In March of 2024, I wrote about an active measles outbreak that was impacting my hometown in Florida. In that post, I discussed why measles is such a difficult disease to control among youth in a school setting, the impact of federal and state guidance (and misinformation) on vaccinations, and the overall importance of vaccinations to the health of the community. Now a new memo, written by the Department of Health and Human Services (HHS), proposes a reduced childhood and adolescent immunization schedule. This proposal from HHS is directed towards the states, which ultimately get to decide on the required immunization schedule for their youth population to enter school.
According to KFF, these changes reduce the number of diseases targeted by vaccines from 17 to 11. In states that implement these new vaccine recommendations, youth will have less immunity to Hepatitis A, Hepatitis B, Influenza, Meningococcal disease, Rotavirus, and COVID-19.
In the memo that HHS released, one of the reasons listed for creating this changed list of vaccine recommendations is because of a decrease in vaccine uptake and trust. Suggesting that states should no longer recommend a set of vaccinations due to poor vaccine rates is like recommending to remove speed limits because drivers keep speeding. Our public leaders should be doubling down to increase funding for research on vaccine safety and effectiveness, as well as increasing public health campaigns to share well-established evidence about the efficacy of vaccinations. We also need to be holding our elected officials accountable for leading with science, and not with fear.
As I discussed in my previous post, it is extremely important that we continue to vaccinate our children, not only for their protection but also for others who cannot be vaccinated or are immunocompromised. I mentioned the importance of reaching herd immunity, which is when enough people in a population are immune to a disease that the disease does not easily spread. According to the Cleveland Clinic, herd immunity is usually not reached without widespread vaccination. Reducing the number of people who receive vaccinations to these communicable diseases puts the whole population at risk of sickness, not just the individuals who choose not to get themselves or their children vaccinated.
Removing the recommendation for these vaccines also impacts the overall health system. Many of these diseases are highly contagious and can result in outbreaks that overrun health infrastructure and can impact the care of people seeking services for other emergency needs. Increased incidence of these illnesses could also cost insurance companies—and the consumer if these costs are translated into increased insurance premiums and decreased coverage—since paying to treat preventable illnesses is more expensive than paying for the prevention itself.
Overall, the recommended reduction of the childhood and adolescent immunization schedule is concerning. Weakened vaccine recommendations shifts us away from evidence-based public health practice that has historically prevented disease and protected vulnerable populations. This change does not rebuild public trust in vaccines: it further erodes it. As states decide whether or not to implement these recommendations, decision makers should use history and science to guide them. Protecting children through strong immunization policies is not just an individual choice, but a collective responsibility that safeguards the health and well-being of the entire community.