Earlier this week, Kennedy changed the childhood vaccine schedule issued by the CDC. Given Kennedy’s long history of discouraging childhood immunization and making false claims about vaccine safety, it wasn’t a surprise that Kennedy used his power of the state to reduce the number of recommended vaccines.
His changes aren’t evidence based and run counter to decades of clinical evidence and public-health practice… but they really just change how vaccines are categorized, not whether they’re available, covered by health insurance or required for preschool / K-12.
How changes to the federal vaccine schedule will affect Arizona
What Didn’t Change
- Insurance coverage and reimbursement aren’t changing.
- Most clinicians are unlikely to change how they practice.
- Arizona’s preschool & K-12 vaccine requirements stay the same.
The following vaccines are still universally recommended by CDC, widely accepted clinically, and are still required for school entry (except for HPV which isn’t required for schools).
- Measles, mumps, and rubella (MMR)
- Polio
- Diphtheria, tetanus, and pertussis (DTaP)
- Haemophilus influenzae type b (Hib)
- Pneumococcal disease
- Human Papilloma Virus
- Varicella (chickenpox)
What Did Change
Rather than removing vaccines entirely, Kennedy shifted several vaccines out of the “routine universal recommendation” category and into “risk-based” or “shared clinical decision-making” buckets. Vaccines no longer universally recommended but still must be covered with no co-pay include:
- Rotavirus
- Influenza (flu)
- Hepatitis A
- Hepatitis B
- Meningococcal disease (ACWY and B)
- Respiratory syncytial virus (RSV)
- COVID-19
Hepatitis A is now on the ‘high-risk’ list but will still be paid for by insurance and the VFC program and will remain a requirement for preschool entry in Arizona (with medical and religious exemptions, but no personal exemption).
Meningococcal vaccines were moved to the ‘shared clinical decision making’ list but are still covered by insurance and VFC and are still required for middle school entry.
Hepatitis B, RSV, and meningococcal vaccines are now recommended only for specific at-risk populations rather than all children, but most pediatricians follow the American Academy of Pediatrics recommended schedule and will continue to recommend and administer them to their patients.
Kennedy’s changes run counter to decades of clinical evidence and public-health practice, but they’re about how vaccines are categorized, not whether they exist or are available and covered.
Vaccine Coverage Unchanged
One of the biggest misconceptions following this announcement is that families will suddenly face new costs or coverage barriers. That’s not the case.
- Commercial insurance plans must still cover childhood vaccines with first-dollar coverage, regardless of whether a vaccine is listed as universal, risk-based, or shared clinical decision-making.
- Medicaid coverage stays unchanged through the Vaccines for Children (VFC) program.
- The same is true for the Indian Health Service.
In short, vaccines are still paid for, accessible, and available at no cost to families.
Most Clinicians Won’t Change Their Practice
Another reality check: most pediatricians, family physicians, and primary care providers are not going to follow Kennedy’s guidance. Clinicians understand that these changes are not grounded in scientific evidence. They know that these vaccines have a tremendous public health and personal health value and are among the most rigorously tested medical interventions, with extensive clinical trials and a robust post-market safety monitoring system.
In practice, most providers will keep recommending and administering vaccines the same way they always have.
Why it Still Matters
Even though the practical and immediate impact of these specific changes are limited they will most likely lead to a further erosion in childhood immunization rates.
Why? Because moving vaccines out of the universal category sends a signal to uninformed and hesitant parents that the vaccines on the high risk and joint clinical decision-making list are optional or less important. Over time that’ll lead to higher exemption rates and lower community protection, particularly for diseases like meningococcal infection and hepatitis A.
Still, the delivery system for childhood vaccines in Arizona is still intact. All these vaccines will still be covered by health insurance and VFC. The Arizona school vaccine requirements stay intact.
Yet, Kennedy’s action will lower vaccination rates and create more outbreaks and bad and even fatal outcomes.
What’s truly chilling is that Kennedy is just getting started and has 3 more years to use his authority to undermine vaccination using his sweeping powers. That will come as his ACIP members continue to change their recommendations.
More about that in my next piece.