Medical groups step in as HHS alters US vaccine guidance
Independent medical organisations are preparing to issue evidence-based vaccine recommendations as federal policy shifts create uncertainty for patients and insurers, after the US Department of Health and Human Services (HHS) adopted advisers’ advice to drop thimerosal from about 4% of flu vaccines while Robert F Kennedy Jr declined votes to recommend annual flu shots for everyone over six months and RSV shots for infants.
As official guidance changes and “science becomes increasingly politicized”, groups including the American College of Obstetricians and Gynecologists (ACOG) plan new recommendations, with ACOG set to release updated Covid, flu and RSV guidance for pregnancy by the end of the summer before the winter respiratory season; the American Academy of Pediatrics, the Infectious Diseases Society of America, the American Academy of Family Physicians, and the American College of Physicians also intend to publish vaccine guidance.
Numbers in context: thimerosal currently appears in about 4% of flu vaccines; recommendations would have applied to everyone over six months and RSV shots for infants; the Vaccine Integrity Project is analysing 16,400 publications and expects to finish in the next two to three weeks; more than five decades have passed since ACIP began advising (1964).
The effort is anchored by the Vaccine Integrity Project at the University of Minnesota’s Center for Infectious Disease Research & Policy (Cidrap), where Michael Osterholm said, “We’re not making recommendations ourselves. We’re just providing them with the information,” while Scott Rivkees of Brown University argued that the medical community now disagrees with health agencies’ approach and is pivoting to collaborate on its own guidance.
Kennedy and other officials have announced new restrictions on Covid vaccines, and Kennedy framed measles, mumps and rubella vaccination as a “personal” choice during the worst US measles outbreak in three decades; Osterholm warned Americans face an “information crisis” and said “the CDC science has been corrupted”, while Rivkees said changing guidance “results in total confusion” that fuels hesitancy and refusal.
Method and implications: medical groups will draw on the project’s wide-ranging review to guide children, high-risk people, pregnant people and healthy adults, and the shift raises practical questions under the Affordable Care Act, which requires insurers to cover vaccines recommended by ACIP—if ACIP alters recommendations, insurers may stop paying and families could face out-of-pocket costs, potentially shrinking vaccine supply as manufacturers reassess markets.
Osterholm said respiratory vaccine guidance is only the beginning and the next focus will be data for other routine vaccinations; Rivkees warned of increased measles, whooping cough and meningitis if uptake falls, while Osterholm added, “We need our old ACIP back,” stressing that outside recommendations are a stopgap until ACIP and CDC leadership return to longstanding roles.
