The American Academy of Pediatrics on Monday released new childhood immunization recommendations that break sharply with updated guidance issued earlier this month by the Centers for Disease Control and Prevention, marking an unusual public split between the nation’s leading pediatric group and federal health officials.
The AAP said it will continue to recommend routine immunization against 18 diseases, including respiratory syncytial virus, hepatitis A and B, rotavirus, influenza and meningococcal disease. The CDC’s revised schedule pared that list back to 11 diseases, limiting several vaccines to children deemed at high risk.
“The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children and adolescents of this country,” AAP President Dr. Andrew Racine said in a statement.
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Dr. Amanda Kravitz, a pediatrician at Weill Cornell Medicine in New York, said the AAP’s guidance effectively preserves the long-standing vaccine schedule.
“There are no changes to the old vaccine schedule based on what the AAP is currently recommending,” Kravitz told CBS Evening News. “We are still recommending all of the vaccines that we have been recommending for many, many years.”
Where the guidance overlaps — and diverges
Both the AAP and CDC continue to recommend routine vaccination against diphtheria, tetanus and pertussis; Haemophilus influenzae type b; pneumococcal disease; polio; measles, mumps and rubella; human papillomavirus; and varicella, or chickenpox. Some vaccines, such as the MMR shot, protect against multiple diseases.
But the CDC’s revised schedule limits routine vaccination for RSV, hepatitis A, hepatitis B, dengue and meningococcal disease to children considered high risk. For children outside those categories, the agency said parents should rely on “shared clinical decision-making” with physicians for vaccines including COVID-19, influenza, meningococcal disease and hepatitis.
The AAP rejected that approach, continuing to recommend nearly all of those vaccines broadly. The lone exception is dengue, which the AAP recommends only for certain children ages 9 to 16 who live in endemic areas and have previously been infected. The group also noted that distribution of the dengue vaccine in the U.S. was discontinued last year because of low demand.
“This is unprecedented,” said Dr. Céline Gounder, a CBS News medical contributor and editor-at-large for public health at KFF Health News. “The AAP and the CDC have worked in concert for decades.”
She added that the AAP’s updated guidance closely mirrors the CDC’s recommendations prior to the current administration.
Criticism of federal changes
The AAP has been sharply critical of the CDC’s revised schedule since it was released, calling the changes “dangerous and unnecessary” and warning they could lead to preventable outbreaks.
“The AAP formerly partnered with the CDC to create a unified set of vaccine recommendations, but recent changes to the CDC immunization schedule depart from longstanding medical evidence,” the organization said Monday. “By contrast, the AAP schedules continue to recommend immunizations based on the specific disease risks and health care delivery in the United States.”
The CDC is overseen by the Department of Health and Human Services, now led by Secretary Robert F. Kennedy Jr., a longtime vaccine skeptic. The revised guidance followed a controversial December vote by the CDC’s vaccine advisory committee — reconstituted under Kennedy — to delay the first dose of the hepatitis B vaccine for some newborns until two months of age, reversing more than three decades of practice recommending vaccination within 24 hours of birth.
Administration response
HHS defended the changes Monday, saying the updated schedule “continues to protect children against serious diseases while aligning U.S. guidance with international norms.”
The department said it would “work with states and clinicians to ensure families have clear, accurate information to make their own informed decisions.”
Kennedy has repeatedly said the administration is not banning vaccines. In an interview earlier this month, he said vaccines would remain covered by insurance, but acknowledged new hurdles, including requiring physician consultations for flu shots rather than allowing routine pharmacy administration.
He also suggested it might be “a better thing” if fewer people receive the flu vaccine, comments that drew swift backlash from public health experts.
What parents are being told
Pediatricians urged parents not to panic over the conflicting guidance and emphasized that insurance coverage remains intact.
“The way the CDC recommended them, there is still the option to get those vaccines if you’d like them,” Kravitz said. “Insurance should cover every vaccine as long as parents want them.”
She encouraged families to speak directly with their pediatricians.
“We are here to help you,” Kravitz said. “We want to rid some of the confusion from families, and we want to keep open lines of communication.”
