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An extensive overhaul of American pediatric immunisation guidelines has led to a reduction in the number of universally recommended immunizations from 17 to 11.

The newly issued list from the CDC includes essential vaccines for illnesses like poliomyelitis and measles. However, others, such as liver infection vaccines and Covid vaccines, are now categorized based on individual risk factors and subject to "joint clinical decision-making" between doctors and parents.

"The new guideline is dangerous and needless," criticized the AAP, describing the change.

This sweeping guideline shift constitutes the most recent major action implemented under the current administration by HHS Secretary Robert F. Kennedy Jr.

Official Rationale and Global Alignment

Kennedy asserted the revision came "after an exhaustive review" and "protects children, honors parents, and restores trust in public health."

"This aligning the American childhood immunization calendar with international consensus while enhancing transparency and parental choice," he added.

According to the announcement, the updated core recommendation for every minors will include immunizations for:

• Measles, mumps, and rubella (MMR)
• Polio
• DTaP/Tdap (Diphtheria, Tetanus, Pertussis)
• Haemophilus influenzae type b (Hib)
• Pneumococcal infection
• HPV
• Varicella (chickenpox)

Three Categories of Recommendations

The new structure creates three separate tiers of immunization guidance:

1. Universal Recommendations: The eleven shots mentioned above are advised for every children.
2. Risk-Based Vaccines: This group contains vaccines for respiratory syncytial virus, Hep A, Hep B, dengue fever, and meningococcal types (ACWY and B). They are suggested based on a child's specific health circumstances.
3. Optional Vaccines: Immunizations for Covid-19, the flu, and a stomach virus are now left to case-by-case consultation and decision between parents and their physicians.

For the time being, medical insurance will continue to pay for vaccines that are currently recommended until the end of 2025.

International Perspective and Recent Debate

The CDC conducted a review of existing childhood schedules with those of 20 other industrialized countries. It determined the US was "an international exception" in both the quantity of diseases covered and the number of doses administered, the Department of Health and Human Services said.

This latest change follows weeks after a separate CDC panel adjusted the schedule for the first liver infection vaccine. Previously, a first shot was advised for newborns within a day of delivery. Revised rules last winter moved that to two months post birth if the mother tested negative for hepatitis B.

That prior change was roundly criticised by paediatricians, with the AAP calling it "a dangerous step that will hurt children."