The Evolving Childhood Vaccine Schedule: Identifying Significant Policy Shifts

This series discusses the ongoing recommendation changes being made to the pediatric vaccine schedule and how this is affecting US public health, especially in children.

Undoubtedly, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices has been at the center of the massive changes to the childhood vaccine schedule over the past several months.

Some of the committee’s biggest changes in vaccine guidance and recommendations include shared clinical decision-making for some vaccines and moving some of the vaccines that were in the recommended-for-all category to high-risk groups. This new federal guidance now recommends childhood vaccines for 11 diseases, downsizing immunization protection from the previous list of 18 diseases.

As part of the federal guidance, there is a new category: vaccines offered through shared clinical decision-making. This category includes the rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B immunizations. This category suggests these vaccines may not be required or needed for everyone.

These changes have led to more confusion than clarity and have left clinicians and families uncertain about how to proceed with immunizations.

To try to understand these changes and obtain some factual information and commentary from clinicians in the field, we have created our Clinical Insights: Childhood Vaccine Schedule Changes roundtable. This roundtable features a panel of clinicians, including:

• Jacinda Abdul-Mutakabbir, PharmD, MPH, associate professor of clinical pharmacy and antimicrobial resistance researcher at the University of California San Diego
• Sharon Nachman, MD, chief of the Division of Pediatric Infectious Disease at Stony Brook Children's Hospital
• Mary Koslap-Petraco, DNP, PNP-BC, CPNP, clinical assistant professor at Stony Brook University School of Nursing
• William Schaffner, MD, professor of medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine
  

In this first episode, the panel discusses which recent pediatric immunization schedule updates represent true paradigm shifts, rather than incremental refinements, and why.