Donald Trump has signed an executive order that could sharply reshape childhood immunization guidance in the United States. The order directs the Centers for Disease Control and Prevention to review a federal assessment that could reduce the number of vaccines recommended for children by nearly half.
The move centers on a January review from Robert F. Kennedy Jr.’s health department, which compared U.S. childhood vaccine guidance with selected peer nations. The language of the order is broad, but the assessment itself points toward a narrower schedule that would keep some vaccines while removing several others from the list recommended for all children.
What the order asks the CDC to do
The executive order tells the CDC and its Advisory Committee on Immunization Practices to examine the health department’s assessment and the underlying clinical data. That review is meant to inform an updated schedule for children and adolescents.
The White House said the policy is to align the “core childhood vaccine schedule” with scientific evidence and best practices from developed peer countries while keeping vaccines available to Americans. The order does not spell out every change in plain terms, but the cited assessment makes clear which vaccines could be affected.
Which vaccines could be removed
The assessment concluded that the CDC director should keep vaccines for 10 diseases on the universal childhood schedule, along with varicella, or chickenpox. Those diseases are measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B, pneumococcal disease, and human papillomavirus.
If that recommendation were adopted, several vaccines would no longer be listed as routinely recommended for all children. Those include hepatitis A, hepatitis B, meningitis, rotavirus, influenza, and Covid-19.
The same assessment also recommended reducing the number of HPV shots from two or three, depending on the child’s age, to just one. That change would be a major shift in one of the most closely watched parts of the childhood vaccine schedule.
Why the change is drawing backlash
The proposal has already triggered a legal fight from 15 states with Democratic governors. Their lawsuit targets the health and human services department and Robert F. Kennedy Jr., arguing that the administration’s changes would strip vaccines of their universal recommendation and create confusion that could leave children sicker and place more pressure on state health systems.
The states also challenged a CDC memo that downgraded the recommendation for an RSV vaccine. Their filing argues that the administration is replacing a clear national standard with unnecessary complexity.
Medical experts warn about disease risk
Dr William Schaffner, a professor of medicine at Vanderbilt University School of Medicine and a former member of ACIP, said there appeared to be “little scientific basis” for changing recommendations that have already gone through review. He warned that if children are not progressively vaccinated, diseases could return, including illnesses now seen in recent measles outbreaks.
Schaffner said the likely result would be “more sick children, more visits to the doctor and more hospitalizations.” That concern sits at the center of the debate over whether the federal schedule should follow the current recommendations or move toward a much narrower list.
Denmark becomes a flashpoint in the debate
The health department assessment has also faced criticism for its focus on Denmark. The states argued that Denmark should not be treated as a true vaccine “peer country” because it has a small, homogeneous population and universal healthcare, unlike the United States.
Attorneys for the states said Denmark’s vaccine policies are a global outlier and cannot simply be copied into the U.S. system. They also cited remarks from Dr Anders Hviid, an official at Denmark’s equivalent of the CDC, who told the New York Times that it is not fair to use Denmark as a comparison unless the broader national differences are also considered.
Hviid also noted the irony of Kennedy’s department relying on Denmark, given that Danish health officials had previously challenged his theories about vaccine harm. The dispute now leaves the CDC at the center of a policy fight that could affect routine childhood protection against several infectious diseases.
Read more at: www.theguardian.com