Amid recent changes in vaccine guidelines coming from the federal government, area medical experts are voicing concerns about children’s health and public confusion.
In 2024, the RSV (respiratory syncytial virus) vaccine, introduced the previous year, decreased hospitalizations for children less than 2 years old by an estimated 50%.
By 2030, the Centers for Disease Control and Prevention predicts that immunizations can prevent more than 50 million deaths, with the hepatitis B vaccination saving 14 million lives.
As of Jan. 5, the CDC’s vaccine guidelines no longer routinely recommend the RSV and hepatitis B vaccines universally — instead, they’re recommended only for high-risk groups.
With the vaccine guideline updates, the CDC reduced its universally recommended childhood vaccinations from 17 to 11. It split recommendations into three categories: vaccines recommended for all children, vaccines recommended only for certain high-risk groups and those that should be given based on “shared clinical decision-making.”
“Unlike routine, catch-up, and risk-based recommendations, shared clinical decision-making vaccinations are not recommended for everyone in a particular age group or everyone in an identifiable risk group,” the CDC website explains. “Rather, shared clinical decision-making recommendations are individually based and informed by a decision process between the health care provider and the patient or parent/guardian.”
Some of the other vaccines not routinely recommended anymore include hepatitis A, COVID-19 and influenza.
The changes were made to restore trust in public health after the COVID-19 pandemic, according to senior Health and Human Services Department officials.
Dr. Amy Lee, professor of family and community medicine at Northeast Ohio Medical University, said she feels this is ironic.
“I think this is actually going to decrease the amount of trust that people have in the CDC and government and public health,” Lee said. “The recommendations seem to be going back and forth, and people are getting whiplash.”
Local experts fear growing mistrust in public health
Childhood vaccinations prevent about 4 million deaths worldwide every year, according to the CDC’s website.
“One of the greatest accomplishments of public health is vaccinations,” said Lee, who is also the program director for the Consortium of Eastern Ohio Master of Public Health.
Kristin Englund, an infectious disease specialist and former president of the Academy of Medicine of Cleveland & Northern Ohio, said she was heartbroken when she learned of the new guidelines.
“It is so hard to imagine that in the near future, we’re going to see children getting ill, hospitalized and, God forbid, even potentially dying from diseases that are completely preventable,” Englund said.
In the past, Lee said, the Advisory Committee on Immunization Practices would discuss evidence and then make it public for comment.
The latest changes, however, were not recommended by the advisory committee, Lee said.
The lack of transparency from the federal health officials who made these changes makes the scientific and public health community skeptical of their decisions, she said.
“How can you trust decisions that are made without any explanation?” Englund asked.
She said she believes the goal was to appease people who are against vaccinations.
She worries that they are going to tear down evidence-based recommendations a little bit at a time.
Dr. Hanna Lemerman, medical director of primary care, quality and improvement at Akron Children’s Hospital, said the decision was based on policy rather than science.
Akron Children’s aligns with the American Academy of Pediatrics’ vaccination schedule, which is based on rigorous scientific review. Lemerman said she trusts the academy’s guidelines both as a physician and as a parent.
“The science around the vaccine childhood schedules has not changed,” Lemerman said.
One of her biggest concerns is that if trust in vaccines goes down, or if people believe certain vaccines aren’t as necessary, preventable diseases will return.
She said diseases like rotavirus, an intestinal illness, and hepatitis B could come back if there is not a certain amount of shared immunity, which is partially achieved through vaccination.
Experts say confusion over childhood vaccines could lead to bad consequences
The three categories the new guidelines lay out are artificial, Lee said.
“Many of the children who die of some of these diseases, they didn’t have any kind of risk to begin with,” Lee said.
Lemerman said the categories add another obstacle to getting vaccines.
“You’re protecting yourself, but you’re also protecting those in the community who haven’t been vaccinated yet or are at higher risk,” Lemerman said.
In the midst of one of the worst flu seasons in more than a decade, Englund said it’s dangerous to tell parents that they don’t need to get their children vaccinated against it.
She worries that parents will think vaccines on the lists for high-risk children and shared medical decision-making aren’t safe for all children.
And for those who were already starting to question vaccines, she said, this gives them more ammunition to opt out.
Have questions? Talk to your child’s doctor
Lemerman said it’s important for parents to talk to their child’s pediatrician, ask all their questions and figure out what’s best for their family.
“We want to talk about it,” Lemerman said. She pointed out that shared clinical decision-making already happens at every visit.
Jennifer Scarbrough, a mom from Copley whose two kids are Lemerman’s patients, said they have established a good relationship over the past decade with open communication.
Because Lemerman knows her kids and their medical history so well, Scarbrough said she trusts the doctor’s knowledge.
When it comes to other kids not getting vaccinated, she said she isn’t that worried because it’s out of her control.
“I can’t control somebody else’s parenting decision, but I know that for my kids, I want them to be safe from these harmful and deadly diseases and things that have been fairly out of the picture for quite some time now because of the vaccines,” she said.
She recommended that other parents trust their gut and find a physician with whom they can have a good, trusting relationship.
“We know that when there’s changes in recommendations as well as differences in guidelines, it naturally leads to confusion, and it’s really understandable that families feel confused right now,” Lemerman said.
Lee emphasized that patients should bring their concerns to their doctors.
“We don’t have to be sick,” Lee said. “We don’t have to die of things like measles and the flu if people get vaccinated.”
Where to get free or reduced-cost vaccines
The Vaccines for Children program covers the cost for low-income families without insurance.
You can learn more about it by calling Summit County Public Health at 330-923-4891. The health department also offers reduced-cost vaccines.
Lauren Cohen is a community reporting intern for the Akron Beacon Journal and Signal Akron. The position is funded through a grant from the Knight Foundation, which is also a financial supporter of Signal Akron.