A leading Chicago pediatrician says he is siding with the influential American Academy of Pediatrics in its split with the federal government over COVID-19 vaccine guidance for children because, he says, the AAP recommendations “are based on science, and not based on politics.”
“Until Secretary [Robert F.] Kennedy [Jr.] took the reins … I was always able to feel very confident in the recommendations that came out,” from the federal government, Dr. Daniel Johnson, a pediatric infectious disease specialist at the University of Chicago, said, referring to the head of the U.S. Department of Health and Human Services.
“Now with the change in administration and direction, I am seeing something unique, which is that politics is a major leading force.”
Johnson says doctors and families now need other sources. “I trust the AAP completely,” he said.
For the first time in 30 years, new COVID-19 vaccine recommendations from the Itasca-based AAP substantially diverge from guidance from the U.S. government. It’s the latest development in 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.
The academy is strongly recommending COVID-19 shots for children ages 6 months to 2 years. Shots should be made available for older children if their parents want them vaccinated, the academy advised.
That differs from guidance established under Kennedy, 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 risk for severe illness from COVID-19, said Dr. Ravi Jhaveri, who heads Lurie Children’s Hospital of Chicago’s infectious disease division. Jhaveri said younger children have smaller lungs with smaller airways, akin to a straw. If their lungs become constricted because of COVID symptoms, it can become very difficult to breathe.
“So the benefits to preventing any and all of these infections is incredibly important for infants,” said Jhaveri, who advises his patients to vaccinate their young children against COVID. “That is why we were very quick to try, as soon as vaccine was available, to approve it for use in kids as young as six months old, and that’s why the AAP has reiterated that recommendation.”
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,” said Dr. James Campbell, vice chair of the academy’s infectious diseases committee.
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 at 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.