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US Cuts Number of Recommended Vaccines 01/06 06:10
WASHINGTON (AP) -- 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.
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