CDC Changes Childhood Vaccine Schedule Recommendations

The CDC just scaled back on their recommendation for vaccine scheduling for childhood. While we normally agree with the CDC's recommendation, we are in complete disagreement with it. 

First, there is no new evidence to support this decision, and all of the vaccines that have been removed are safe and EFFECTIVE in avoiding diseases. The only difference is the change in who is running the CDC. The vaccines that the CDC removed are the following: flu, rotavirus, hepatitis A, hepatitis B, meningococcus, RSV, & covid. I will spend a few paragraphs at the end of this news statement on each of these illnesses, especially since we see very little of some of them now that most people have been vaccinated.

Second, it may take time to see an uptick in all of these diseases if the general population does not vaccinate for them, so we are looking at outbreaks perhaps years away although the United States has seen more measles and pertussis then it has in decades due to the drop in immunization rates around the nation, including some deaths. 

Third, the decision is based on the Country of Denmark which has a population smaller than NYC and is mostly a homogenous population (no diversity). It also has universal healthcare. It does not address the size and heterogenous population that we have in the United States. Most recommendations that public health agencies make are geared to their own population data, not those of a different country. 

Fourth, we are still able to vaccinate for these diseases but removing them from the recommendation will prompt people to doubt their safety, and move away from scientifically proven evidence that they are safe and effective. I would ask any of you to call and discuss any of your concerns regarding these changes. 

The Flu vaccine is a highly effective tool to avoid influenza and may be used from 6 months of age and up. It is an extremely safe vaccine with rare serious side effects, and the typical side effects of fever, body aches or pain at the injection site are mild and limited to a couple days versus a week of flu symptoms that include high fever, cough, headache, body aches, chills, sore throat.  This year, we are seeing a large outbreak, and the vaccine is approximately 50% effective in children in avoiding contracting the illness, but notably 75% effective in avoiding severe and life threatening disease requiring intubation/ICU admission. That means that although your child may still contract flu, the risk of serious illness is significantly decreased if there was prior vaccination. In our office, we are seeing about 50% coverage which means some patients are coming in sick despite the vaccine but their  immunized sibling may not get it. 

Rotavirus vaccines are given in infancy and estimates are that it avoids approximately 40,000 to 50,000 hospitalizations per year among infants and small children. Again, side effects of the vaccine are rare, and most infants have no symptoms or mild diarrhea or fussiness for a day. 

Meningococcal vaccines are well tolerated and given in middle school here in our country. There has been a 60% drop in meningococcal disease in the last 20 years in the group of children that needed the most protection: middle/high school/young adults. What is true about meningococcal disease, is that once contracted, it has a very high mortality rate of 10-40% even with medical treatment. On a small practice note, there were several deaths early on in the practice from this, and none since we have given it going into the  middle school years. 

RSV is the most shocking of those vaccines removed from the recommendation since everyone knows a child who was hospitalized, and in the ICU on a respirator in the first year of life. We have only had a year or two of this vaccine for pregnant women, and the antibody RsV immunoglobulin shot for infants, but in one year, the incidence of hospitalizations from RSV dropped by 50% in infants under 1 year, and 55-60% in those less than 2 months of age. The vaccine is effective if given to a pregnant woman in her last trimester, affording the infant maternal antibody protection in the first few months of life. The other option is a rsv specific antibody shot given in the first 8 months of life when the infant is the most vulnerable. 

The Hepatitis B vaccine is a very safe vaccine given at birth and in the first year, with a very high safety profile. It may be given any time in the child's life if they were not vaccinated at birth. Hepatitis B was a fairly common illness prior to this vaccine, and it is spread by blood and blood products but this is well screened today. It is spread by sexual contact, deep kissing, and any activity where there is inadvertent blood exposure (razors, bites etc). It is often acquired at birth through the birth canal in much of the world, and the infants are at risk or Hepatitis B carrier status, and ultimately at risk for liver failure as an adult. That was the main reason for early vaccination. 

Hepatitis A is a food borne illness, or contaminated water borne illness. Occasionally we have an out break in the area due to either contaminated foods or a water main break. The vaccine is highly effective, and has rare side effects. I have a father in my practice who contracted it possibly from food, and had liver failure and a liver transplant. He was not inoculated as a child. 

Dr Ginsburg and I would like to believe that we are your partners in your child's health journey. We are fully up to date with all vaccines, new and old , and are aware that it can be overwhelming for parents since there is so much information/misinformation in the news. AS of now, there are no changes in access to all vaccines, and we are continuing to implement the American Academy of Pediatrics guidelines. Please reach out to us if you have any specific questions.