It was, in a word, unprecedented.
As Helen Branswell, STAT’s infectious diseases correspondent, explains in this video, Monday’s move by the Department of Health and Human Services — political appointees of health secretary Robert F. Kennedy Jr. — to unilaterally rewrite the list of vaccines recommended for all American children broke new ground. Until now, the list of vaccines has been derived via a lengthier and far more transparent process driven by longtime vaccine experts.
“It’s jaw-dropping for people who work in this field,” said Branswell. “For several political appointees … to come up with a new schedule instead of the scientists who work at the CDC who work with an expert panel — it’s just not the way this is normally done.”
Kate O’Brien, the head of the World Health Organization’s division of immunization, vaccination, and biologicals, told STAT she has never seen a situation where a country rewrote its childhood vaccine status to remove multiple established and demonstrably safe vaccines in this way. The analysis that HHS used to justify the move did not present data to suggest the current schedule — or individual vaccines within it — was unsafe.
“Recommendations should be based on biology, science, evidence, and the attributes of the country in which those are being made,” O’Brien said.
“Vaccination programs all around the world have won the trust of parents, grandparents, communities, families, doctors, because they’re based on evidence,” she said. “So I think the concern is when decisions are made that are not following the processes that are recommended to be in place.”
Previously decisions about which vaccines should be recommended for American children have been the purview of a committee of experts that advises the Centers for Disease Control and Prevention and have involved extensive review of the safety, efficacy, and cost-benefits of individual vaccines. That committee, now stacked with Kennedy appointees, had indicated it planned to review whether children need all the vaccines recommended for them.
But the leadership of HHS, with the apparent blessing of the White House, decided not to wait, announcing it was shaving multiple vaccines off the list of inoculations recommended for all children, taking the U.S. core list from 17 to 11. While the rationale given was that this was bringing U.S. policy in line with peer nations, in fact it puts the country almost at the bottom of the list in terms of vaccines recommended. Most of the countries on the list of peer countries recommend several more.
Vaccines struck from the core list should still be available, HHS officials argued, with some targeted to children at high risk of the particular disease and others an option for parents who choose to give them to their children after discussion with a health professional. Among those no longer recommended for all are monoclonal antibody shots that pediatricians have described as game-changers in helping infants get through RSV season, and which parents have clamored for.
