The Centers for Disease Control and Prevention (CDC) has introduced a new approach to the childhood vaccination schedule, classifying vaccines into three categories: for all children, for high-risk groups, and based on shared clinical decisions. This change seeks to align the US schedule with those of other developed countries.
“President Trump directed us to examine how other developed countries protect their children and take action if they do better,” Health Secretary Robert F. Kennedy Jr. said in a statement. “After a thorough review of the evidence, we are aligning the US childhood vaccination schedule with international consensus, while reinforcing transparency and informed consent. This decision protects children, respects families and rebuilds trust in public health,” he noted. Associated Press (AP).
This change has been met with criticism from several doctors and public health experts. Concerns have been raised about the lack of prior discussion and adequate consultation with pediatric and infectious disease specialists.
Experts such as Dr. Dave Margolius, internist and public health director for the city of Cleveland; and Demetre Daskalakis, former director of the CDC’s National Center for Immunization and Respiratory Diseases, have said that the new vaccination schedule has not adequately considered the unique characteristics of the American health system. Confidence in the government’s ability to protect children has been seriously shaken.
Senate criticism
Republican Senator Bill Cassidy has disapproved of the changes, arguing that the decision lacks scientific basis and could create unnecessary fear in parents and doctors. He states that, although the new scheme is not mandatory, it does affect the perception of vaccination safety.
With the change in the calendar, the implication of these new guidelines on public health and childhood vaccination in the United States is debated. The lack of consensus between health authorities and doctors poses challenges to trust and compliance with vaccination programs.
They reduce the number of vaccines
The United States has taken the unprecedented step of reducing the number of vaccines it recommends for each child, a move that leading medical groups say would undermine protections against half a dozen diseases.
The change takes effect immediately, meaning the CDC will now recommend that all children be vaccinated against 11 diseases. Protection against
influenza, rotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV. Instead, protection against these diseases is only recommended for certain groups considered high risk or when recommended by doctors in what is called “shared decision making.”
Among the vaccines recommended for everyone, those against measles, whooping cough, polio, tetanus, chickenpox and human papillomavirus (HPV) are still maintained; even the latter is reduced to two or three doses.
Vaccination rates in the US
Overall, U.S. vaccination rates are in the lower-middle range of high-income countries: better than many developing countries, but clearly below most other developed countries on several key vaccines, especially COVID-19.
COVID‑19:
- Recent comparative reports on health systems show that the US has one of the lowest COVID-19 vaccination rates among high-income countries, despite early access and ample supply of doses.
- Several global vaccination trackers show countries such as Canada, most of Western Europe and some in East Asia achieving higher percentages of fully vaccinated populations than the US, which lags behind the leading OECD group.
Other calendar vaccines:
- At the Americas level, the region as a whole (including the US) tends to have relatively high coverage for classic childhood vaccines (measles, polio, DTP), but data from pediatric organizations and the WHO show that some Western European and Nordic countries reach more homogeneous coverage, close to 95% for various doses, while in the US there are more state and community variations.
- In the last decade, pockets of low coverage have been documented in certain states and counties in the US, which has favored localized outbreaks of diseases such as measles, a less frequent phenomenon in many other developed countries with stricter school vaccination policies.
Factors that explain the differences:
- Studies and health policy analyzes highlight the role of misinformation about vaccines, political polarization, and distrust in institutions as factors that reduce vaccine acceptance in part of the US population more than in other developed countries.
- Characteristics of the US health system also play a role: financing fragmentation, access difficulties, and socioeconomic inequalities, which contrast with more universal systems in other high-income countries and are associated with lower vaccination rates in certain groups.
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