The federal government has drastically reduced the number of recommended childhood vaccines, excluding six routine immunizations that have protected millions of people from serious illness, organ failure and death.
Only three of the six hepatitis A, hepatitis B and rotavirus vaccines, which are no longer routinely recommended by the U.S. Centers for Disease Control and Prevention (CDC), have prevented nearly 2 million hospitalizations and more than 90,000 deaths over the past 30 years. Publications from the same institution.
Vaccines for these three diseases, including respiratory syncytial virus (RSV), meningococcal disease, influenza and COVID-19, are now only recommended for children at high risk for severe disease or only after ‘shared clinical decision-making’, i.e. consultation between doctors and parents.
CDC maintains recommendations for 11 childhood vaccines: measles, mumps, and rubella; whooping cough, tetanus, and diphtheria; A bacterial disease known as Hib; pneumonia; polio; varicella; and human papillomavirus (HPV).
According to information sheet Public and private health plans from the Department of Health and Human Services (HHS) will continue to cover vaccines for diseases that are no longer universally recommended by the CDC. Parents who wish to vaccinate their children against these diseases do not need to pay for vaccinations out of their own pocket.
Pediatric disease experts were perplexed by the change in guidelines. HHS said the modifications were made after a “scientific review of the evidence” and are consistent with immunization programs in other developed countries.
Secretary of Health and Human Services Robert F. Kennedy Jr., an anti-vaccination activist, cited Denmark as a model. However, the vaccination schedules of most European countries are more similar to the recently revised U.S. standards.
For example, in Denmark, where rotavirus vaccination is not available, there are approximately 1,200 hospitalizations per year among infants and young children due to this infection. In a country of 6 million people, this rate is similar to the rate in the United States before the introduction of the vaccine.
“They accept the fact that 1,200 to 1,300 children are admitted to the hospital, and that’s just the tip of the iceberg when you consider what they’re going through,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and co-inventor of the approved rotavirus vaccine. “We don’t accept that. They should try to imitate us, not the other way around.”
Public health officials said the new guidelines place the onus on parents to research and understand each childhood vaccine and why it is important.
The following is a summary of diseases that can be prevented with vaccines but have been neglected.
VRS. Respiratory syncytial virus is the most common cause of infant hospitalization in the United States.
This respiratory virus is mainly prevalent in the fall and winter and causes cold-like symptoms, but can be fatal to young children. There are tens of thousands of hospitalizations and hundreds of deaths each year. According to the National Foundation for Infectious Diseases, about 80% of children under 2 years of age hospitalized with RSV have no identifiable risk factors. A long-awaited vaccine against this disease will be released in 2023.
Hepatitis A. Hepatitis A vaccination, phased in in the late 1990s and recommended for all young children from 2006, has reduced cases by more than 90% since 1996. This foodborne virus causes a very unpleasant illness that still affects adults, especially those who are homeless or use drugs or alcohol. It was reported in 2023. total The cumulative number of confirmed cases is 1,648, and the number of deaths is 85.
Hepatitis B The disease causes liver cancer, cirrhosis, and other serious diseases, and is especially dangerous for infants and young children. Hepatitis B virus is transmitted in microscopic amounts through blood and other body fluids and can survive on surfaces for up to a week. Between 1990 and 2019, vaccination reduced reported cases of acute hepatitis B in children and adolescents by 99%. Pediatric liver cancer has also decreased significantly thanks to universal childhood immunization. However, the virus still exists, with 2,000 to 3,000 acute cases reported each year among unvaccinated adults. In 2023, more than 17,000 cases of chronic hepatitis B will be diagnosed. The CDC estimates that about half of infected people do not know they are infected.
Rotavirus. Before routine administration of the current rotavirus vaccine began in 2006, about 70,000 children were hospitalized each year and about 50 died from the virus. “This is known as winter vomiting syndrome,” explains Sean O’Leary, a pediatrician at the University of Colorado. “It was a terrible disease that you don’t see anymore.”
But the virus is still common on surfaces that babies touch, and “if vaccination rates drop, children will be put back in the hospital,” Offit warned.
Meningococcal vaccine. These vaccines are primarily needed for adolescents and college students, who are particularly vulnerable to serious illness caused by these bacteria. Although 600 to 1,000 cases are reported each year in the United States, more than 10% of patients die and one in five survivors becomes permanently disabled.
Flu and Corona. These two respiratory viruses have caused the deaths of hundreds of children in recent years, but tend to be more serious in older people. There is currently a resurgence of flu in the country, and 289 minors died from this cause last season.
What is shared clinical decision making?
Under the new changes, decisions about whether to vaccinate children against flu, COVID-19, rotavirus, meningococcal disease and hepatitis A and B will now depend on what authorities call “shared clinical decision-making.” That means families should talk to their health care provider to determine if a vaccine is right for their child.
“This means that health care providers must have conversations with patients to explain the risks and benefits and make personalized decisions,” he said. Lori HandyHe is a pediatric infectious disease specialist at the Children’s Hospital of Philadelphia.
Previously, the CDC used the term only in very specific situations, such as when determining whether people in monogamous relationships needed the HPV vaccine, which prevents sexually transmitted diseases and certain types of cancer.
According to Handy, given the proven protective benefits that vaccines provide for the majority of the population, the CDC’s new approach is inconsistent with scientific evidence.
In a report justifying the change, HHS officials Tracy Beth Høeg and Martin Kulldorff said the U.S. vaccination system needs more safety studies and greater choice for parents. They said overly broad vaccination schedules, in part, have led to a loss of trust in public health, leading to more families refusing vaccines against major threats such as measles.
The vaccine in the revised schedule by the CDC had already undergone extensive safety studies when it was evaluated and approved by the Food and Drug Administration (FDA).
“These vaccines have a higher safety standard than any other medical intervention we use,” Handy said. “The value of regular recommendations is to help the public understand that these vaccines have been vetted on all fronts.”
Eric BallA pediatrician in Orange County, California, said the guideline change would create more confusion among parents who might think it’s the vaccine’s safety that’s at issue.
“It is important for public health that vaccine recommendations are very clear and accurate,” Ball said. “Anything that causes confusion will only lead to more children getting sick.”
Ball explained that limited counseling time often has to be used to convince parents that vaccines are safe instead of focusing on the child’s medical needs. The fact that vaccines fall under ‘shared clinical decision-making’ has nothing to do with safety issues, but many parents may interpret it that way.
The HHS changes do not affect state vaccination laws, so your doctor should be able to continue recommending the vaccine as before. Richard Hughes IVis a lawyer and professor at George Washington University who is leading the lawsuit against Kennedy over the vaccine changes.
“You can expect any pediatrician to follow solid scientific evidence and recommend vaccination to their patients,” he said. He said the law protects providers who follow professional guidelines for treatment, adding, “RSV, meningococcal disease and hepatitis remain serious threats to the health of children in this country.”
