Taking a child to the doctor can be a handful. Kansas City health officials say federal changes to recommended childhood immunizations add another complication parents must prepare for before visiting the doctor.
The overhaul to the childhood immunization schedule reduced the number of universally recommended vaccines from 17 to 11. Among the changes – it is no longer recommended children receive vaccines for meningitis, rotavirus, hepatitis A and hepatitis B, RSV, COVID and the flu.
“Of all the things you’re thinking about when your little kid is going to the doctor, now you’ve also got to remember that,” said Kansas City Health Department Director Dr. Marvia Jones.
The changes came after a bevy of comments from Health and Human Services Secretary Robert F. Kennedy Jr., during his campaign for president and after his appointment as the nation's chief health care officer. So it didn’t come as a surprise, but it does present new challenges for local officials and parents, while casting unnecessary doubt over the efficacy of these vaccines.
That’s why, while the new federal schedule is already in effect, most health organizations, local and some national, are breaking away from these recommendations, suggesting they will follow alternative guidance. Jones and the Kansas City Health Department are among those following precedent over new federal priorities.
Many of her colleagues across the Kansas City area are doing the same, sending a unified message that parents need to be better educated, and become advocates for their child’s health.
“There is going to be a likelihood that some people may not ask or be equipped with information, so you’re having people grow up with increased risk of contracting these different diseases,” Jones said.
New parental burdens
Under the new recommendations, the CDC divides vaccinations for children into three categories: universally recommended vaccines for all children, vaccines for high-risk children and shared clinical decision-making, or those that should be discussed with a child’s provider first.
For example, the updated CDC schedule dictates the flu vaccine only be given when the provider recommends it.
“If the doctor doesn’t ask or offer it, that puts the pressure on that parent to then know about it and go in and ask for it,” Jones said, adding that parents should be “in discussion early on with their child’s care providers.”
At many public health departments, like in Kansas City and Johnson County, nurses will go over all that information either way, but not every doctor will take on this added responsibility.
Tetanus, diphtheria, pertussis, measles, mumps, rubella, polio, pneumococcal disease, Haemophilus influenza, HPV and chickenpox are all still universally recommended, so parents won’t have to worry about those. But the rest? It will be up to them to gather necessary information.
Charlie Hunt, the health director in Johnson County, said the changes introduce unnecessary doubt and conflict where there should not be any.
“By deemphasizing that these vaccines are recommended, it puts some doubt about the state of the science,” he said, “when all these major medical groups have come out with their own recommendations different from what the CDC has.”
Groups that have challenged the new federal guidelines include the American Academy of Pediatrics and the American Academy of Family Physicians.
Hunt also noted that it's been widely reported the CDC changes weren’t based on an extensive study or new research. Kennedy said following the announcement that the changes were approved after an “exhaustive review of evidence.”
A new approach for practitioners
The good news for parents concerned about accessing these vaccines is that, unlike the COVID-19 shot, nothing has changed with immunization licensure. So, parents can still go into their local public health department or their doctor and get these vaccines if they desire.
Hunt reports Johnson County is still seeing the usual, steady flow of people bringing their kids in for vaccinations.
“We’re not seeing a lot of additional questions from parents yet,” Hunt said. “We’ve had a lot of organizations that have been very clear about these vaccines, so we haven’t seen as much of an impact as we feared we might have seen.”
Hunt said public health practitioners will have to keep in mind it will increasingly fall on them to dispel doubts and answer questions. They’ll have support from the Kansas Department of Health and Environment, which is recommending providers stick to their clinical training and professional judgement, as well as consider immunization schedules from other major medical groups.
“At this time, we do not anticipate changes to Kansas' clinical guidance regarding childhood immunization schedules,” reads a KDHE statement released after the updated CDC guidance.
It’s not just public health officials who are challenging new CDC guidelines. Some hospitals in Kansas City were quick to address the changes.
In a statement, Children’s Mercy said they will continue to follow the American Academy of Pediatrics’ recommended child and adolescent immunization schedule, and we encourage parents and guardians to speak with their medical providers about vaccinations for their children.”
Enhanced messaging efforts
There is widespread agreement among Kansas City health experts that the response and the messaging around the recommended changes require a unified approach. Many health care institutions are doubling down on this effort.
In Johnson County, officials are prepared to answer more questions and face increased skepticism. Jackson County responded similarly, emphasizing they will continue to rely on decades of scientific research and empirical data to help assure parents that vaccines remain an essential part of protecting their children’s health.
“Jackson County Public Health will continue to emphasize vaccination as a core element of individual and community health,” said Jackson County Public Health director Bridgette Shaffer.
Kansas City, Missouri, is preparing more “overt and intentional” documentation for parents and clinicians, providing information about what they have been recommending for decades. Jones is urging parents to have these conversations with trusted medical professionals and avoid social media and hearsay as a source for information. She says it may take more than the slogan “vaccines are safe and effective” to persuade parents what vaccines they need to keep their kids healthy.
“It makes people wonder if there is a debate,” Jones said. “We want to be very clear that there is no debate based on decades of research. It’s just another obstacle, but we want to give people the tools to persevere.”
