Trump's vaccine changes pit doctors against the government
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Illustration: Aïda Amer/Axios
Parents around the country are suddenly confronting a bizarre dynamic: Their pediatrician's vaccine advice doesn't match that of the federal government.
Why it matters: Kids' health is at stake at a time when vaccine-preventable diseases are on the rise and trust in public health institutions is already low.
State of play: Doctors and health systems are ignoring the Trump administration's new and narrower childhood vaccine recommendations and sticking to the old schedule.
- Coalitions of blue states and local health officials are also rejecting the changes, which dropped six shots — including those for the flu, rotavirus and hepatitis — from the recommended list and instead urged parents to consult providers about the shots.
- At least 19 states have said they won't follow the new Centers for Disease Control and Prevention schedule and will instead follow the American Academy of Pediatrics' recommendations, which continue to call for the same immunizations CDC did before Trump's current term.
- And more than 200 medical, public health and patient advocacy groups signed onto a letter urging Congress to investigate the schedule changes. Some — including the American Academy of Pediatrics — are suing to reverse them.
What they're saying: "This is the first time in memory that parents aren't able to count on federal health agencies to provide evidence-based vaccine recommendations," said Michael Osterholm, director of the the Center for Infectious Disease Research and Policy and the Vaccine Integrity Project.
Between the lines: The Trump administration has stressed that all of the previously recommended vaccines will still be covered by insurance, and that whoever wants them will be able to get them.
- But parents now are in the unfamiliar position of deciding whether their child should receive certain vaccinations, which necessitates choosing which authority figures they'll listen to.
- Health and Human Services Secretary Robert F. Kennedy Jr. — a leading anti-vaccine activist before becoming health secretary — has suggested that parents figure it out themselves.
- "What I would say to people is do your own research. This idea that you should trust the experts, a good mother doesn't do that," Kennedy said on a podcast last week.
The other side: "AAP's lawsuit against HHS is a baseless attempt to litigate for the interests of the organization's top corporate donors, which make virtually every vaccine across the CDC immunization schedules," HHS spokesman Andrew Nixon said in a statement.
- As for doctors and health departments ignoring the new federal advice, Nixon added: "Democrat-led states that imposed unscientific school closures, toddler mask mandates and vaccine passports during the COVID era are the ones who destroyed public trust in public health and should not be guiding policy."
- Some organizations that represent smaller groups of health professionals have praised the schedule changes.
- "This is a long-overdue recalibration of the number of vaccines administered to newborns and young children at the very outset of life," Joseph Varon, president and chief medical officer of the Independent Medical Alliance, said in a statement following the update.
By the numbers: It's too soon to measure with any real accuracy how many pediatricians are simply disregarding the CDC's advice, or how many parents are choosing to follow the new federal recommendation list. But prior surveys offer some clues.
- One study published in Vaccine in 2022 found that 10% of primary care doctors do not agree that vaccines are safe, 9% don't agree they're effective and 8% do not agree that they are important.
A KFF/Washington Post poll last fall found that parents' view of vaccines' importance varied based on which shot they were being asked about.
- While 9 in 10 said it is important for children to receive MMR and polio vaccines — which are both still recommended for all children by the CDC — only 56% felt the same way about flu shots, and just 43% about COVID shots. Both vaccines were among those removed from the recommendation list.
- A quarter of parents surveyed said they thought the CDC recommended too many vaccines, meaning they likely welcome the new, slimmed-down schedule.
The bottom line: Pediatricians are by far parents' most trusted source of vaccine information, according to the KFF/Washington Post poll.
- That means whatever is happening in doctors offices around the country is likely much more impactful than whatever federal health officials are saying.
