US cuts broad recommendation for four childhood vaccines

• Parents are advised to decide with doctors in the context of shared decision making.
• Experts warn that the rollover could lead to avoidable hospitalizations and deaths.
• Vaccine experts condemn the changes, which they say puts America’s children at risk.
  

WASHINGTON: The United States on Monday ended its long-standing directive that all children get shots against the flu and three other diseases, a sweeping change that advances one of Health Secretary Robert F Kennedy Jr’s long-term goals.

Public health experts warn that the latest twist could lead to avoidable hospitalizations and deaths.

The action, which removes the recommendation for rotavirus, influenza, meningococcal disease and hepatitis A and states that parents should consult with health care providers under what he calls shared clinical decision making, was approved by Centers for Disease Control and Prevention Deputy Director Jim O’Neill without the agency’s usual external review. Promotes Kennedy’s campaign to ease childhood vaccinations.

Last month, President Donald Trump urged the US to “get in line with other developed countries” in reducing the number of shootings of children.

Trump said the new program was rooted in the Gold Standard of Science and brought the United States in line with other developed countries. In a post on the Truth Social platform, the president congratulated Kennedy and other health officials on the change.

“Many Americans, especially “MAHA moms”, have been praying for these COMMON SENSE reforms for many years. Thank you for your attention to this matter!” he wrote, referring to Kennedy’s Make America Healthy Again movement.

Kennedy, a prominent vaccine critic, has previously led efforts to reject universal recommendations for Covid-19 and hepatitis B vaccines for children, citing links to autism that scientists have repeatedly debunked.

American children at risk

Vaccine experts decried the changes, which they said put America’s children at risk.

Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said there should have been a public debate about the risks and benefits of the potential impact of withdrawing the recommendations.

Dr. Sean O’Leary, president of the American Academy of Pediatrics, said other developed countries face different disease risks and have different health care systems than the United States. Unlike the US, which depends on private healthcare, most countries provide basic universal healthcare paid for by the government.

“Any decision about the U.S. childhood vaccination program should be based on evidence, transparency, and sound scientific procedures, not on comparisons that overlook critical differences between countries or health systems,” he said.

The vaccination policy of 20 nations is examined

To change the policy, two top officials at the Department of Health and Human Services, Martin Kulldorff and Tracy Beth Hoeg, reviewed vaccine protocols in 20 other developed countries — all of which have universal health care — and made the recommendations to change the U.S. program, the agency said.

In a report, HHS wrote that the level of risk varies by disease and child.

The vaccine programs of the 20 countries examined show that the influenza vaccine is recommended globally in four countries and the hepatitis A vaccine is only recommended in Greece. Rotavirus vaccine is recommended for all children in 17 of 20 countries, and meningococcal vaccines are recommended in 16.

Each of the four vaccines prevents diseases that once caused unnecessary hospitalizations and death in children, said Dr. Jesse Goodman, a Georgetown University professor and former FDA chief scientist.

Flu shots can help prevent childhood deaths from the flu, which killed 288 children in 2024-25, according to the CDC. Hepatitis A, which infects the liver, usually goes away on its own, but can lead to hospitalization and lifelong liver damage.

Rotavirus, which causes severe diarrhea and dehydration, used to send tens of thousands of children to the hospital each year, but vaccines have made that extremely rare, Goodman said.

While meningitis, a bacterial infection of the brain, is rare in children, about 15 percent of those infected do not respond to antibiotics and die, he said. “If you can safely prevent it, it makes perfect sense.”

The updated recommendations maintain vaccinations for 11 diseases, including measles, mumps and chickenpox, while categorizing others as targeted high-risk groups or subject to shared decision making, HHS said.

Insurance providers will continue to cover vaccination costs regardless of category, senior HHS officials told reporters in a phone call.

The new program also recommends that US children receive a single dose of the human papillomavirus (HPV) vaccine, rather than a two-dose course. Recent studies have concluded that a single dose is non-inferior to longer duration and noted that the World Health Organization also supports a single dose schedule.

Merck, which makes Gardasil, the only US-approved HPV vaccine, was not immediately available for comment. The drugmaker said that since there are insufficient data for the US FDA to license the vaccine as a single-dose regimen, the CDC’s recommendations should be consistent with the agency’s approval.

Merck recorded $2.4 billion in U.S. sales of Gardasil in 2024.