CDC’s Newly Revised Guidelines Reduce the Number of Immunizations Recommended for All Kids
by DEMI GUILLORY
In early January, the CDC announced changes to the U.S. childhood vaccination schedule, reducing the number of immunizations regularly recommended for all children.
The new guidelines break the vaccines into the following categories:
Recommended for All Children
- MMR
- Polio
- Chickenpox
- DTaP
- TDaP
- Hib
- PCV
- HPV
- Polio
Recommended for Those at High Risk
- RSV
- Hepatitis A
- Hepatitis B
- Meningococcal
- Dengue
Based on Shared Clinical Decision-Making
- Rotavirus
- Covid-19
- Flu
While the new recommendations aren’t a mandate, the CDC’s guidelines have previously been used to guide insurance and school admission requirements.
Dr. Sergio Seoane, who made clear he was speaking as an individual physician and that his views do not represent the position of the Polk County Medical Association, shared multiple concerns regarding the new recommendations, and they go far beyond worrying they will result in lower vaccination rates.
“These recommendations have circumvented the time-tested, structured, evidence-based approach we have had for decades,” he says, adding that the Advisory Committee on Immunization Practices and the American Academy of Pediatrics were not consulted.
In addition, Seoane says, “De-emphasizing vaccinations and decreasing universal recommendations may lead to insurance companies denying coverage. Insurance companies do not need another excuse to deny care and treatment.”
Seoane also disagrees with the comparison tactics used to reformulate the recommendations, which he calls confusing because of the new tiered system.
“Using Denmark and Japan as a benchmark for comparison to the United States regarding healthcare is flawed.” He goes on to cite the many differences between the countries, including size, healthcare systems, ethnic diversity, and population.
“Making vaccination comparisons between the USA and Denmark is misleading at best.”
Having the Important Discussions
The announcement has drawn reaction from parents who are looking for guidance from trusted medical professionals.
BayCare Kids Medical Director Dr. Christina Canody says the number one piece of advice is for parents to have an open conversation with their child’s pediatrician.
“I caution families not to make a rash decision based on this change from one body and to really have that discussion and look at all the recommendations that are out there,” Canody says.
While the CDC has removed universal recommendations for rotavirus, influenza, meningitis, RSV and Hepatitis A and B, Canody notes that the American Academy of Pediatrics, who works closely with pediatricians, has not made any changes to its recommendations.
“This is the first time in the history of our vaccination schedule that there is a difference between the CDC and the American Academy of Pediatrics (AAP),” she adds, acknowledging the uncertainty parents may be feeling about the conflicting recommendations.
The changes to the CDC vaccination schedule are what Canody views as an opportunity for parents to build a rapport with their child’s doctor, if they haven’t already.
One of the components of the updated schedule, Canody emphasizes, is that it is a recommendation that not every child gets those vaccines, however those considered high risk or whose doctor recommends the vaccine are encouraged to have those conversations.
“This really changes some of the thinking, not so much to not get the vaccines but [encourages] shared decision making with parents and caregivers as well as their physician,” she explains.
For Canody, who already advocates for this in her practice, the CDC’s change, while significant, reinforces her belief that parents should be actively involved in their child’s health care.
“From my standpoint, nothing really changes; those are things that I’ve always recommended, and I will continue to recommend.”
As a medical professional, she also understands the concern from those within the community.
“Vaccines are developed truly to decrease morbidity and mortality as well as the disease burden for children experiencing illness,” she states. Early vaccinations, she added, protect children against conditions that have historically put them at greater risk, such as death or severe illness. “[Those illnesses] are really the ones that have been the target of developing vaccine strategy.”
Lower Vaccination Rates a Top Concern
With the removal of these major vaccines from the CDC’s recommendation, many in the medical field, including Canody, are cautioning that lower vaccination rates could impede the strides made in protecting children against certain illnesses.
“During the last 25 years of my career, we have seen illnesses, such as rotavirus, almost completely decreased as far as the cause of hospitalization,” Canody elaborates. “Early on in my practice, rotavirus was the number one cause of hospitalization for kids under two for vomiting and dehydration.”
She says the vaccine for rotavirus has had a dramatic effect on the number of cases in her pediatric patients, estimating a drop of between 90 and 95 percent.
“If we take the process and the progress that we have made against decreasing the rates of illness and the rates of hospitalizations and doctor visits for these illnesses, then we will see those increase,” she says.
Younger children are not the only ones at risk for contracting meningitis. College campuses, according to Canody, have frequent outbreaks on campus even with required meningitis vaccinations for students living on school grounds or in dorms. Additionally, the RSV vaccine is “a vaccine for pregnant moms, for children,” she says.
“The risk for [RSV] is just being a child. Ninety-seven percent of all children have that disease by the time they’re 2 years old, so there is a high risk just with the term ‘healthy newborn.’ It’s not just the kids at the highest risk because those kids are at high risk because it affects all children equally.”
Ultimately, Canody believes the best decision is the most informed decision and one that protects the children.
“The biggest issue that we see is that the kids are going to have to suffer with these illnesses as a result of these decisions being made.”