CDC Adopts ‘Individual-Based’ Approach for COVID-19 Vaccination in New Schedule

The CDC has updated its child and adult immunization schedules in accordance with the most recent recommendations from the Advisory Committee on Immunization Practices (ACIP). The new vaccination schedules call for individual-based decision-making for COVID-19 vaccination. The varicella (chickenpox) vaccine is recommended as a standalone vaccine rather than in combination with measles, mumps, and rubella (MMR).

The CDC press release states, “Clinical decision to vaccinate should be based on patient characteristics that, unlike age, are difficult to incorporate in recommendations, including risk factors for the underlying disease as well as the characteristics of the vaccine itself and the best available evidence of who may benefit from vaccination.”

During the COVID-19 vaccine rollout and the subsequent years of booster doses, many Americans received their vaccinations at pharmacies like CVS and Walgreens, which bypassed any discussion with a doctor or primary care physician about the patient’s personal health history.

According to CDC data, 59.8 million COVID-19 bivalent doses were administered in the US from September 1, 2022, to September 30, 2023. 67.7% of those doses were administered at pharmacies within the Federal Retail Pharmacy Program (FRPP). 81.6% of doses in urban areas were administered at these locations compared to 60% of doses in rural areas.

An NPR article about the updated regulations includes remarks challenging the assertion by acting CDC Director Jim O’Neill that health care providers were deterred from talking with their patients about the risks and benefits of getting the COVID-19 vaccination.

Dorit Reiss is a professor of law with expertise in vaccine policy and has advocated against religious exemptions. She said, “Doctors [have always been] required to get informed consent. Shared clinical decision-making simply signals the vaccine is not routinely recommended and decreases uptake.”

The COVID-19 vaccines are no longer routinely recommended based on updates at the CDC and FDA that align more closely with the policies of other countries. The uptake for COVID-19 boosters in the US has significantly declined since the initial rollout. Despite recommendations last year that everyone over 6 months of age receive a booster, less than 25% of all Americans received a COVID-19 booster in the previous two years. Less than 10% of children under 12 received the booster last year, and about 50% of adults over the age of 75 received the booster, despite being considered in the high-risk category.

Dr. Tina Tan, the president of the Infectious Diseases Society of America, said, “This is extremely unfortunate and critically increases the American public’s risk for serious vaccine-preventable diseases.”

The NPR article states that getting the vaccine in previous years was as easy as walking into a pharmacy and asking for the shot, and the new recommendations are making it more challenging. While all Americans can still access the vaccine after a discussion with a health care provider, the United Kingdom only provides the vaccines to elderly individuals in care homes, those over the age of 75, and those who are immunocompromised. Anyone else is ineligible to receive a COVID-19 booster.

In May, the FDA announced it would no longer routinely approve new formulations of the COVID-19 vaccine for healthy individuals under the age of 65. At the time, Commissioner Dr. Marty Makary said the US has been the contrarian in COVID-19 vaccine policy until these changes were implemented.

“I think the most compelling information in the New England Journal paper is the vaccine COVID booster recommendation schedule in so many other countries in Europe and the world,” Dr. Makary said during the press conference. “And so it would almost seem as if the current US strategy, which is urging every single baby, and teenager, and child, and healthy American, and high-risk American, encouraging every single one to get a booster every year. That is the outlier contrarian approach.”

NPR states there is “overwhelming evidence the vaccines are very safe and highly effective,” without providing the sources or documenting the particular concerns that have been raised regarding COVID-19 vaccination. In June, the administration updated the labels for the COVID-19 vaccines by Pfizer and Moderna to warn consumers about the increased risk of myocarditis. Florida Surgeon General Joseph Ladapo has called for the shots to be removed from the market after the federal health agencies failed to provide proof that DNA integration is not possible following reports of DNA contaminants in the vaccine doses.

The House Committee on Energy and Commerce’s Subcommittee on Oversight and Investigations released a report last year detailing the unscientific COVID-19 vaccination campaign that relied on inflated numbers of pediatric deaths. A report from the American Academy of Pediatrics showed that pediatric deaths only represent 0.26% of all COVID-19 deaths in 2022.

Texas Attorney General Ken Paxton issued a statement condemning the Texas Medical Association (TMA) for “undermining” the ACIP and CDC recommendations. While the TMA has not issued an official statement about the updated guidance, it is now directing members to resources other than federal government health agencies, such as the American Academy of Pediatrics (AAP), which has been criticized for conflicts of interest due to its active partnerships with pharmaceutical companies.

“It’s outrageous TMA is undermining ACIP’s new federal guidelines for COVID-19 vaccines that expand personal freedom and mitigate the medical tyranny of the Biden Administration,” AG Paxton said. “TMA has chosen to try and ignore the overwhelming evidence and science-backed recommendations from ACIP that ensure Texas children are not subjected to a one-size-fits-all COVID-19 vaccine mandate.”

In addition to the COVID-19 vaccine update, the MMRV vaccine will no longer be covered by federal programs. Children are recommended to receive the varicella (chickenpox) vaccine separately from the MMR vaccine due to an increased risk of febrile seizures associated with the combination vaccine.