Uncertainty rises in wake of CDC vaccine overhaul: 4 notes

Several states are rejecting the CDC’s changes to the U.S. childhood immunization schedule, reaffirming their commitment to long-standing vaccine guidance amid growing confusion among patients, providers and public health leaders.

The federal update on Jan. 5 removed routine, age-based recommendations for six pediatric vaccines — flu, COVID-19, hepatitis A and B, rotavirus and meningococcal disease — and instead placed them under “shared clinical decision-making,” a model in which immunization is left to family-clinician discussion. Insurance coverage is still required, but public health experts warn the shift may fuel distrust and lower uptake, especially as measles outbreaks and other vaccine-preventable threats reemerge.

California, Maryland, Illinois, Minnesota and Pennsylvania are among the states that said they will continue following the American Academy of Pediatrics’ full 17-vaccine schedule. Medical groups have also pushed back, saying the CDC changes were made without sufficient scientific review and could erode hard-won progress in childhood immunization.

Here are four more updates on the CDC’s vaccine overhaul:

1. Career CDC scientists say they were shut out.

Multiple CDC staffers said they learned of the policy change only after it was finalized. The Advisory Committee on Immunization Practices was not consulted, despite its statutory role in reviewing vaccine guidance. One agency physician resigned in protest, according to a Jan. 7 report from The Washington Post.

2. Public confusion is widespread.

In December polling by the Annenberg Public Policy Center, 25% of adults thought “shared decision-making” meant discussing vaccines with family, and 13% were not sure what the term meant at all. The CDC defines it as a provider-parent conversation for vaccines not universally recommended. Public health experts say that lack of clarity may deepen mistrust and lead to lower uptake, particularly as providers, parents and pharmacies navigate mixed signals.

3. Dozens of medical groups are calling for reversal.

A Jan. 7 letter signed by more than 70 organizations, including the American Medical Association and the Infectious Diseases Society of America, urged HHS to restore the previous recommendations. The letter criticized the absence of scientific review and warned the change “increases the risk of preventable diseases, hospitalizations, and death.”

4. The scientific rationale is in dispute.

Internal CDC slides presented in December showed the U.S. is aligned with peer countries — and is not an outlier — in both vaccine targets and dose counts. The Denmark model cited by HHS vaccinates against fewer pathogens than the U.S., Canada, Germany and Australia, according to The Washington Post, which reviewed the internal comparison prepared by CDC scientists before the policy change.

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