WASHINGTON — On Monday, the US took the unprecedented step of reducing the number vaccine it recommends for every child, a step that leading medical groups say would undermine protection against a half-dozen diseases.
The change takes effect immediately, meaning that US Centers for Disease Control and Prevention will now recommend that all children be vaccinated against 11 diseases. What is no longer widely recommended is protection from flurotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV. Instead, protection against these diseases is recommended only for certain high-risk groups or when doctors recommend it as part of what is known as “shared decision making.”
Trump administration officials say the overhaul is a step long sought Secretary of Health Robert F. Kennedy Jr.will not cause families who want vaccines to lose access to them, and said insurance will continue to pay out. But medical experts say the decision creates confusion for parents and could lead to an increase in preventable diseases.
States, not the federal government, have the authority to require schoolchildren to be vaccinated. Although CDC requirements often influence these state regulations, some states have begun creating your own alliances to counter the Trump administration's vaccine recommendations.
The change comes as vaccination rates in the U.S. slipped and the share of children exempt has reached an all-time high, according to federal data. At the same time the pace illnesses which can be protected against with vaccines such as measles and whooping cough are growing throughout the country.
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 has asked the agency to review how similar countries approach vaccine recommendations and consider revising U.S. guidance accordingly.
HHS said its comparison with 20 comparable countries showed the U.S. was “outstanding” in both the number of vaccinations it gave and the number of doses it recommended for all children. Agency officials pitched the change as a way to boost public confidence by recommending that children receive only the most important vaccinations.
“This decision protects children, respects families and restores 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 “much more reasonable” and will “finally bring the United States in line with other developed countries in the world.”
Vaccines against measles, whooping cough, polio, tetanus, chickenpox and human papillomavirusor HPV. The guidelines are reducing the number of recommended doses of the HPV vaccine from two or three shots, depending on age, to one for most children.
Medical experts said Monday's changes, without public discussion or transparent analysis of the data, would put children at risk.
“Removing recommendations for vaccines that prevent influenza, hepatitis and rotavirus, and changing recommendations for HPV without a public process of weighing risks and benefits, will lead to increased 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 vaccination recommendations based on the level of disease in their populations and their health systems.
“You can't just copy and paste public health, and that's what they're doing here,” O'Leary said. “The health and lives of children are literally 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 advocate for vaccine use.
France now recommends that all children be vaccinated against 14 diseases, up from the 11 the US will now recommend for every child under the new schedule.
O'Leary said the changes were made by political appointees without any evidence that the current guidelines were harming children.
The pediatricians' group has developed its own childhood vaccination schedule that its members follow and continues to widely recommend vaccines, which the Trump administration has downgraded.
O'Leary highlighted the flu vaccine, which the government and leading medical experts have long called for nearly everyone to get, starting at 6 months of age. He said the government was “pretty tone-deaf” about lifting its advice while the country is at the start of a severe flu season and after 280 children died from the flu last winter, the most since 2009.
Even a disease that parents may not have heard of—rotavirus—could come back with a vengeance if vaccinations weaken, he added. This diarrheal disease once hospitalized thousands of children every winter, but that no longer happens.
The decision was made without input from an advisory committee that typically consults on the vaccination schedule, senior HHS officials said. The officials spoke on condition of anonymity because they were not authorized to discuss the changes publicly.
Officials added that the new recommendations were the result of a joint effort between federal health agencies, but did not say who was consulted.
Scientists at the CDC's National Center for Immunization and Respiratory Diseases were asked to present the agency's policymakers with vaccination schedules in other countries in December, but were not allowed to make any recommendations and were not privy to any decisions about changes to the vaccination schedule, said Abby Tye, executive director of the National Public Health Coalition, an advocacy organization for current and former CDC employees and their supporters.
“Changes of this magnitude require careful analysis, expert and public input, and clear scientific justification. This level of rigor and transparency was not part of this decision,” said Dr. Sandra Freihofer of the American Medical Association. “The scientific evidence remains unchanged, and the AMA supports continued access to childhood immunizations recommended by national specialty medical societies.”
This step happens as Kennedya longtime anti-vaccine activist, has repeatedly used his authority in government to translate his skepticism about vaccinations into national recommendations.
In May, Kennedy announced that the CDC would no longer recommend COVID-19 vaccines to healthy children and pregnant women. The move was immediately questioned by public health experts who saw no new data to justify the change.
In June, Kennedy fired the CDC's entire 17-member vaccine advisory committee and later appointed several of his own to replace it, including numerous vaccine skeptics.
Kennedy in November also personally instructed the CDC give up your position that vaccines do not cause autism, without providing any new evidence to support these changes.
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Swenson reported from New York. Associated Press writer Mike Stobbe contributed to this report. ___
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