President Donald Trump has directed HHS and the CDC to conduct a review of childhood vaccine recommendations abroad, aiming to align U.S. guidance with best practices from “peer, developed countries.”
The directive came via a memorandum the president signed Dec. 5, comparing the U.S.’ vaccination schedule to those of countries such as Denmark and Japan, which recommend children be vaccinated for 10 diseases and 15 diseases, respectively. The U.S. recommends children be vaccinated for 17 infectious diseases.
In a fact sheet, the White House said the HHS and CDC should update the nation’s core childhood immunization schedule to align with scientific evidence and best practices from peer nations if their review determines that best practices abroad “are superior to current domestic recommendations.”
In response to news, public health experts said comparing vaccine recommendations in the U.S. to international guidelines in many cases is irrelevant, given differences in population size and disease rates.
“Denmark is about the size of Maryland, so what works to protect a small, very highly vaccinated population like Denmark cannot be extrapolated for a very large, heterogeneous and much more diverse population like the U.S.,” Jessica Malaty Rivera, an epidemiologist and member of Defend Public Health, an advocacy group of public health researchers and healthcare workers, told The Washington Post, which covered a breakdown of vaccine recommendations for infants and young children in five countries.
“The exposure rate, the disease status rate in the U.S. is terrible, and that’s why we have the policy that we have to protect children,” she added. “We shouldn’t be asking what another country is doing. We should be asking, ‘What should we be doing based on the exposures and risks and concerns that we have for our population?'”
Two more recent updates on federal vaccine policy:
1. CDC panel recommends delaying hepatitis B birth dose: President Trump’s directive to review international vaccine guidelines came shortly after the CDC’s influential Advisory Committee on Immunization Practices voted to end a decades-old recommendation that all newborns receive their first dose of the hepatitis B vaccine at birth.
Under the new guidance, women who test negative for the virus are advised to consult with their clinicians about when — and whether — to vaccinate their child. If they choose to vaccinate, they should wait until the baby is at least 2 months old. The recommendation for infants born to mothers who test positive or have unknown hepatitis B status — to receive the vaccine at birth — remains unchanged.
2. FDA floats changes to vaccine approval process: Earlier the same week, the FDA’s chief vaccine official, Vinay Prasad, MD, proposed major revisions to how vaccines are reviewed and approved. In an internal memo obtained by The New York Times, Dr. Prasad called for longer clinical trials and more rigorous efficacy data, including requiring manufacturers of pneumonia vaccines to demonstrate that their products reduce actual disease incidence, not just an antibody response. The memo said the agency plans to update its annual framework for approving seasonal flu vaccines.
Dr. Prasad also said the FDA conducted an internal review linking at least 10 pediatric deaths to COVID-19 vaccines — a claim public health experts swiftly challenged due to a lack of data transparency. The FDA did not disclose the children’s ages, health histories or how the deaths were determined to be vaccine-related. The Infectious Diseases Society of America called the agency’s statements “vague” and “reckless,” warning that they risk undermining trust in vaccines that have undergone years of safety monitoring.
