The Evolving Childhood Vaccine Schedule: Where’s the Data?

This roundtable series discusses the ongoing recommendation changes being made to the pediatric vaccine schedule, and how this is impacting US public health.

Back in the 1980s, there was a very popular TV commercial made by Wendys, and the tagline was, “Where’s the Beef?” The line was delivered by an older woman, and in all her candid honesty was questioning other fast food restaurants about the size of their ground beef hamburgers.

Fast forward to today and this tagline could be altered to, “Where the Data?” for the current discussion around the pediatric vaccine changes. In the ACIP meetings over the last year, there has been no new data presented to support the vaccine changes that have been made.

“There is not any data to really support these changes,” said Jacinda Abdul-Mutakabbir, PharmD, MPH, assistant professor of clinical pharmacy and antimicrobial resistance researcher at UC San Diego.

And she points to the anecdotal evidence about the efficacy of pediatric vaccines, witnessed in the diseases she has never had to treat.

“I have not seen most of these diseases before, especially when it comes to polio and measles, and I think that's the evidence. I have not seen these because we have had vaccinations.”

Sharon Nachman, MD, chief of pediatric infectious diseases, Stony Brook Children's Hospital, says the decision to change the vaccine policies not only didn’t show any data to justify it, the federal government agencies did not go through the regular process of discourse to align with the public and medical field.

“All of us here rely on data. We read studies. We are careful with what we read,” Nachman said. “The most recent set of recommendations, of we don't need this vaccine, and we don't need that vaccine. Actually, were just thrown out there. They did not, in fact, go through ACIP. They did not have any public forum. They were not discussed in any manner, shape, or form. They were just sort of told to us on a Monday, ‘Okay, we're done with these vaccines. Thanks. Goodbye. You're finished.’ And that just stretches the bounds of credibility for anyone. None of us would go in front of a family and say, ‘Here's this medication you need, because I said so.’ We always explain to families why we're doing what we're doing, and there's a reason and a rationale and information about it—it's not my opinion.”

“I think what Dr Nachman said, is just so important, when she said about how we speak to families. I mean, this whole thing about we want shared clinical decision making so parents can weigh in. We have always done that,” said Mary Koslap-Petraco, DNP, PNP-BC, CPNP. “You never say, ‘oh, take this vaccine,’ and that's the end of it. It was an explanation, [including] what was the disease, why it's needed, and these are the potential side effects.”

In the next episode, the panelists discuss how clinicians should approach vaccination in children who have chronic disease or are immunocompromised.