Hospitals and health systems are navigating a wave of vaccine-related developments, including a Texas investigation into alleged financial incentives for pediatric immunizations, sharp criticism of federal vaccine guidance, and public remarks by the CDC’s vaccine panel chair suggesting polio shots should be optional.
The news comes amid a sweeping overhaul of the U.S. childhood immunization schedule, finalized Jan. 5 under a directive from President Donald Trump. The update reduces the number of routine vaccine recommendations from 18 to 11 and reclassifies others — including hepatitis A and B, flu, RSV and meningococcal disease — as optional based on risk or shared clinical decision-making. While federal officials said the move aims to rebuild trust, leading physician groups have warned it may lead to confusion, declining coverage and increased disease risk.
Here are four developments hospital and health system leaders should watch:
1. Texas Attorney General investigates alleged pediatric vaccine incentives
Texas Attorney General Ken Paxton launched an investigation Jan. 21 into alleged unlawful financial incentives tied to childhood vaccine recommendations. The probe will examine whether medical providers, insurers or pharmaceutical companies failed to disclose financial arrangements influencing vaccine decisions, according to a news release from the attorney general’s office. More than 20 civil investigative demands were issued to entities including insurers, drug companies and medical providers. The attorney general’s office cited reports of children being dismissed from practices based on vaccination status.
2. Flu shot rates down in kids as season intensifies
Childhood flu vaccination is trailing last year’s pace amid what CDC officials warn may be a historically severe season. As of Jan. 3, uptake among children 6 months to 17 years old was down 1.5 percentage points nationally compared to the same time last year, CDC data shows. Rhode Island (down 16 points), Tennessee (down 14.4 points) and Massachusetts (down 10.7 points) reported the sharpest declines. The drop comes as federal guidance now encourages shared decision-making for flu shots rather than universal recommendation.
3. ACIP chair: Routine vaccines should be optional
Kirk Milhoan, MD, chair of the CDC’s Advisory Committee on Immunization Practices, said polio, measles and other vaccines should be optional rather than required, The New York Times reported Jan. 23. Dr. Milhoan said an individual’s right to refuse vaccination outweighs the risk of illness or transmission. He described the panel’s role as re-evaluating all vaccine products and said some school-entry requirements are “authoritarian.”
4. AMA: Weakening vaccine guidance ‘a dangerous step backward’
In response to recent comments from the ACIP chair, the American Medical Association said efforts to weaken routine vaccine recommendations “do not increase freedom—they increase suffering.” In a Jan. 23 statement, AMA Trustee Sandra Fryhofer, MD, warned that such changes would “undermine public health protections” and could lead to preventable deaths.
“Vaccines have saved millions of lives,” she said. “Weakening vaccine recommendations will cost lives, and that is a price our nation should not be willing to pay.”
