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Federal health officials announced Monday a significant overhaul of the vaccines recommended by the Centers for Disease Control and Prevention for children, reducing the number from 17 to 11. These changes are effective immediately.

No vaccines were removed from the schedule entirely, but their status was adjusted.

Under the new schedule, vaccines that were previously recommended for all children, such as those for flu, rotavirus, hepatitis A and B, certain types of meningitis and RSV are now advised only for children who are identified as high-risk or if a health care provider recommends them through a process known as “shared decision-making.”

Health officials said the vaccines will remain accessible to anyone who wants them, but medical experts in Minnesota criticized the decision, expressing concerns that it could lead to a decrease in the uptake of essential vaccinations and an increase in disease outbreaks.

Michael Osterholm of the University of Minnesota’s Vaccine Integrity Project and director of the U’s Center for Infectious Disease Research and Policy decried the changes to the U.S. childhood immunization schedule.

“Eliminating vital U.S. childhood vaccine recommendations without public discussion of the potential impacts on children in this country, or a transparent review of the data on which the changes were based, is a radical and dangerous decision,” Osterholm said. “This wildly irresponsible decision will sow further doubt and confusion among parents and put children’s lives at risk.”

The authority to mandate vaccinations lies with the states, not the federal government. But state regulations are influenced by CDC recommendations.

The Minnesota Medical Association also weighed in, issuing a statement Monday conveying deep concern about the revised recommendations.

“The changes add unnecessary confusion and uncertainty around vaccines that have been shown to be both safe and effective,” the MMA said in a statement. “The MMA urges parents and families to talk directly with their physicians about the critical role that childhood vaccines play in preventing serious disease and death, and in protecting the most vulnerable members or our communities.”

Dr. Gigi Chawla, chief of general pediatrics at Children’s Minnesota, said that the model of shared decision-making, where health care providers and patients collaborate on treatment decisions, is the foundation of their approach to all vaccines. She emphasized that this is central to the administration's recommendations and will continue moving forward.

“I’m still working through how to have conversations with families, so they understand that the science hasn't changed on this,” Chawla said. “But we have to help families understand the science in a very different way by making sure they understand that vaccines are safe, that health care professionals strongly recommend these vaccines to prevent lifelong illness, disease and cancer and also why a vaccine is no longer part of the routine recommendation.”

Chawla said that the change in recommendations may lead to confusion among some patients, which could result in a decline in vaccine rates. She noted that despite the efforts of clinicians and health care providers, some families may choose not to rely on scientific guidance when it comes to vaccination.

Patients and their families have always had the opportunity to participate in shared decision-making regarding whether to wait for vaccines or opt for an alternative vaccination schedule, according to Chawla. 

She said that individual choices can collectively affect community vaccination rates. When people are given more permissibility, it may lead to lower overall vaccine coverage. This, she cautions, can increase the risk to the community and weaken herd immunity, making it easier for diseases to spread.

Minnesota Commissioner of Health Dr. Brooke Cunningham said in a statement that the unilateral decision by the federal government to change the childhood immunization schedule is highly concerning.

“The previous CDC childhood immunization schedule had been supported by decades of rigorous scientific evidence showing it works to protect our young ones from diseases that can make them very sick,” Cunningham said. “The Minnesota Department of Health unequivocally continues to support immunization as a life-saving public health measure.”

Cunningham said the state health department will share more information with providers, parents and the public as they sort out next steps.

The Centers for Medicare & Medicaid Services administrator Dr. Mehmet Oz said in a

 that all vaccines recommended by the CDC will continue to be covered by insurance.

All U.S. states and territories require children attending childcare centers and schools to be vaccinated against several diseases. Minnesota law mandates immunizations for hepatitis B, polio, measles, mumps, rubella, tetanus, whooping cough and chickenpox, among others.

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Minnesota medical experts criticized the move, saying it could lower vaccination rates and increase the risk for outbreaks.

A child holds a hand while getting vaccinated.

Minnesota health experts sound alarm over new CDC childhood vaccine recommendations

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