On Monday, the U.S. took an unprecedented step by reducing the number of vaccines it recommends for every child, cutting protection against half a dozen diseases, a move that has been criticized by the nation’s pediatricians.
The overhaul is in effect immediately, meaning the Centers for Disease Control and Prevention will now recommend vaccines against 11 diseases. Protection against rotavirus, hepatitis A, hepatitis B, some forms of meningitis, or RSV is no longer broadly recommended. Instead, protection against these diseases is only recommended for certain high-risk groups or if their doctors recommend them in what is called “shared decision-making.”
Trump administration officials said the overhaul, a move long sought by Health Secretary Robert F. Kennedy Jr., will not result in families who want the vaccines losing access to them and that insurance will continue to cover them. But medical experts said the move increases confusion for parents and could lead to an increase in preventable diseases.
The change came after President Donald Trump in December asked Health and Human Services to review how peer nations approach vaccine recommendations and consider revising its guidance to align with theirs.
HHS said its comparison with 20 peer nations found that the U.S. was an “outlier” in both the number of vaccinations and the number of doses it recommends for all children. Agency officials presented the change as a way to increase public trust by only recommending the most important vaccinations for children to receive.
Among those still on the recommended-for-everyone list are measles, whooping cough, polio, tetanus, chickenpox, and HPV.
“This decision protects children, respects families, and rebuilds trust in public health,” Kennedy said in a statement on Monday.
Medical experts disagreed, saying the change without public discussion or a transparent review of the data would put children at risk.
Dr. Sean O’Leary of the American Academy of Pediatrics said countries carefully consider vaccine recommendations based on the 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 lives are at stake.”
The new guidance also reduces the number of recommended vaccine doses against human papillomavirus from two or three shots to one for most children, depending on age.
The decision was made without input from an advisory committee that typically consults on the vaccine schedule, said senior HHS officials. The officials spoke on the condition of anonymity because they were not authorized to discuss the changes publicly.
“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 at the University of Minnesota.