On Tuesday, Robert F. Kennedy Jr., the Secretary of Health and Human Services (HHS), announced a significant shift in COVID-19 vaccine policy. He declared that the Centers for Disease Control and Prevention (CDC) would no longer recommend COVID vaccinations for healthy children and pregnant women. Kennedy said in a video, “I couldn't be more pleased to announce that, as of today, the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC's recommended immunization schedule.”
This announcement came abruptly, bypassing the usual process. The CDC’s Advisory Committee on Immunization Practices (ACIP), which advises the agency on vaccination guidelines, was still reviewing the recommendations. They had been considering narrowing COVID vaccine guidance to focus mainly on older adults and those with underlying health conditions. However, Kennedy’s announcement goes beyond this, excluding even pregnant women, a group traditionally viewed as higher risk for severe COVID illness.
As of Tuesday morning, the CDC’s official immunisation schedule had not yet been updated to reflect Kennedy’s declaration. The reason for this sudden decision remains unclear. The ACIP was expected to vote on the matter during its routine June meeting.
Vianca N. Rodriguez Feliciano, spokesperson for HHS, said, “With the COVID-19 pandemic behind us, it is time to move forward. HHS and the CDC remain committed to gold standard science and to ensuring the health and well-being of all Americans — especially our nation's children — using common sense.”
Disruption to established processes and other vaccine delays
Kennedy’s decision also interrupts other vaccine recommendations awaiting approval. The advisory panel had already voted on updated guidance for vaccines against respiratory syncytial virus ( RSV) and meningococcal disease back in April. Typically, the CDC director would approve such updates. But since Susan Monarez stepped aside while undergoing CDC director nomination, Kennedy has been the final authority. He has only approved one April recommendation so far: restricting a Chikungunya vaccine linked to severe side effects.
The Department of Health and Human Services has not explained why other vaccine updates remain stalled. The delays have raised concern among experts who rely on these advisory panels for vaccine policy.
Impact on access and insurance coverage for COVID vaccines
Removing CDC recommendations for healthy children and pregnant women could make COVID vaccines harder to access and more costly. The CDC’s vaccine guidance directly influences what health insurance plans must cover at no cost to patients. If vaccines are no longer recommended, insurers might refuse to cover the cost, meaning families would face out-of-pocket expenses.
The federal Vaccines for Children program, which supplies free vaccines to uninsured children, also bases eligibility on CDC recommendations. Similarly, Medicaid and the Children’s Health Insurance Program (CHIP) rely on CDC guidance for vaccine coverage.
Richard Dang, assistant professor of clinical pharmacy at the University of Southern California, explained, “That would essentially close the door to pharmacists administering COVID-19 vaccines to children and pregnant women at pharmacies. And as we know, throughout the pandemic and over the last few years, the pharmacy has been the primary location where many have been receiving their vaccines.”
Dang warned that even if pharmacies were allowed to vaccinate off-label under certain protocols, patients might have to pay cash. “Even if a pharmacy were allowed to administer vaccine off-label through a protocol or collaborative practice agreement, the individual patient would likely have to pay cash for it,” he said.
Kennedy’s move contrasts with the stance of FDA officials, who still list pregnancy as a condition warranting COVID vaccination due to increased risks of severe illness.
Dr Naima Joseph, assistant professor at Boston University and a member of the CDC vaccine advisory group, stressed the importance of vaccination for pregnant women: “This one preventive strategy that is cost-effective, that can be readily available when the ACIP provides a universal recommendation, limits barriers to access. It is a really important mechanism to protect our moms and babies.”
The American College of Obstetricians and Gynecologists criticised the HHS announcement in a statement: “We have seen firsthand how dangerous Covid infection can be during pregnancy and for newborns who depend on maternal antibodies from the vaccine for protection… the science has not changed. It is very clear that Covid infection during pregnancy can be catastrophic and lead to major disability.”
Joseph noted that pregnant people remain at higher risk of hospitalisation from COVID-19. She added, “Infants are the second leading group of our population being hospitalised. And when we look into those risks, it's really that they're born to moms who haven't received an updated COVID-19 vaccine.”
Conflicting messages and expert concerns
Despite Kennedy’s announcement, as of Tuesday afternoon, the CDC’s website still recommended COVID vaccines for everyone aged six months and older. This mismatch creates confusion for families and healthcare providers.
Dr Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Pennsylvania, voiced concern: “We still have children in our emergency department with Covid. When we see them, they have bronchiolitis or bronchitis. Do they consider that not worthy of prevention?”
Richard Besser, former acting CDC director, commented on the shift in decision-making: “One of the things that I relied on as a pediatrician was an assurance that the recommendations that came to me were based on the best available science and evidence, and came from the work of the expert advisors to the CDC. This is clearly not coming from that direction, and that’s greatly concerning.”
Dr Sean O’Leary of the American Academy of Pediatrics said no consultation occurred with his organisation before Kennedy’s announcement.
Questions remain over the availability of COVID vaccines this fall. The FDA’s vaccine advisory committee recently recommended updating vaccines to target newer variants like LP.8.1, a descendant of the Omicron variant dominant in the U.S. However, the agency has moved towards requiring placebo-controlled clinical trials for new vaccines, a process that could delay their rollout.
If Pfizer’s and Moderna’s updated vaccines are treated as “new” products needing fresh trials, doses may not be ready in time for the upcoming flu season. This could leave vulnerable populations, including older adults and pregnant women, at greater risk.
Additionally, a new COVID variant, NB.1.8.1, is circulating globally and has been detected among travellers entering the U.S. from several countries. Although not yet widespread in America, public health experts are monitoring its transmissibility and potential impact.
The ongoing presence of variants and the recent policy changes underscore a critical tension: how to balance evolving scientific evidence with public health guidance, insurance coverage, and vaccine access — especially for the most vulnerable.
(With inputs from NYT)
This announcement came abruptly, bypassing the usual process. The CDC’s Advisory Committee on Immunization Practices (ACIP), which advises the agency on vaccination guidelines, was still reviewing the recommendations. They had been considering narrowing COVID vaccine guidance to focus mainly on older adults and those with underlying health conditions. However, Kennedy’s announcement goes beyond this, excluding even pregnant women, a group traditionally viewed as higher risk for severe COVID illness.
As of Tuesday morning, the CDC’s official immunisation schedule had not yet been updated to reflect Kennedy’s declaration. The reason for this sudden decision remains unclear. The ACIP was expected to vote on the matter during its routine June meeting.
Vianca N. Rodriguez Feliciano, spokesperson for HHS, said, “With the COVID-19 pandemic behind us, it is time to move forward. HHS and the CDC remain committed to gold standard science and to ensuring the health and well-being of all Americans — especially our nation's children — using common sense.”
Disruption to established processes and other vaccine delays
Kennedy’s decision also interrupts other vaccine recommendations awaiting approval. The advisory panel had already voted on updated guidance for vaccines against respiratory syncytial virus ( RSV) and meningococcal disease back in April. Typically, the CDC director would approve such updates. But since Susan Monarez stepped aside while undergoing CDC director nomination, Kennedy has been the final authority. He has only approved one April recommendation so far: restricting a Chikungunya vaccine linked to severe side effects.
The Department of Health and Human Services has not explained why other vaccine updates remain stalled. The delays have raised concern among experts who rely on these advisory panels for vaccine policy.
Impact on access and insurance coverage for COVID vaccines
Removing CDC recommendations for healthy children and pregnant women could make COVID vaccines harder to access and more costly. The CDC’s vaccine guidance directly influences what health insurance plans must cover at no cost to patients. If vaccines are no longer recommended, insurers might refuse to cover the cost, meaning families would face out-of-pocket expenses.
The federal Vaccines for Children program, which supplies free vaccines to uninsured children, also bases eligibility on CDC recommendations. Similarly, Medicaid and the Children’s Health Insurance Program (CHIP) rely on CDC guidance for vaccine coverage.
Richard Dang, assistant professor of clinical pharmacy at the University of Southern California, explained, “That would essentially close the door to pharmacists administering COVID-19 vaccines to children and pregnant women at pharmacies. And as we know, throughout the pandemic and over the last few years, the pharmacy has been the primary location where many have been receiving their vaccines.”
Dang warned that even if pharmacies were allowed to vaccinate off-label under certain protocols, patients might have to pay cash. “Even if a pharmacy were allowed to administer vaccine off-label through a protocol or collaborative practice agreement, the individual patient would likely have to pay cash for it,” he said.
Kennedy’s move contrasts with the stance of FDA officials, who still list pregnancy as a condition warranting COVID vaccination due to increased risks of severe illness.
Dr Naima Joseph, assistant professor at Boston University and a member of the CDC vaccine advisory group, stressed the importance of vaccination for pregnant women: “This one preventive strategy that is cost-effective, that can be readily available when the ACIP provides a universal recommendation, limits barriers to access. It is a really important mechanism to protect our moms and babies.”
The American College of Obstetricians and Gynecologists criticised the HHS announcement in a statement: “We have seen firsthand how dangerous Covid infection can be during pregnancy and for newborns who depend on maternal antibodies from the vaccine for protection… the science has not changed. It is very clear that Covid infection during pregnancy can be catastrophic and lead to major disability.”
Joseph noted that pregnant people remain at higher risk of hospitalisation from COVID-19. She added, “Infants are the second leading group of our population being hospitalised. And when we look into those risks, it's really that they're born to moms who haven't received an updated COVID-19 vaccine.”
Conflicting messages and expert concerns
Despite Kennedy’s announcement, as of Tuesday afternoon, the CDC’s website still recommended COVID vaccines for everyone aged six months and older. This mismatch creates confusion for families and healthcare providers.
Dr Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Pennsylvania, voiced concern: “We still have children in our emergency department with Covid. When we see them, they have bronchiolitis or bronchitis. Do they consider that not worthy of prevention?”
Richard Besser, former acting CDC director, commented on the shift in decision-making: “One of the things that I relied on as a pediatrician was an assurance that the recommendations that came to me were based on the best available science and evidence, and came from the work of the expert advisors to the CDC. This is clearly not coming from that direction, and that’s greatly concerning.”
Dr Sean O’Leary of the American Academy of Pediatrics said no consultation occurred with his organisation before Kennedy’s announcement.
Questions remain over the availability of COVID vaccines this fall. The FDA’s vaccine advisory committee recently recommended updating vaccines to target newer variants like LP.8.1, a descendant of the Omicron variant dominant in the U.S. However, the agency has moved towards requiring placebo-controlled clinical trials for new vaccines, a process that could delay their rollout.
If Pfizer’s and Moderna’s updated vaccines are treated as “new” products needing fresh trials, doses may not be ready in time for the upcoming flu season. This could leave vulnerable populations, including older adults and pregnant women, at greater risk.
Additionally, a new COVID variant, NB.1.8.1, is circulating globally and has been detected among travellers entering the U.S. from several countries. Although not yet widespread in America, public health experts are monitoring its transmissibility and potential impact.
The ongoing presence of variants and the recent policy changes underscore a critical tension: how to balance evolving scientific evidence with public health guidance, insurance coverage, and vaccine access — especially for the most vulnerable.
(With inputs from NYT)
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