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Families who want their child to get vaccinated against COVID may be able to do so after a conversation with their health care provider, federal health officials said as the guidance continues to evolve.
While officials announced earlier this week they no longer recommend routine COVID vaccination for healthy children, the Centers for Disease Control and Prevention (CDC) added a provision to the immunization schedules Thursday for shared clinical decision-making. The guidance applies to children ages 6 months to 17 years who are not moderately or severely immunocompromised.
“If a parent desires their healthy child to be vaccinated, their decision should be based on informed consent through the clinical judgment of their health care provider,” a Health and Human Services (HHS) spokesperson said Friday.
The AAP has been deeply concerned about the changing guidance in recent weeks and said it is relieved families will have access to the immunization after confusing and mixed messages. Including the vaccine on the immunization schedule means it will be covered by insurance.
“This means many children and adolescents can access a vaccine to protect them from some of the serious complications of this disease, including long Covid,” AAP President Susan J. Kressly, M.D., FAAP, said in a statement. “However, the deeply flawed process to reach the recommendation raises serious concerns about the stability of the nation’s immunization infrastructure and commitment by federal leaders to make sure families can access critical immunizations, whether for Covid or other infectious diseases.”
Federal guidance on COVID-19 vaccines has been in a state of flux over the past 10 days with several agencies making conflicting recommendations without coordination with physician groups or explanation of the underlying evidence and process informing recommendations.
On May 20, the Food and Drug Administration (FDA) announced new randomized, controlled trials would be needed for COVID vaccines for healthy people under 65 years. Earlier this week, HHS Secretary Robert F. Kennedy Jr. said the CDC would remove the routine recommendations for COVID vaccination for healthy children and people who are pregnant, with no mention of an option for families who want a vaccine to be able to get one. The guidance evolved again Thursday with the addition of shared clinical decision-making for children.
However, this option is currently not listed for people who are pregnant, which would leave them at risk of severe illness as the CDC considers pregnancy a high-risk condition. It also leaves their infants unprotected until they are able to get vaccinated at 6 months of age. The AAP is continuing to advocate for pregnant people and health care workers to have access to COVID vaccines.
The actions by federal officials circumvent the standard process for vaccine recommendations. Typically, the FDA reviews safety and efficacy data and decides whether to license vaccines. Then, the CDC’s Advisory Committee on Immunization Practices makes recommendations as to who should receive the vaccines. That group was in the process of discussing recommendations and is scheduled to meet in late June.
“The AAP urges our nation’s public health leaders to return to a process that is transparent, based in science, inclusive of medical expertise, and focused on the needs of children and families,” Dr. Kressly said. “The AAP also urges families to continue to talk with their pediatricians about their child’s immunizations. For many families, the Covid vaccine will remain an important way they protect their child and family from this disease and its complications, including long Covid.”
The AAP’s Committee on Infectious Diseases will be examining the evidence to make its own recommendations about vaccination as it typically does.
“While the shared clinical decision-making model in the updated immunization schedule preserves families’ choice, this model has consistently proven challenging to implement because it lacks clear guidance for the conversations between a doctor and a family,” Dr. Kressly said. “Doctors and families need straightforward, evidence-based guidance, not vague, impractical frameworks.”
