The federal government has removed the recommendation that children and pregnant women get routine COVID-19 vaccines.
The change, reflected in new vaccine schedules posted by the Centers for Disease Control and Prevention on May 30, results from a directive announced on May 27 by Health and Human Services Secretary Robert F. Kennedy Jr., in a minute-long video posted on X.
"I couldn't be more pleased to announce that as of today the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC recommended immunization schedule," Kennedy said in the video, "We're now one step closer to realizing President Trump's promise to make America healthy again."
The reality of the recommendations is more nuanced.
Previously, the CDC had urged everyone six months and older to get annual, updated COVID shots as a routine recommendation.
Now, the CDC's vaccine schedule recommends COVID vaccines for children through shared clinical decision-making — that is, if a doctor and a patient decide together that it makes sense. And there's no recommendation for pregnant women to get COVID vaccines.
"We are relieved to see today that the U.S. Centers for Disease Control and Prevention (CDC) updated its schedules for child and adolescent immunizations to allow families to maintain the choice to immunize their children against COVID in consultation with their doctor," Dr. Susan Kressly, President of the American Academy of Pediatrics, said in an emailed statement.
"However, the deeply flawed process to reach the recommendation raises serious concerns about the stability of the nation's immunization infrastructure and commitment by federal leaders to make sure families can access critical immunizations, whether for COVID or other infectious diseases," Kressly said.
Kennedy's announcement on May 27 blindsided CDC staff, who were not informed of the change to COVID-19 vaccine policy before the decision went public, according to a CDC official who requested anonymity since they were not authorized to speak to the media.
Hours after the post on X, CDC staffers received a directive from Secretary Kennedy — dated May 19, but sent May 27 — rescinding the department's 2022 acceptance of the CDC's recommendations for the use of COVID shots in children and during pregnancy. The directive, viewed by NPR, ordered the CDC to remove these recommendations from their vaccine schedules.
The changes contradict the advice of professional medical groups such as the American Academy of Family Physicians and the American Academy of Pediatrics, who continue to recommend COVID vaccines to children and pregnant women based on scientific evidence that shows they are safe and effective. Their logos appeared on previous versions of the CDC's vaccine schedules, but are absent from the current versions as their recommendations no longer align.
Although children don't tend to get seriously ill from COVID, some do, especially very young children. Pregnant women remain at high risk for serious complications from the virus, according to the American Academy of Obstetricians and Gynecologists.
Public health experts are alarmed by how the changes were made. Typically, "it's a very transparent public process," says Dr. Sean O'Leary, a professor of pediatrics at the University of Colorado School of Medicine, who represents the AAP as a liaison to the CDC's vaccine advisory committee. "The data are shared publicly, the discussion happens publicly and then they come to a decision on how to recommend vaccines."
The closed-door process upends the public discussions and votes that have been a hallmark of vaccine policymaking for decades.
The decision will make it much harder for parents to get their children vaccinated and for pregnant people to get the shots, O'Leary says. For clinicians, "shared clinical decision-making conversations are really challenging to have in a ten-minute office visit," he says, and with a loosening of the recommendations, fewer doctors' offices may choose to keep the vaccines on hand.
Some insurance companies may no longer pay for them, says Richard Hughes, a former executive at the vaccine company Moderna, who now teaches healthcare law and policy at George Washington University. "Expect variability in coverage, prior authorization and out-of-pocket [costs], all of which will discourage uptake," he says.
The downgrading of COVID vaccine recommendations comes soon after the administration made changes that could dramatically restrict the availability of the next round of COVID boosters. The government will now require additional testing for the vaccines to be approved for use by anyone other than people who are at high risk from COVID because they are age 65 or older or have risk factors for other health problems.
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