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It’s normal for parents, or anyone for that matter, to have questions about vaccinations — but what if your pediatrician insists on a shot that doesn’t involve vaccinations? trump Administration?
It’s looking increasingly likely: The nation’s leading doctors’ groups are in an unprecedented standoff with federal health officials who have attacked long-used, life-saving vaccines.
The rebellion of pediatricians, obstetricians, family physicians, infectious disease specialists and trainees reached a climax when an advisory panel selected by Health Secretary Robert F. Kennedy Jr. urged ending routine newborn vaccination against hepatitis B, a virus that can cause liver failure or liver cancer.
The vaccine saves lives, helps reduce childhood infections and has been safely given to millions of children in the US alone, it says American Academy of Pediatrics And another doctors’ group vowed Tuesday to keep recommending it.
But this is not the only difference. The Advisory Committee on Immunization Practices is now examining possible changes to the entire childhood vaccination program, raising questions about some ingredients and how many doses youngsters get.
Stepping back, the American Academy of Pediatrics has released its own recommendations for youth. Other medical groups — as well as some city and state public health departments that have come together — also are issuing their own advice on some vaccines, largely mirroring federal guidance prior to 2025.
“We want to give our patients a consistent message informed by evidence and lived experience, not a message driven by political imperatives,” Dr. Ronald Nahas, president of the Infectious Disease Society of America, told reporters Tuesday.
But Nahas acknowledged the inevitable consumer confusion a relative called her last weekend for advice about hepatitis B vaccination for her new grandson.
“Most Americans I don’t have a cousin Ronnie to call. They are left alone with fear and disbelief,” he said, urging parents to talk to their doctors about vaccines.
New guidelines without new data worry doctors
hepatitis B This is not the only vaccine challenge. Kennedy’s health department recently altered a Centers for Disease Control and Prevention webpage to refute the longstanding scientific conclusion that vaccines do not cause autism. Federal agencies have also moved to restrict COVID-19 vaccinations this fall, and are planning policy changes that could restrict flu and coronavirus shots in the future.
But when it comes to vaccine advice, “for decades, ACIP was the gold standard,” said Dr. Jake Scott, an infectious disease physician and MD. Stanford University Researcher.
He said panels once routinely enlisted experts in specific diseases for lengthy deliberations of the latest science and safety data, resulting in recommendations generally adopted not only by the CDC but by the medical field at large.
The meeting of Kennedy’s panel last week, which also included vaccine skeptics, marked a paradigm shift. CDC experts were not allowed to submit questions about data on hepatitis B, the childhood vaccine schedule, or vaccine ingredients. Few committee members have public health experience, and some have expressed confusion about the panel’s proposals.
At one point, a doctor called in to say that the panel was misrepresenting the findings of its study. And the panel chairman wondered why one dose of yellow fever vaccine protected him during a trip to Africa, while American children get three doses of hepatitis B vaccine. The hepatitis B vaccine is designed to protect children throughout their lives from exposure to the virus, which they may encounter anywhere, not just when traveling abroad. And other scientists noted that it took years of careful study to prove that a three-dose course provides decades of immunity — evidence that a single dose does not.
“If they’ve got new data, I’m all for it — let’s look at it and have a conversation,” said Dr. Kelly Gebo, an infectious disease expert and public health dean at George Washington University, who followed it. “I haven’t seen any new data,” so she’s not changing her vaccine advice.
Committee members argued that the risk of hepatitis B infection in most infants is very low and that earlier research on infant shot safety was inadequate.
Particularly unusual was a presentation by an attorney who expressed skepticism about studies that proved the benefits of many childhood vaccines and promoted discredited research pointing to harms.
Jason Schwartz, a vaccine policy expert at Yale University, said, “I don’t think at any point in the committee’s history, there was an uninterrupted 90-minute presentation on this topic by someone who was not a physician, scientist or public health expert – let alone someone who makes a living in vaccine litigation.”
By discarding data and the consensus of front-line doctors, ACIP is “actively destroying the credibility that has made its recommendations so powerful,” Stanford’s Scott said. “Most parents will still follow their pediatricians, and the AAP is holding the line here. But the mixed messages certainly erode confidence over time.”
Parents Already Have a Choice – They Need Solid Guidance
Trump administration health officials say it is important to restore options for parents and avoid mandates. This is how the panel’s hepatitis B recommendation was formulated – that parents who really want it can get their children vaccinated at a later date.
Dr. Aaron Milstone of the American Academy of Pediatrics said parents already have a choice. The government makes population-wide recommendations while families and their doctors make choices tailored to each individual’s health needs.
But many doctors do not — or cannot — conduct their own lengthy scientific reviews of vaccines and thus have relied on ACIP and CDC information, Yale’s Schwartz noted.
“They rely on trusted expert voices to help navigate, even in the best of times, a complex landscape about the evidence for vaccines and how best to use them,” he said.
It’s a role that groups of pediatricians and other doctors, as well as those multistate collaborations, aim to fill with their own guidelines — while acknowledging it will be a huge task.
For now, “Ask your questions, bring your concerns and let us talk about them,” said Dr. Sarah Nossel of the American Academy of Family Physicians, urging anyone with any questions about the vaccine to have an open conversation with their doctor.
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