U.S. federal health authorities are drawing controversy after overhauling children's vaccination policy to sharply reduce the number of diseases for which vaccination is recommended. The move is being viewed as the most radical policy change since Robert Kennedy Jr. took office as Minister of the Ministry of Health and Welfare.
According to the New York Times (NYT) on the 5th (local time), the Ministry of Health and Welfare accepted a vaccination recommendation that reduces from 17 to 11 the number of diseases for which vaccination is recommended for all children and ordered the Centers for Disease Control and Prevention (CDC) to implement it. Because this recommendation critically affects state policies and school admission requirements, the ripple effects are expected to be significant.
Under the new recommendation, the CDC classified children's vaccinations into three categories: ▲ vaccinations recommended for all children ▲ vaccinations recommended for specific high-risk individuals and groups ▲ vaccinations based on shared clinical decision-making. Of these, the "vaccinations recommended for all children" total 11, including ▲ measles ▲ rubella ▲ polio ▲ pertussis.
By contrast, ▲ hepatitis A ▲ hepatitis B ▲ meningococcus ▲ dengue fever ▲ respiratory syncytial virus (RSV) are recommended only for high-risk groups. In addition, ▲ rotavirus ▲ COVID-19 ▲ influenza are expected to be recommended only when a physician's judgment is involved. For the HPV vaccine, the number of doses is reduced from two to one.
The Ministry of Health and Welfare says the policy change was made under U.S. President Donald Trump's directive to readjust the recommendations with reference to vaccination policies in advanced countries. Minister Kennedy said, "Through cases in Germany, Denmark, and Japan, we adjusted the schedule to align with international consensus and strengthened transparency and choice," adding, "This is a decision to protect children and restore trust in public health."
The medical community immediately pushed back. Helen Chu, a professor at the University of Washington School of Medicine, said, "This sudden reversal of the nationwide childhood vaccine schedule is unnecessary and dangerous and will threaten children's health," noting, "Vaccination rates are already falling as parents are confused about vaccine safety."
In fact, in the United States, vaccination-related policies have been repealed or eased one after another since the inauguration of Minister Kennedy, an so-called "vaccine skeptic," and vaccination rates have continued to decline. As a result, the number of measles cases in the United States last year hit a record high since 1993, and by the end of this month the United States may lose the "measles elimination" status it has maintained since 2000. The incidence of vaccine-preventable infectious diseases such as pertussis has also reportedly risen rapidly in recent years.
There are also claims of procedural flaws in the decision-making. The previous vaccination recommendations were developed after comprehensive review—based on investigations by an independent federal advisory committee—of vaccine efficacy, risks, and timing, but in this overhaul those procedures were effectively skipped, pushing ahead without sufficient concrete data and expert input.
On this point, Sean O'Leary, chair of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases, criticized, "A situation in which the federal government cannot provide reliable information about vaccines will lead to tragic suffering." The AAP said it will release its own vaccination recommendations separate from the government's action.
Legal controversy also appears inevitable. Richard Hughes, a vaccine law expert and professor at George Washington University, said, "Under the Administrative Procedure Act, federal agencies must have sufficient grounds for major policy changes," adding, "The key is whether a clear reason has been presented to overturn existing expert recommendations."