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Tag: Vaccine Guidance

  • What should parents do about the CDC’s new vaccine recs? We asked NC experts

    The Centers for Disease Control and Prevention (CDC) recently updated the U.S. Childhood vaccination schedule, reducing the number of diseases for which vaccines are universally recommended.

    Under the revised guidance, several vaccines that had been standard for all children will now instead be recommended primarily for high-risk groups or through shared clinical decision-making between families and healthcare providers, rather than automatically for every child.

    The vaccines no longer universally recommended for all children are those protecting against:

    • Rotavirus
    • Influenza 
    • COVID-19
    • Hepatitis A
    • Hepatitis B
    • Respiratory Syncytial Virus (RSV)
    • Meningitis

    In a statement posted Monday, American Academy of Pediatrics (AAP) President Dr. Andrew D. Racine called the decision to update the vaccine schedule “ill-considered” and said it will “sow further chaos and confusion and erode confidence in immunizations.”

    “This is no way to make our country healthier,” he wrote.

    The updated schedule still recommends routine vaccination for diseases such as measles, mumps, rubella, polio, pertussis, tetanus, HPV and chickenpox for all children.

    However, the shift has presented questions about what health professionals are recommending, whether insurance will continue to cover the cost of the vaccines and whether the updates will lead to lower vaccine uptake in the state.

    Here’s what you need to know.

    Which vaccines are doctors recommending?

    Despite recent changes to the vaccine schedule, doctors are recommending that parents continue following the schedule released by the AAP, Dr. Zach Willis, a pediatric infectious disease specialist at UNC Health, told The Charlotte Observer.

    “The data that supports the recommendations for those vaccines has not changed, and there hasn’t been a significant update to the interpretation of the data,” Willis said. “The vaccine schedule is something that has been built very meticulously over the years. There is a very strong reasoning for every dose of every vaccine that’s recommended, and they’ve been tested.”

    State health officials echoed that guidance, emphasizing that the underlying science supporting childhood vaccines has not changed.

    “Vaccines remain one of the most effective means available to prevent severe illness, hospitalization and death,” a NCDHHS spokesperson told The Observer in an email. “NCDHHS recommends that clinicians continue to rely on their clinical training and professional judgment and consult information published by the American Academy of Pediatrics and the American Academy of Family Physicians when engaging in shared clinical decision-making with parents, caregivers and patients.”

    Here’s when the vaccines that are no longer universally recommended by the CDC are recommended by the AAP:

    • Rotavirus: First dose at two months, second dose at four months
    • Influenza: One or two doses annually from ages six months to six years, the one dose annually for ages seven and up
    • COVID-19: At least one dose of the 2025-2026 vaccine after six months
    • Hepatitis A: First dose at 12 months, then a second dose six months after
    • Hepatitis B: First dose at birth, second dose at one month and a third dose at six months
    • Respiratory Syncytial Virus (RSV): Seasonal administration during pregnancy if not previously vaccinated
    • Meningitis: Two doses anytime between the ages of 11 and 12, then a booster dose between the ages of 16 and 18

    A nurse readies a syringe during a vaccination.
    A nurse readies a syringe during a vaccination. Matt Stone/The Louisville Courier Journal Matt Stone/The Louisville Courier Journal / USA TODAY NETWORK

    Will insurance still cover the cost of vaccines?

    Yes, Willis said.

    “The new guidance put out by does not, in any way, prevent any parent or child, or any person from getting the vaccines according to the schedule,” he added.

    Willis also emphasized that federal programs, such as Medicare, Medicaid and the Vaccines for Children program will still cover the cost of vaccines, even if they’re not recommended.

    That means most people will still save hundreds of dollars on vaccines, such as COVID-19, which carries an out-of-pocket cost of more than $200 at some pharmacy chains, The Charlotte Observer reported.

    Will the updated schedule lead to lower vaccination rates?

    It could, Willis said.

    “That is certainly the concern,” said Willis. “I think that there are certainly a lot of folks who follow the vaccine recommendations very closely, but I think for the vast majority of people, they just accept the recommendations that their child’s primary care provider gives them.”

    Recent data show that vaccine uptake for certain shots has already gone down.

    N.C. Department of Health and Human Services data show just 20% of North Carolina residents have been vaccinated against the flu this season, with Mecklenburg and Wake counties at 20% and 25%, respectively. Those rates are lower than usual, as most counties are typically 30–50% vaccinated by this point, Dr. David Weber, an infectious disease specialist at UNC Health, previously told the Observer.

    “It depends obviously on age and risk factors,” he added. “It’s not surprising that older people who are at higher risk are more likely to be immunized.”

    A recent measles exposure in Gaston County, just west of Mecklenburg, also has health officials worried.

    Dr. David Wohl, an infectious disease specialist at UNC Health, previously told the Observer that vaccination rates in North Carolina are likely not high enough to prevent an outbreak.

    While the state’s overall vaccination rate is relatively high, coverage varies widely by community, Wohl said, and those gaps matter. He noted that measles is far less likely to spread when about 95% of people are vaccinated, but even small drops into the low 90s can significantly increase risk.

    In areas where MMR rates fall into the 80% range, he said, a single case can quickly ignite an outbreak, calling it “a forest fire waiting to happen.”

    What can parents do to protect their children?

    Though the vaccine schedule changes could lead to lower vaccination rates, Willis said those who are vaccinated have little to worry about.

    “I don’t think that we’re in a situation where anybody needs to live in fear,” Willis said, noting that people who are immunocompromised may need to be more cautious in public settings. “If a parent is immunocompromised themselves, or has a child who’s immunocompromised, they should talk to their specialist who manages that condition.”

    Related Stories from Raleigh News & Observer

    Evan Moore

    The Charlotte Observer

    Evan Moore is a service journalism reporter for the Charlotte Observer. He grew up in Denver, North Carolina, where he previously worked as a reporter for the Denver Citizen, and is a UNC Charlotte graduate.

    Evan Moore

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  • 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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  • Science in the Spectacle

    On Monday, September 22nd, millions of Americans tuned in to watch our nation’s leaders announce a correlation between the common pain reliever acetaminophen (Tylenol) and autism. As no surprise, the language was unprofessional and accusatory. The press conference was chaotic, but behind the chaos, some good points were made.

    The central claim was simple: studies have raised questions about whether prenatal use of acetaminophen may increase the risk of autism or ADHD in children. The reality is far more complicated. The science is not settled. Some research suggests a weak association, while others find no link. No causal connection has been proven. What is certain is that millions of pregnant women rely on acetaminophen as one of the few safe over-the-counter options. The stakes of this announcement were enormous.

    Instead of offering clarity, it produced confusion. Pregnant women across the country were left wondering whether to throw away the only medication their doctors had long assured them was safe. Wondering if they were the reason their child has autism. Families who already distrust government health guidance now feel more justified in ignoring medical advice. Meanwhile, pharmaceutical companies are demonized without evidence, as though medicine itself were the enemy.

    This is the wrong way to communicate science.

    We’ve seen this play out before. From the mixed messaging during COVID to the ever-shifting vaccine guidance, Americans have been whiplashed by a stream of warnings and politically charged statements. Each time, trust erodes more. Announcing an unsettled scientific finding with the flourish of a campaign rally doesn’t inform people; it terrifies them.

    To me, the CDC isn’t just a federal agency; it’s my neighbor. I walk past its gates on my way to class. Inside those buildings, scientists are undertaking some of the most challenging work in the world. Outside those gates, their voices are drowned out by politicians who treat public health like a prop. That disconnect, between the science and the show, is exactly why trust in health institutions is in freefall. To be clear: it is right for the government to investigate potential risks to maternal and child health. It is right to be cautious, to study the data, to give families the best information available. But how we share that information matters. Panic is not prevention.

    Warning without context is not protection.

    So what should have happened? First, the announcement should have come from scientists. The CDC and FDA should be leading these conversations, explaining clearly what we know, what we don’t, and what research is underway. Second, the message should have included practical guidance for patients: Talk to your doctor. Don’t stop medications abruptly. Watch for further updates as studies progress. Finally, the rollout should have modeled humility, the courage to say, “We’re still learning.” That kind of honesty builds trust, not fear.

    Millions tuned in hoping to learn whether Tylenol is safe. What they got instead was another reminder of how fragile trust in public health has become. We deserve better than a circus.

    The opinions expressed in this commentary are those of the writer and not necessarily those of the The Atlanta Voice.

    Caroline Rubin

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