- Pediatric medical professionals are pushing back against new CDC recommendations that implemented major changes to the childhood immunization schedule.
- Many pediatricians rely on advice from the American Academy of Pediatrics (AAP), as major medical organizations have filed a lawsuit against the CDC.
- Healthline spoke with pediatricians and physicians to learn more about the possible risks that could result from the changes to child vaccine guidelines.
Pediatricians have raised serious concerns about the Centers for Disease Control and Prevention’s recent changes to its vaccination schedule for children, which cut vaccination against 16 diseases down to 11.
Rotavirus, COVID-19, and flu vaccines moved to a new “shared clinical decision-making” category, encouraging parents to consult their doctor before deciding.
All vaccines remain available for families who want them, and insurance must cover the full cost.
The Trump administration said the health policy shift fulfilled a campaign promise.
“Americans voted for transparency and HHS is delivering it,” Emily Hilliard, press secretary for the U.S. Department of Health and Human Services, told Healthline. She said the new guidance relies on “trust, education, and strong doctor-patient relationships.”
However, many children’s medical offices and state health departments aren’t in compliance with the new guidelines. Many are adhering to recommendations from the American Academy of Pediatrics (AAP) instead.
Some major medical groups have also filed a lawsuit against the CDC to block the new recommendations.
The plaintiffs include the AAP and its Massachusetts chapter, the American College of Physicians, the American Public Health Association, the Infectious Diseases Society of America, the Massachusetts Public Health Association, and the Society for Maternal-Fetal Medicine.
Healthline spoke with pediatric healthcare professionals to learn more.
For pediatricians who’ve seen these diseases firsthand, the changes are confusing.
Amanda Furr, MD, chief medical officer of Zarminali Pediatrics, which operates clinics in 10 states, said her heart sank when she heard the news. She recalled working in hospitals when infants arrived severely dehydrated from rotavirus. “You’d do everything to try to even get an IV because they were so dehydrated.”
Helena Bentley, MD, who owns Kid Care Pediatrics in Georgia, trained when these diseases were still common. “I saw the complications,” she said. “The reason I don’t see them now is because of vaccines.”
She described a former employee’s son left severely disabled by meningitis, and children who lost limbs or died within 24 hours of infection.
Benjamin Lopman, PhD, an epidemiologist at Emory University’s Rollins School of Public Health, has spent more than a decade researching rotavirus vaccines. He pointed to last year’s measles outbreaks in the Southwest, which began in communities with low vaccination rates.
Measles is a disease that the
“If vaccine coverage goes down, it increases everyone’s risk, not just the kids who missed the vaccine,” Lopman said.
Vaccine science hasn’t changed
The medical professionals interviewed by Healthline say they can’t implement changes that aren’t backed by science.
They emphasized that the scientific evidence supporting these vaccines remains strong.
“Nothing has changed as far as our understanding of the science of these vaccines, how effective they are, how well they work,” Lopman said.
“They’re the best tools we have for avoiding most of these infections. And nothing has changed about our understanding of the safety as well. These changing guidelines is not about new science. It’s about politics.”
Furr said her organization is following AAP guidelines, not the CDC’s new recommendations. “Our patients deserve science and evidence,” she said. “I’m not going to be pressured from one more source to do what is not right for patients.”
Some children’s hospitals have taken similar positions. The newly-formed West Coast Health Alliance — California, Oregon, and Washington — announced on January 5 that it would follow AAP recommendations.
A week later, a coalition of eight northeastern states and jurisdictions followed suit, warning the changes could leave children “more vulnerable to preventable illness and death.”
Patient care impacts
Furr and Bentley said that since the COVID pandemic, parents’ conversations about vaccines have increased, giving them the opportunity to talk through concerns.
“I go over all the vaccines that are due, explain what they are,” Bentley said. “We have those conversations and it’s still up to the parents to get it.”
Those conversations, though, are increasingly shaped by what parents see on social media and sometimes laced with misinformation.
Parents know their children. Doctors know the science. For years, that partnership worked for the most part.
But misinformation and political rhetoric appear to be disrupting a partnership both sides value. “The parents don’t want that. They want to trust us, and we want them to trust us and work together as a team,” Furr said.
Bentley worried the current climate “is going to feed into the frenzy that people already have and their lack of confidence in what they’re doing and what we’re recommending.”
Furr said the challenge is conveying urgency without seeming alarmist. “People don’t understand how bad this can be because vaccines work,” she said.
“How do you tell those stories in an exam room without people thinking this is dramatic or you’re just trying to scare me? We’re trying to inform them.”
Weakened herd immunity
A major concern is weakening vaccine coverage.
As states and local communities set their own vaccine mandates, Lopman predicts the country will see widening gaps in protection from these vaccine-preventable diseases.
Lopman pointed to rotavirus as an example. “It doesn’t require the pathogen to be introduced. It’s here already circulating.” These diseases haven’t disappeared; they’re held in check by vaccination.
“If there are more susceptible kids because they haven’t been vaccinated, we will see more disease, we will see more hospitalizations and we may even see some deaths occur,” he said.
The vaccines moved to “shared clinical decision-making” protect against serious illnesses.
Influenza and COVID-19 vaccines are the two vaccines in this new category that parents have more likely had conversations about with physicians. The others are less familiar.
Meningococcal disease
Teenagers are especially vulnerable because of how they live: in close groups, away from parents who might recognize early symptoms. Two vaccines protect against it — Meningococcal ACWY, given at ages 11 and 16, and Meningococcal B, given at 16 or 17 as teens prepare to leave home.
Survivors often face permanent consequences, including vision loss, hearing loss, and loss of motor function or speech. “Very few people recover from true bacterial meningitis without some consequence,” Furr said.
Of all the changes, Furr said this one hit hardest. “No amount of healthy, athletic, well-balanced diet can protect you against meningitis. It comes for everybody the same.”
Rotavirus
Rotavirus is a contagious viral infection of the gut spread through hands and food contaminated with stool, according to the
It causes severe diarrhea and dehydration. It can be fatal, especially for infants. An oral vaccine is given to babies starting at 2 months old, either as a two-dose series (RV1) or three-dose series (RV5).
“Babies can become dehydrated in 24 to 48 hours with this disease and typically require a hospital stay in order to rehydrate them,” Furr said.
Lopman worries the new classification will undermine the highly effective vaccine.
“We’re going to see a reduction in coverage, and we know exactly what happens when vaccine coverage falls — especially for a virus like rotavirus, which is endemic. It’s always with us.”
Hepatitis A and B
Hepatitis A and B are contagious viral infections of the liver that can lead to liver failure and death, according to the
Hepatitis B spreads through infected body fluids. A three-dose vaccine series is given to infants ages 2 to 18 months.
According to the
The new CDC guidelines still recommend vaccination for high risk groups, but that assumes people know they’re in one. Many don’t.
Cases have dropped dramatically since the vaccine was introduced. “20 years ago, we would see kids on the transplant list because of early exposure to Hep B,” Furr said. “It’s rare now, but the consequences are devastating.”
Hepatitis A spreads through contaminated food or drink or close contact. A two-dose series is given between 12 and 23 months — “when everything is going in the mouth,” Furr said. Illness in infants can be more severe and prolonged.
For both, she emphasized the even though infections are more rare, ”nobody cares about statistics when it’s your kid.”
