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Tag: Children vaccination

  • US overhauls childhood vaccine schedule to recommend fewer shots

    (CNN) — The US Department of Health and Human Services is recommending fewer vaccines for most American children, health officials said Monday.

    Health officials will continue to recommend the measles, mumps and rubella vaccines and immunizations against polio, chickenpox, HPV and others, but they are narrowing recommendations for vaccination against meningococcal disease, hepatitis B and hepatitis A to children who are broadly at higher risk for infections.

    They recommend that decisions on vaccinations against flu, Covid-19 and rotavirus be based on “shared clinical decision-making,” which means people who want one must consult with a health care provider.

    HHS said that its recommendations for immunizations against respiratory synctytial virus, or RSV, remain unchanged and that infants born to mothers who did not receive the vaccine should have one dose.

    The changes come amid a sharp increase in flu cases across the country. The US Centers for Disease Control and Prevention has reported nine pediatric deaths from flu this season.

    HHS said that all insurers will still cover these vaccines without cost-sharing. However, the changes could present new hurdles for parents who need to consult with doctors about immunizations no longer recommended for healthy children.

    ‘Public health is not one size fits all’

    The new US schedule of childhood vaccines more closely resembles that of other developed nations such as Denmark, as CNN reported last month.

    Denmark does not currently recommend childhood vaccinations against rotavirus, hepatitis A, meningococcal, flu or chickenpox.

    US health officials initially planned to announce the changes in December, weeks after Dr. Tracy Beth Hoeg, newly named acting director of the US Food and Drug Administration’s Center for Drug Evaluation and Research, gave a presentation on the Danish vaccine schedule to the CDC’s panel of vaccine advisers.

    The panel, the Advisory Committee on Immunizations Practices, was reconstituted last year with a new group of members after US Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine skeptic, dismissed all previous appointees.

    The overhaul comes one month after President Donald Trump ordered the health department to review the childhood vaccine schedule.

    “It is ridiculous!” Trump wrote in a Truth Social post in December, after his executive order. “That is why I have just signed a Presidential memorandum directing the Department of Health and Human Services to ‘FAST TRACK’ a comprehensive evaluation of Vaccine Schedules from other Countries around the World, and better align the U.S. Vaccine Schedule.”

    In a post on X, Kennedy responded: “Thank you, Mr. President. We’re on it.”

    The new vaccine schedule is a “far more reasonable” one that protects children against “11 of the most serious and dangerous diseases,” Trump wrote in a Truth Social post Monday night. “Parents can still choose to give their children all of the Vaccinations, if they wish, and they will still be covered by insurance.”

    In a separate post, Trump signaled that he still wanted to see more changes: Namely, the separation of the measles, mumps and rubella vaccine into three separate shots.

    Several public health experts warned that the changes announced Monday could fuel outbreaks of preventable diseases.

    “I think that a reduced schedule is going to endanger children and lay the groundwork for a resurgence in preventable disease,” said Dr. Caitlin Rivers, an epidemiologist and director of the Center for Outbreak Response Innovation at the Johns Hopkins Bloomberg School of Public Health.

    Denmark is not a good blueprint for US vaccine policy, said Anders Hviid, who leads vaccine safety and effectiveness research at the Statens Serum Institut in Denmark.

    They’re “two very different countries. Public health is not one size fits all,” he told CNN in an email.

    In Denmark, “everyone has access to excellent prenatal and childhood care. As I understand it, that is not the case for everyone in the US. Vaccines prevent infections that may have poor outcomes for children who do not have access to good healthcare.”

    Faltering information

    HHS in a statement said that reducing the number of recommended vaccines would help restore public trust in health agencies — and possibly confidence in vaccines themselves. The agency reasoned that despite recommending more shots, the US does not have higher vaccination rates than peer countries that rely on “education rather than mandates.”

    The government’s vaccine outreach and messaging has been vastly reshaped under Kennedy, who has questioned vaccine safety for decades.

    It is a “confusing time” for doctors and parents, Dr. Sean O’Leary, chair of the American Association of Pediatrics Committee on Infectious Diseases, said Monday.

    “What was announced today is part of a decades-long effort on the part of the health secretary to spread fear and falsehoods about vaccines, and this is another step in the secretary’s effort to dismantle the US vaccination system,” O’Leary said.

    At the same time, public information about vaccination rates is faltering.

    Last week, the Centers for Medicare & Medicaid Services dropped requirements for states to report childhood vaccination status for beneficiaries, a move that experts say may raise unnecessary doubts about the importance of vaccines. CMS sent a letter to state health officials on December 30 stating that vaccination data no longer needs to be submitted to the agency that oversees Medicaid and Medicare.

    “This is another message that could create doubt in people’s minds about the need for vaccines, and that isn’t something that’s supported by current science,” said ​Dr. Michelle Fiscus, a pediatrician and chief medical officer of the Association of Immunization Managers.

    The CMS requirement for reporting childhood immunization status was relatively new — it was implemented in 2024 — and there are other federal systems to track immunization rates. But more than 40% of children in the US are covered by Medicaid and the Children’s Health Insurance Program, or CHIP, and immunization surveillance offers important insights.

    CMS said it plans to “explore options to facilitate the development of new vaccine measures” after dropping this requirement. These new measures may include tracking how often parents are informed about vaccine safety and side effects and alternative vaccine schedules, as well as how to capture “preferences related to vaccines” and how religious exemptions may be accounted for.

    States may continue to voluntarily report childhood vaccination data to CMS, but Fiscus says that may depend on the political party of local leaders.

    “I think this is going to contribute to this schism between states based on their party of government,” she said. “We’ll see more of this patchwork of state policies around immunizations, and that’s unfortunate, because these diseases don’t really care about state borders so much.”

    Can’t ‘cowboy’ change

    The changes drew criticism from Louisiana Republican Sen. Bill Cassidy, a physician who voted for Kennedy as health secretary only after assurances that he would “work within” the current vaccine approval and safety monitoring systems.

    “Changing the pediatric vaccine schedule based on no scientific input on safety risks and little transparency will cause unnecessary fear for patients and doctors, and will make America sicker,” Cassidy wrote in an X post that also pointed to ongoing measles and whooping cough outbreaks.

    Cassidy, who chairs the Senate Health, Education, Pensions and Labor Committee, asked Kennedy months ago to testify before the committee. The request followed a September hearing with ousted CDC Director Dr. Susan Monarez, who alleged that Kennedy sought to override vaccine decisions.

    Health officials said Monday that they consulted with career staff at the CDC and the FDA about the changes to the vaccine schedule.

    Officials also insisted that these changes do not sideline ACIP, the panel of vaccine advisers that convenes for public meetings several times a year to discuss and vote on recommendations.

    A senior official said that ACIP will continue to meet several times a year and that the CDC will update the vaccine schedule based on their advice.

    But a sudden, broad change to the schedule without public debate won’t instill confidence, said public health experts including former ACIP member Dr. Noel Brewer, a professor of public health and health behavior at the University of North Carolina at Chapel Hill.

    “We can’t cowboy the nation to good health with a bunch of sudden and poorly considered health policy changes,” Brewer added.

    Correction: A previous version of this report incorrectly listed RSV among the vaccinations with new recommendations.

    Sarah Owermohle and CNN

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  • With CDC signoff, CVS says Covid-19 vaccines will be available nationwide without a prescription

    (CNN) — The US Centers for Disease Control and Prevention signed off on a recommendation that patients must consult a health care provider to get a Covid-19 vaccine, although they don’t necessarily need a prescription.

    The updated CDC recommendation — made by a new panel of vaccine advisers chosen by US Health and Human Services Secretary Robert F. Kennedy Jr. — shifted away from a broader push in past years for most people to get an updated Covid-19 vaccine. It became final with signoff from Acting CDC Director Jim O’Neill.

    The new recommendations mean people ages 6 months and older can get Covid-19 vaccines after consulting with a qualified health care provider, which keeps the shots available but may also create more barriers to access than in past years.

    Before the finalized recommendation this year, access to Covid-19 shots has differed from state to state as pharmacies and providers navigated new federal vaccine policies. CVS, which had previously limited access to Covid-19 shots in some places, said Monday that it was “updating our systems to be able to offer the updated COVID-19 vaccines to patients nationwide” and that “prescriptions from outside prescribers will no longer be required in any states.”

    The signoff is also coming later than usual for the fall respiratory virus season. With the recommendation, the government can finally distribute Covid-19 vaccines through its Vaccines for Children program, which provides free inoculations to about half of US children.

    The CDC’s independent vaccine advisers, the Advisory Committee on Immunization Practices, voted unanimously last month that people who want a Covid-19 vaccine should consult with a health care provider, a process called shared clinical decision-making. However, they narrowly voted down a recommendation that a prescription should be required to get the shot.

    In August, the US Food and Drug Administration moved to limit approval of Covid-19 vaccines to adults 65 and older as well as younger people who are at higher risk of severe illness because of other health conditions.

    A study published last month in the journal JAMA Network Open found that a universal Covid-19 vaccine recommendation — as had been in place for the US in recent years — could save thousands more lives than limiting the recommendation to high-risk groups.

    Experts said that even requiring shared clinical decision-making could make Covid-19 shots harder to get.

    The recommendation “assumes health care and insurance,” said Dr. Demetre Daskalakis, who recently resigned as head of the CDC’s National Center for Immunization and Respiratory Diseases. “We do not have universal health care in this country, and we know millions of people are losing insurance.”

    HHS said it was bringing back “informed consent” ahead of vaccination.

    “CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today,” O’Neill, who is also the deputy secretary of HHS, said in a statement.

    Another new recommendation will mean toddlers get their first vaccines against measles and chickenpox separately, around their first birthdays. In this case, the ACIP guidance formalizes an existing recommendation, which is designed to reduce a very rare, slightly elevated risk of seizures when the two shots are combined into a single injection.

    The CDC advisers said that the single-dose measles, mumps, rubella and varicella vaccine was not recommended before age 4 and that younger kids should get the varicella vaccine, which protects against chickenpox, separately from the shot that protects against measles, mumps and rubella.

    Brenda Goodman, Katherine Dillinger and CNN

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  • RFK Jr. promised to ‘Make Our Children Healthy Again.’ Here’s how he plans to do it

    (CNN) — President Donald Trump’s strategy to ‘Make America Healthy Again’ includes investigating vaccine injuries and pharmaceutical practices but stops short of new regulatory action, for now.

    US Health and Human Services Secretary Robert F. Kennedy Jr. unveiled the MAHA strategy on Tuesday, joined by Agriculture Department Secretary Brooke Rollins, Environmental Protection Agency Administrator Lee Zeldin, and other top Trump officials.

    The report hews closely to a draft document circulated in August that cites earlier Trump administration announcements — developing a definition for ultraprocessed foods, educating the public about synthetic kratom — but largely bypassed industry crackdowns.

    Language around pesticides strategy also remained unchanged. Environmental and food activists had rallied for the administration to include steps to reduce pesticide usage and probe potential health risks of commonly used chemicals such as RoundUp.

    The report says that USDA, EPA and the National Institutes of Health will develop a framework to study cumulative exposures to chemicals including pesticides and microplastics. USDA and EPA will also invest in new farming approaches to reduce chemical use, and EPA will launch a public awareness campaign about the limited risk of approved products.

    The commission’s first report this May suggested a broad range of factors driving chronic disease in the US, including ultraprocessed foods, environmental exposures, and overprescription of pharmaceuticals like antidepressants.

    The report noted previous announcements that HHS, the NIH and the Centers for Medicare and Medicaid Services are studying the causes of autism. Kennedy had previously promised some answers on the root causes in September; NIH is expected to announce autism research grants this month.

    Recent reports suggest that HHS will issue a report that links the development of autism to taking Tylenol during pregnancy.

    Medicines and vaccines

    Kennedy has drawn criticism for suggesting antidepressants, particularly those that are part of a family known as SSRIs are as addictive as heroin and can be dangerous. Following the August 27 shooting in Minneapolis, he told Fox News that HHS is launching studies “on the potential contribution of some of the SSRI drugs and some of the other psychiatric drugs that might be contributing to violence.”

    SSRIs, or selective serotonin reuptake inhibitors, are the most prescribed class of antidepressants for depression, anxiety disorders and many other mental health conditions. Several SSRIs have been on the market in the United States since the 1990s, including Prozac, Zoloft and Celexa. Experts agree that there is no scientific evidence or correlation between these drugs and violence towards others.

    Tuesday’s report states that HHS will assemble a working group of federal officials to evaluate SSRI prescribing patterns, specifically among children. HHS will also “evaluate the therapeutic harms and benefits of current diagnostic thresholds,” or the current common practices doctors use to diagnose patients with mental health disorders.

    Dr. Theresa Miskimen Rivera, president of the American Psychiatric Association said access to care, not over-medication is the bigger problem when it comes to helping kids’ mental health in the country, and there is no mention of the issue in the report. The report said addressing a child’s nutrition, screen time, and exercise can improve their mental health, but can’t address everything. “Psychiatric conditions are complex in nature,” she said. Extreme poverty, post traumatic stress disorder, trauma-related factors should also be addressed, but there is no mention in the report of any of those issues either.

    “In terms of over medication, that’s not what we do. We have a comprehensive evaluation and we are evidence based. We diagnose than create a comprehensive treatment plan, “ Miskimen Rivera told CNN. “Medication can save lives, not only in children, but in adults and elderly.”

    When asked about whether or not the commission chose to consider gun violence – the leading cause of death for children – as one of the issues to be investigated, Kennedy doubled down on the issue of prescription drugs, saying “We are doing studies now, or initiating studies to look at the correlation and the connection, potential connection between over medicating our kids and this violence.”

    HHS will also work with the White House Domestic Policy Council on a new vaccine framework that, the report said, will ensure “America has the best childhood vaccine schedule” and ensure “scientific and medical freedom.”

    The report comes as Kennedy continues to defend his shakeup of the US Centers for Disease Control and Prevention over vaccine policy, including the ouster of CDC Director Dr. Susan Monarez.

    The administration will also increase oversight of “deceptive” direct-to-consumer advertising of pharmaceutical products, including from social media influencers and telehealth companies, it said.

    Food policy stays the course

    FDA will continue work on developing a definition for ultraprocessed foods, but the report bypasses recommendations, like those of former FDA Director Dr. David Kessler, to essentially order certain additives off the market until they are reviewed.

    Dr. Dariush Mozaffarian, director of Tufts Food is Medicine Institute said a definition of ultraprocessed foods would be “really important.” With more than half of calories in the food supply coming from ultraprocessed foods, addressing this and other issues involving the nation’s diet would mean a “massive fight with the industry and is going to be incredibly controversial, but is much needed.”

    “Overall, this is really quite thorough, quite specific, and even if parts of this are accomplished, this could have tremendous positive impact for Americans,” Mozaffarian told CNN.

    Other experts, like Marion Nestle, agreed the report was ambitious in scope, but noted it fell short on regulatory action. “What’s still missing is regulation. So much of this is voluntary, work with, promote, partner,” said Nestle, who is the Paulette Goddard professor emerita of nutrition, food studies and public health at New York University.

    The report also nods to new, user-friendly dietary guidelines expected later this year. Kennedy has promised a vastly shortened set of recommendations that will emphasize whole foods.

    The commission also cited ongoing work to reduce ultraprocessed foods in the Supplemental Nutrition Assistance Program (SNAP) and Head Start.

    While the report also touches on agriculture deregulation with the aim of making it easier for small farms to get greater access to markets and schools, Ken Cook, co-founder of the Environmental Working Group, a health advocacy organization said the report abandons earlier MAHA promises to ban toxic pesticides and instead “echoes the pesticide industry’s talking points.”

    “Secretary Kennedy and President Trump cynically convinced millions they’d protect children from harmful farm chemicals – promises now exposed as hollow,” Cook said in a statement.

    There were minor changes from the draft document leaked in August. For instance, the August 6 draft stated that the FDA and other agencies will crack down on “Illegal Chinese Vapes,” while the final version promises enforcement on vapes more broadly.

    “We support the goal of making children healthier and addressing and preventing chronic disease, but unfortunately, the recommendations fall short in some really critical ways,” Laura Kate Bender, vice president nationwide advocacy and public policy for the American Lung Association told CNN.

    “They continue to cast doubt on vaccines, one of the most, important, proven public health interventions that we can have for kids health. They don’t address some major contributors to diseases in kids like pollution, tobacco use, beyond the mention of vaping, and this report is coming out at the same time that we’re continuing to see dramatic cuts in staff and funding of a lot of the programs that could make the good parts of the report a reality.”

    The report’s emphasis on kids’ health can help overall, Dr. Michelle Macy, director of the Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center in Chicago told CNN. “I’m really trying to look for bright spots in this report, and I think that the focus on data and infrastructure for us to be able to answer big questions about what environmental and food exposures and medication exposures do to shape the trajectory of someone’s health and chronic disease across the lifespan is something that has promise and potential.”

    Dr. Richard Besser, pediatrician and president and CEO of the Robert Wood Johnson Foundation said that having a focus on preventing chronic disease in children is a good thing, but he said, with Kennedy’s track record that includes firing thousands of federal health employees, slashing millions in health research funding, dismantling entire offices that managed important issues like smoking and chronic disease specifically, in addition to his “assault on vaccinations” will undermine any potential good of this kind of report.

    “Neither RFK Jr.’s record, nor his policies outlined in the report give me confidence that he is going to make any difference whatsoever on chronic diseases in children,” Besser told CNN.

    Sarah Owermohle, Jen Christensen and CNN

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  • Florida plans to end vaccine mandates statewide, including for schoolchildren

    (CNN) — Florida will move to end all vaccine mandates in the state, Florida Surgeon General Dr. Joseph Ladapo announced Wednesday.

    The move would make Florida the first state to end a longstanding – and constitutionally upheld – practice of requiring certain vaccines for school students.

    The state health department will immediately move to end all non-statutory mandates in the state, Ladapo said at a news conference. Florida Gov. Ron DeSantis, who was also at the event, said state lawmakers would then look into developing a legislative package to end any remaining mandates.

    Ladapo said that every vaccine mandate “is wrong and drips with disdain and slavery.”

    All 50 states have had school immunization requirements since the beginning of the 1980s, with incoming kindergartners needing shots to protect against diseases including measles, polio and tetanus. No states require a Covid-19 vaccine for schoolchildren.

    All states allow medical exemptions from these school vaccine mandates, and most also allow for exemptions due to personal or religious beliefs. Exemption rates have been on the rise for years in the US, with a record share of incoming kindergartners skipping the required shots in the 2024-25 school year.

    Florida’s school vaccine exemption rate last school year– about 5% – was higher than the national average, data from the US Centers for Disease Control and Prevention shows, and nearly all were for nonmedical reasons.

    “We are concerned that today’s announcement will put children in Florida public schools at higher risk for getting sick, which will have a ripple effect across our communities,” Dr. Rana Alissa, president of the Florida Chapter of the American Academy of Pediatrics, said in a statement.

    “For many kids, the best part of school is being with friends – sharing space, playing on the playground, and learning together. Close contact makes it easy for contagious diseases to spread quickly,” she said. “When everyone in a school is vaccinated, it is harder for diseases to spread and easier for everyone to continue learning and having fun. When children are sick and miss school caregivers also miss work, which not only impacts those families but also the local economy.”

    A study published last year by the CDC estimated that routine childhood vaccinations – such as those included in school mandates – will have prevented about 508 million illnesses, 32 million hospitalizations and 1,129,000 deaths among children born between 1994 and 2003. They also were estimated to avert $540 billion in direct costs.

    Ladapo said that vaccination should be an individual choice.

    “People have a right to make their own decisions, informed decisions,” he said. “What you put into your body is because of your relationship with your body and your god. I don’t have that right. Government does not have that right.”

    But experts say that freedom comes with responsibilities.

    “We’re all routinely subject to rules that enable us to live together safely, and I personally want those rules in place to protect me and the people I care about. We abide by speed limits, traffic lights, infant car seat and seatbelt laws – all requirements that have expanded over the years as safety technology and engineering has improved,” said Dr. Kelly Moore, president and CEO of immunize.org, a nonprofit organization focused on vaccine access.

    “I share with many other people the belief that all children who are required to attend school should also have a right to the best possible defense from vaccine-preventable diseases while they are there,” she said.

    Some vaccine mandates in Florida can be rolled back unilaterally by the state health department, Ladapo said, but others will require coordination with lawmakers.

    Experts who oppose the move to end vaccine mandates emphasize that the change is not final and that timing is critical.

    With the announcement coming after the start of the school year, Floridians will have a chance to experience and reflect on what a year of low vaccination coverage looks like, Moore said.

    “This timing gives leaders several months to reconsider whether this is what’s best for Florida families. It’s quite likely that Floridians will have reasons to regret that decision as time goes by and outbreaks disrupt learning,” she said.

    The American Medical Association “strongly opposes” the plan to end vaccine mandates, Dr. Sandra Adamson Fryhofer, an internal medicine physician and member of the professional organization’s board of trustees, said in a statement.

    “This unprecedented rollback would undermine decades of public health progress and place children and communities at increased risk for diseases such as measles, mumps, polio, and chickenpox resulting in serious illness, disability, and even death,” she said. “While there is still time, we urge Florida to reconsider this change to help prevent a rise of infectious disease outbreaks that put health and lives at risk.”

    Deidre McPhillips, Shawn Nottingham and CNN

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