Health and Human Services Secretary Robert F. Kennedy Jr. addresses a Senate panel this month. Marvin Joseph/The Washington Post
Coronavirus vaccines are still recommended for healthy children if their doctors approve, according to updated immunization schedules published late Thursday by the Centers for Disease Control and Prevention, contradicting Health and Human Services Secretary Robert F. Kennedy Jr.’s announcement earlier this week.
The revisions, which also say the vaccines are no longer advised during pregnancy, add to the confusion surrounding the Trump administration’s move to bypass the traditional system for immunization advice through expert review and CDC guidance.
The CDC did not remove the Coronavirus vaccines from the childhood schedule, as Kennedy said it would, when it updated its website late Thursday. Instead, the agency recommends the shots based on "shared clinical decision-making,” meaning children can get vaccinated if their parents and doctors agree.
"Where the parent presents with a desire for their child to be vaccinated, children 6 months and older may receive COVID-19 vaccination, informed by the clinical judgment of a healthcare provider and personal preference and circumstances,” the new language says.
"The CDC and HHS encourage individuals to talk with their healthcare provider on any medical decisions,” HHS spokesman Andrew Nixon said in an email Friday. "Under the leadership of Secretary Kennedy, HHS is restoring the doctor-patient relationship. If a parent desires their healthy child to be vaccinated or if a pregnant woman desires to be vaccinated, their decision should be based on informed consent through the clinical judgment of their healthcare provider.”
When announcing this week that Coronavirus vaccines would no longer be recommended for healthy children and healthy pregnant women, Kennedy did not say patients could consult doctors about the decision. He said there was a "lack of any clinical data to support the repeat booster strategy in children.”
Nixon said there was no contradiction between Kennedy’s position and the CDC’s actions. "The old recommendation that was on the vaccine schedule that said get a covid shot for a healthy kid is no longer there,” Nixon said. "The only recommendation is go talk to a health-care provider.”
Vaccine experts said maintaining a "shared clinical decision-making” recommendation for childhood coronavirus immunization should preserve parental choice and compel insurers to cover the shots. But they cautioned that it can lead to more confusion than a blanket recommendation, leading to some parents paying out of pocket or prompting some doctors to not vaccinate their patients.
"At least how some clinicians perceive it is, ‘You guys are the experts, and if you don’t know what the right thing to do is, how are we supposed to have that conversation in a 10-minute office visit?’” said Sean O’Leary, the chair of the American Academy of Pediatrics’ committee on infectious diseases.
The pediatrics association and the American College of Obstetricians and Gynecologists criticized Kennedy’s Tuesday announcement, saying it undermined public trust in vaccination policy and understated the dangers of covid. The guidance change blindsided the CDC, which did not receive a directive to alter its recommendations until hours after Kennedy’s video posted.
Federal officials have offered mixed messaging about coronavirus vaccination during pregnancy, a condition health agencies have identified as a risk factor for severe covid.
During an interview with NBC News this week, Food and Drug Administration Commissioner Marty Makary said the decision to receive updated Coronavirus vaccines "should be between a doctor and a pregnant woman.”
But the updated CDC immunization schedule for adults instead says covid vaccination should be delayed until after pregnancy, which experts said would make it much less likely that insurers would cover it during pregnancy.
Nixon, the HHS spokesman, did not respond to a request for comment to explain the discrepancy.
Richard Hughes IV, who teaches vaccine law at George Washington University Law School, said the messy implementation of the new vaccine recommendations raises questions about federal health officials’ approach.
"They are running roughshod over processes when they are doing all this. They’re just sort of trying to implement the biased positions that they came in with,” said Hughes, a former vice president of public policy at Moderna, a coronavirus vaccine manufacturer. "I don’t think they thought it through a lot.”
