Pediatricians group snubs RFK Jr., offers its own vaccine guidelines

A major medical organization is splitting from the federal government in crafting recommendations for Covid-19 vaccinations, an unprecedented move that reflects a growing rift between the scientific community and the Trump administration’s health agencies.

On Tuesday, the American Academy of Pediatrics released its own immunization schedule ahead of respiratory virus season, including guidance on which children should receive RSV, flu, and Covid-19 vaccines. The organization recommended Covid shots for all children between 6 and 23 months old, as well as for children over 2 at high risk for severe disease. This guidance runs counter to the Food and Drug Administration’s recent decision to limit access to the vaccines to people over 65 and others who are at high risk of becoming seriously ill if infected.

“The AAP will continue to provide recommendations for immunizations that are rooted in science and are in the best interest of the health of infants, children and adolescents,” AAP President Susan J. Kressly said in a statement. 

The FDA authorized Covid-19 vaccines for emergency use for children in 2021, following trials that found the vaccine was 90.7% effective in preventing infection and did not lead to any serious side effects. Since then, booster shots had been authorized when needed. 

However, under the Trump administration the FDA has changed course. In May, the agency moved away from blanket recommendations for future Covid booster vaccines with a commentary published in the New England Journal of Medicine by FDA Commissioner Marty Makary and Vinay Prasad, the head of the FDA’s Center for Biologics Evaluation and Research. 

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“For all healthy persons — those with no risk factors for severe Covid-19 — between the ages of 6 months and 64 years, the FDA anticipates the need for randomized, controlled trial data evaluating clinical outcomes before Biologics License Applications can be granted,” they wrote in the commentary. 

The FDA’s new framework did not apply to vaccines already on the market, meaning that people’s access to shots had not yet been affected. But the agency’s decisions could impact forthcoming booster shots.

AAP’s recommendations on RSV and flu do not dramatically differ from the current government guidance. In July, Health and Human Services Secretary Robert F. Kennedy Jr. signed off on a recommendation by advisers to expand the population of adults eligible for the RSV vaccine. Kennedy also approved the removal of thimerosal from flu vaccines, despite little evidence that it causes harm. 

Since the mid-1990s, the AAP’s vaccine recommendations have been in lockstep with the Centers for Disease Control’s Advisory Committee on Immunization Practices. But the committee has been reconstituted in recent months. In June, Kennedy fired all 17 ACIP members — public health and infectious disease experts chosen through a nomination process — and replaced them with seven appointees who have, in several cases, a history of skepticism around vaccines. Kennedy also announced recently that he was canceling half a billion dollars worth of grants for development of mRNA vaccines, and the head of the National Institutes of Health has repeatedly insisted the public has lost trust in mRNA vaccines.

It’s unclear how the splintering guidance will be interpreted by doctors, nurses, and other medical professionals. In the past, physicians relied on a uniform set of vaccine recommendations endorsed by the federal government and professional medical groups. Now, providers will be forced to navigate conflicting counsel. They’ll also have to explain the various recommendations to confused parents at a moment when public trust in vaccines is falling precipitously.

The AAP’s recommendations are part of a larger push by medical and professional groups to counter the skepticism put forth by the Trump administration. Later on Tuesday, the Vaccine Integrity Project, a newly created group aimed at assessing the best ways for vaccine proponents to safeguard vaccination policy and information, will host a presentation where it will lay out the latest evidence on flu, Covid, and RSV vaccines.