Why pediatricians are breaking with the CDC on childhood vaccines

In early December, the Advisory Committee on Immunization Practices — the body that advises the Centers for Disease Control and Prevention on vaccine recommendations — voted to remove its universal recommendation that all newborns receive the hepatitis B vaccine at birth. And, as of the New Year, the CDC, under the direction of Secretary of Health and Human Services Robert F. Kennedy Jr., has continued to discredit childhood vaccine recommendations.

It now states vaccines against rotavirus, COVID-19, influenza, meningococcal disease and hepatitis A are also not necessary for all children.

These recommendations are unsafe, and children will suffer and even die because of them. The World Health Organization notes that vaccines prevent 3.5 million to 5 million deaths every year "from diseases like diphtheria, tetanus, pertussis (whooping cough), influenza and measles."

So why eliminate protections that have prevented so many illnesses and deaths? Particularly when no new data has been presented or clinically documented to inform this change.

The answer lies, in large part, with who is now making these decisions.

RFK Jr. is not a medical doctor or a health care worker. He is an attorney by training. His views on medical and public health matters are not grounded in clinical education or patient care experience. RFK Jr. has not spent four years in medical school and between three to eight years in post-medical school training and research to know how to protect your children. He has not witnessed countless children die in their heartbroken parents’ arms from illnesses that could have been prevented by a vaccine.

Additionally, the current Advisory Committee on Immunization Practices includes an obstetrician-gynecologist, a neuroscientist, a business researcher, a pediatric cardiologist, an emergency medicine physician, a transplant physician, a tuberculosis researcher and a registered nurse with publicly documented ties to anti-vaccine groups. Only one member, Dr. Cody Meissner, is a pediatric infectious disease specialist.

This represents a stark departure from previous advisory committees, which included multiple pediatric and adult infectious disease experts, public health leaders from state health departments, immunization program directors, epidemiologists and vaccine education specialists. Listing credentials may sound tedious, but expertise matters — especially when deciding national policy for children who cannot decide for themselves.

The consequences of this shift are already apparent. We are seeing consistent refusal of immunizations in our clinics, and measles outbreaks are increasing, as seen in South Carolina recently.

Stick with AAP guidelines

In response, the American Academy of Pediatrics — the professional organization representing more than 67,000 pediatricians across the U.S. — has taken the extraordinary step of breaking from this recent CDC guidance. The academy continues to recommend that all children receive all 17 vaccines, starting in infancy through adolescence.

This recommendation preserves the integrity of these vaccinations, including rotavirus, COVID-19, flu, meningococcus, hepatitis A and B.

Rotavirus is a severe gastrointestinal illness that can severely dehydrate young children. Hepatitis (A and B) can result in severe liver injury, and hepatitis B particularly can lead to chronic liver disease and even liver cancer. Influenza cases are currently mounting throughout our health care system, including our own children’s hospital.

Potentially the most problematic of all the ill-advised recommendations is to remove universal recommendations for the meningococcal vaccine, which prevents meningococcal meningitis. This vaccine prevents a life-threatening illness that can result in permanent brain damage, hearing loss and death. This disease can also manifest as a systemic illness that can cause organ failure and limb loss in a matter of hours. It is one of the most horrific illnesses we as pediatric infectious disease experts treat.

We understand how confusing — and unsettling — it is for parents to see government guidance diverge from their pediatrician’s advice. For much of our medical training, the CDC’s recommendations were a definitive gold standard. But we have reached a moment when pediatricians must scrutinize those recommendations just as carefully as the public has been urged to scrutinize vaccines themselves.

And increasingly, the American public must rely on the academic institutions dedicated to the service of their health, including the American Academy of Pediatrics, the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society. All are easily accessible on the internet.

The evidence is clear. These vaccines are safe, effective and lifesaving. Removing universal recommendations places children at unnecessary risk.

When it comes to protecting children from preventable, potentially deadly diseases, pediatricians are choosing evidence over politics. We urge parents to do the same and follow the guidance of the physicians whose careers are devoted to improving children’s health and preventing them from getting sick in the first place.

Dr. Kristen Kelly is a second-year pediatric infectious disease fellow at the University of Chicago with specific interests in vaccine hesitancy and antimicrobial stewardship. Dr. Madan Kumar is an assistant professor and a pediatric infectious disease physician at the University of Chicago with expertise in immunocompromised hosts and medical education.