Health secretary Robert F. Kennedy Jr. announced Tuesday that he has unilaterally struck the recommendation that healthy children and healthy pregnant people get Covid-19 booster shots — a move that experts say is unprecedented.
Kennedy made the announcement on the social media site X, flanked by Jay Bhattacharya, director of the National Institutes of Health, and Marty Makary, the commissioner of the Food and Drug Administration.
“It’s common sense, and it’s good science,” said Bhattacharya, whose agency has no involvement in the regulation of vaccines, or in decisions on who should get them.
Absent from the video was anyone from the Centers for Disease Control and Prevention, which sets policy for who should get approved vaccines on the advice of its expert panel, the Advisory Committee on Immunization Practices. The CDC is currently without an acting director.
The CDC’s website still lists Covid vaccines in the pediatric vaccination schedule, the list of which vaccines children and pregnant people ought to get, and at which time.
It is extraordinary that a health secretary would remove vaccines from a CDC vaccination schedule without undergoing a consultation process, and without asking the advice of the ACIP, Dorit Reiss, a law professor at UC Law San Francisco who follows vaccination policy closely.
“There is a process, and it hasn’t been followed,” Reiss told STAT in an interview. She suggested the lack of process could make the decision vulnerable to being overturned, if it is challenged in court. A court would demand that such a change in policy was the result of a deliberative process, she said.
“Administrative decisions actually have to be made on the basis of something, not just because the agency feels like it,” Reiss said. “A one-minute video on Twitter is not a thorough explanation.”
Kathryn Edwards, a vaccines expert who is a former member of the ACIP and a professor emeritus at Vanderbilt University, was also critical of Kennedy’s move. “He’s overstepped his bounds,” she said.
Reiss noted that in a New England Journal of Medicine article last week announcing a new approach to use of Covid booster shots, Makary and Vinay Prasad, who oversees the FDA’s Center for Biologics Evaluation and Research, listed pregnancy as one of the medical conditions that warrants Covid vaccination.
Removing booster shots from the recommended schedules for healthy children and healthy pregnant people may induce some insurers to remove coverage for the vaccines, Reiss said, suggesting the result will likely be a patchwork, with some insurance companies retaining coverage and others dropping it.
She also said that even for parents who want to vaccinate their children, and pregnant people who want to get boosters, there may be confusion on the part of health professionals who give vaccines as to whether vaccination is permitted.
Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, noted that Kennedy’s decision is in contradiction to a promise he made during his Senate confirmation process that he would not take vaccines away from people who want them.
The decision comes at a time when the ACIP has been in the process of reviewing who should get Covid vaccines. A subcommittee of the group that focuses on Covid vaccination policy indicated last month that it intends to recommend that the current universal vaccination recommendation be replaced with one that urges people at high risk of severe illness if they contract Covid to continue to be vaccinated.
Though final details of its recommendation haven’t yet been made public, it appears the group will suggest that people over age 65; people at high risk because of medical conditions — including pregnant people; and very young children should still be urged to be vaccinated. It is likely the new recommendation — if approved by the full committee and the CDC director — would stipulate that other people could be vaccinated against Covid if they wish.
This story has been updated with additional comments.
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