of diseases that can be protected against with vaccines, such as measles and whooping cough, are rising across the country.
Review came at the request of President Trump
The U.S. Department of Health and Human Services said the overhaul was in response to a request from President Donald Trump in December. Trump asked the agency to review how peer nations approach vaccine recommendations and consider revising U.S. guidance accordingly.
HHS said its comparison to 20 peer nations found that the U.S. was an “outlier” in both the number of vaccinations and the number of doses it recommended to all children. Officials with the agency framed the change as a way to increase public trust by recommending only the most important vaccinations for children to receive.
“This decision protects children, respects families, and rebuilds trust in public health,” Kennedy said in a statement Monday.
Trump, reacting to the news on his Truth Social platform, said the new schedule is “far more reasonable” and “finally aligns the United States with other Developed Nations around the World.”
Among those left on the recommended-for-everyone list are vaccines against measles, whooping cough, polio, tetanus, chickenpox and human papillomavirus, or HPV. The guidance reduces the number of recommended vaccine doses against HPV from two or three shots depending on age to one for most children.
Medical experts said Monday’s changes without what they said was public discussion or a transparent review of the data would put children at risk.
“Abandoning recommendations for vaccines that prevent influenza, hepatitis and rotavirus, and changing the recommendation for HPV without a public process to weigh the risks and benefits, will lead to more hospitalizations and preventable deaths among American children,” said Michael Osterholm of the Vaccine Integrity Project, based at the University of Minnesota.
Dr. Sean O’Leary of the American Academy of Pediatrics said countries carefully consider vaccine recommendations based on levels of disease in their populations and their health systems.
“You can’t just copy and paste public health and that’s what they seem to be doing here,” said O’Leary. “Literally children’s health and children’s lives are at stake.”
Most high-income countries recommend vaccinations against a dozen to 15 serious pathogens, according to a recent review by the Vaccine Integrity Project, a group that works to safeguard vaccine use.
France today recommends all children get vaccinated against 14 diseases, compared to the 11 that the U.S. now will recommend for every child under the new schedule.
Doctors’ groups criticize decision
The changes were made by political appointees, without any evidence that the current recommendations were harming children, O’Leary said.
The pediatricians’ group has issued its own childhood vaccine schedule that its members are following, and it continues to broadly recommend vaccines that the Trump administration demoted.
O’Leary singled out the flu vaccine, which the government and leading medical experts have long urged for nearly everyone starting at age 6 months. He said the government is “pretty tone deaf” for ending its recommendation while the country is at the beginning of a severe flu season, and after 280 children died from flu last winter, the most since 2009.
Even a disease that parents may not have heard of, rotavirus, could come roaring back if vaccination erodes, he added. That diarrheal disease once hospitalized thousands of children each winter, something that no longer happens.
The decision was made without input from an advisory committee that typically consults on the vaccine schedule, said senior officials at HHS. The officials spoke on the condition of anonymity because they weren’t authorized to discuss the changes publicly.
The officials added that the new recommendations were a collaborative effort between federal health agencies but wouldn’t specify who was consulted.
Scientists at the CDC’s National Center for Immunization and Respiratory Diseases were asked to present to the agency’s political leadership about vaccine schedules in other countries in December, but they were not allowed to give any recommendations and were not aware of any decisions about vaccine schedule changes, said Abby Tighe, executive director of the National Public Health Coalition, an advocacy organization of current and former CDC employees and their supporters.
“Changes of this magnitude require careful review, expert and public input, and clear scientific justification. That level of rigor and transparency was not part of this decision,” said Dr. Sandra Fryhofer, of the American Medical Association. “The scientific evidence remains unchanged, and the AMA supports continued access to childhood immunizations recommended by national medical specialty societies.”
Kennedy is a longtime vaccine skeptic
The move comes as Kennedy, a longtime activist against vaccines, has repeatedly used his authority in government to translate his skepticism about the shots into national guidance.
In May, Kennedy announced the CDC would no longer recommend COVID-19 vaccines for healthy children and pregnant women — a move immediately questioned by public health experts who saw no new data to justify the change.
In June, Kennedy fired an entire 17-member CDC vaccine advisory committee — later installing several of his own replacements, including multiple vaccine skeptics.
Kennedy in November also personally directed the CDC to abandon its position that vaccines do not cause autism, without supplying any new evidence to support the change.
Swenson reported from New York. Associated Press writer Mike Stobbe contributed to this report. _
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—Ali Swenson and Lauran Neergaard, Associated Press