For the first time in 30 years, the American Academy of Pediatrics is substantially diverging from U.S. government vaccine recommendations.
The Itasca-based group’s new COVID-19 recommendations — released Tuesday — come amid a tumultuous year for public health, as vaccine skeptics have come into power in the administration of President Donald Trump, and government guidance has become increasingly confusing.
This isn’t going to help, said Dr. James Campbell, vice chair of the academy’s infectious diseases committee.
“It is going to be somewhat confusing,” Campbell said. “But our opinion is we need to make the right choices for children to protect them.”
The academy is strongly recommending COVID-19 shots for children ages 6 months to 2 years. Shots also are advised for older children.
That differs from guidance established under U.S. Health and Human Services Secretary Robert F. Kennedy Jr., which doesn’t recommend the shots for healthy children of any age but says kids can get the shots in consultation with physicians.
Children 6 months to 2 years old are at high risk for severe illness from COVID-19, and it was important that recommendations continue to emphasize the need for them to get vaccinated, said Campbell, a University of Maryland infectious diseases expert.
Vaccinations also are recommended for older kids with chronic lung diseases or other conditions that put them at higher risk for severe disease.
In response, HHS spokesperson Andrew Nixon said, “The AAP is undermining national immunization policymaking with baseless political attacks.”
He accused the group of putting commercial interests ahead of public health, noting that vaccine manufacturers have been donors to the academy’s Friends of Children Fund, which is paying for projects on a range of topics, including health equity and prevention of injuries and deaths from firearms.
The 95-year-old pediatrics organization has issued vaccination recommendations for children since the 1930s. In 1995, it synced its advice with recommendations made by the federal Centers for Disease Control and Prevention.
There have been a few small differences between the academy and CDC recommendations since then. For example, the academy has advised that children get HPV vaccinations starting at 9, while the CDC says that’s OK but has emphasized vaccinations at ages 11 and 12.
But in 30 years, this is the first time the recommendations have differed “in a significant or substantial way,” Campbell said.
Until recently, the CDC — following recommendations by infectious disease experts — has been urging annual COVID-19 boosters for all Americans ages 6 months and older.
But in May, Kennedy announced that COVID-19 vaccinations no longer are recommended for healthy children and pregnant women. Days later, the CDC said healthy children can get the shots, but that there was no longer a “should” recommendation.
The idea that healthy older kids might be able to skip COVID-19 boosters has been brewing for some time among public health experts. As the pandemic has waned, experts have talked about possibly focusing vaccination efforts on people 65 and older — who are among those most as risk for death and hospitalization.
In June, a CDC expert panel was set to make recommendations about the fall shots. Among the options the panel was considering was whether to suggest shots for high-risk groups but still giving lower-risk people the choice to get vaccinated.
But Kennedy bypassed the group and also decided to dismiss the 17-member panel and appoint his own, smaller panel, which included vaccine skeptics. Kennedy later excluded the academy, the American Medical Association and other top medical organizations from working with the advisers to establish vaccination recommendations.
Kennedy’s new vaccine panel has yet to vote on COVID-19 shot recommendations.
The panel endorsed continuing to recommend fall flu vaccinations but also made a decision that led to another notable difference with the academy. The new advisory panel voted that people should get only flu vaccines that are packaged as single doses and do not contain the preservative thimerosal.
The academy said there’s no evidence of harm from the preservative and recommended doctors use any licensed flu vaccine product that’s appropriate for the patient.