(CNN) — The American Academy of Pediatrics released its updated recommendations for vaccines on Tuesday, including Covid-19 shots for infants and young children – a break from the current US for Centers for Disease Control and Prevention recommendations.
“It differs from recent recommendations of the Advisory Committee on Immunization Practices of the CDC, which was overhauled this year and replaced with individuals who have a history of spreading vaccine misinformation,” the AAP said in a news release.
Current CDC recommendations for the Covid-19 vaccine for children ages 6 months to 17 years should be “based on shared clinical decision-making,” the agency says.
The AAP recommendations are more explicit. It says that all children ages 6 through 23 months should receive a Covid-19 vaccine unless they have known allergies to the vaccine or its ingredients. It also recommends a single dose of the vaccine for children ages 2 through 18 years if they are at high risk of Covid-19, residents of long-term care facilities, have never been vaccinated against Covid-19, or live in a household with people who are high risk for Covid-19. It also says that the vaccine should be available for this age group even if they are not in these risk groups.
AAP has provided vaccine recommendations and published its own vaccine schedule throughout its nearly century-long history. But it has not traditionally diverged from federal recommendations.
Other groups – including the Vaccine Integrity Project, a group of outside public health experts – have also been independently reviewing data on vaccines out of concern for vaccine misinformation and access under current federal health leadership.
Tension between AAP and those driving federal health policy has been running high for months, particularly around changes to the Advisory Committee on Immunization Practices, or ACIP.
AAP has long been a liaison to ACIP, participating in meeting discussions and analyzing research in workgroups behind the scenes. But AAP chose not to participate in the ACIP meeting in June – the first since health secretary Robert F. Kennedy Jr. dismissed all 17 members of the expert panel, replacing them with seven new ones.
Dr. Sean O’Leary, chair of the AAP Committee on Infectious Diseases, said at the time that AAP liaisons to ACIP did not participate in the meeting “because we view it as illegitimate.”
“What we heard in this meeting was really a false narrative that the current vaccine policies are flawed and that they need fixing,” he said.
In August, AAP was one of roughly 30 medical and public health organizations that were formally sidelined from their roles as ACIP liaisons and told by email that they could no longer participate in the committee’s crucial workgroups. The email called the liaison members “special interest groups” that are “expected to have a ‘bias’ based on their constituency and/or population they represent.”
Vaccine recommendations from ACIP have statutory implications. Under the Affordable Care Act, insurance companies are required to cover vaccines for adults if they’ve been recommended by ACIP. The committee also votes on whether vaccines should be added to the federal Vaccines for Children program, which provides vaccines to children who would not otherwise be able to afford them.
In Tuesday’s news release, AAP urged insurance providers to cover the vaccines that are included in their schedule.
“The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children and adolescents,” AAP President Dr. Susan J. Kressly in the said in the news release. “Pediatricians know how important routine childhood immunizations are in keeping children, families and their communities healthy and thriving.”
The AAP also issued updated recommendations for RSV and flu vaccines, in addition to more than 10 other vaccines.
The US Department of Health and Human Services responded to the AAP’s immunization schedule by calling on the agency to “strengthen conflict-of-interest safeguards and keep its publications free from financial influence.”
“The American people deserve confidence that medical recommendations are based solely on science and public health,” HHS communications director Andrew Nixon wrote in a statement. “Instead, the AAP is undermining national immunization policymaking with baseless political attacks. Secretary Kennedy has stood firm in his commitment to science, transparency, and restoring public trust. By bypassing the CDC’s advisory process and freelancing its own recommendations, while smearing those who demand accountability, the AAP is putting commercial interests ahead of public health and politics above America’s children.”
In response to HHS’ comments, AAP continued to emphasize its commitment to evidence-based recommendations.
“AAP created its vaccine schedule based on the health of children and the evidence showing how vaccines support their immune systems, so they can stay healthy and do all the things we want children to be able to do,” Kressly said in a statement.
“The Academy has been making vaccine recommendations for over 90 years, longer than ACIP has been in existence, and we remain committed to supporting children’s access to vaccines,” she said. “AAP’s recommendations are based only in the science, the needs of children, and the care that pediatricians have for the children in every community.”
The Vaccine Integrity Project on Tuesday presented data from its independent review of thousands of research papers assessing the safety and effectiveness of Covid-19, flu and RSV vaccines. The evidence it found is “very consistent” with the latest recommendations from the AAP, said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and leader of the new initiative.
“Let me just be clear: We’ve looked at this very carefully, and there simply is no scientific evidence to support the change that HHS made to the Covid [vaccine] recommendations for pregnant women or for children most at risk for high-risk transmission or severe disease,” Osterholm said.
“Over the last few months, we’ve seen policy changes by federal officials based on evidence that has been shown as flawed, analytically fraught or flat out wrong. It’s vital that providers and the public continue to have vaccine information they can rely on,” he said. Analyses by the Vaccine Integrity Project are ongoing, with more information to be shared in the coming weeks as the US quickly approaches respiratory virus season.
Other changes may make access to vaccines difficult in other ways this fall. The US Food and Drug Administration has said it may limit future Covid-19 shots to older people and those who are at high risk for serious infection, and may not renew authorization for Pfizer’s Covid-19 vaccine for children younger than 5 years old.
CNN’s Brenda Goodman, Sarah Owermohle and Meg Tirrell contributed to this report.
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