AAP Counters ACIP Guidance in New Immunization Schedule

America’s leading professional pediatric association has released its latest immunization schedule, contravening current federal COVID-19 immunization guidance.

The immunization schedule was published on August 19 in the American Academy of Pediatrics (AAP)’s Redbook Online and calls for universal COVID-19 immunization beginning at 6 months. It also includes the group’s formal recommendations for routine infant, children, and adolescent immunizations against 18 diseases. There are also updated recommendations for respiratory syncytial virus and influenza.

“We extensively reviewed the most recently available data about COVID-19 risks in kids, as well as safety and effectiveness of available COVID-19 vaccines. It’s clear they are very safe for all populations,” Sean O’Leary, MD, chair of the AAP Committee on Infectious Diseases, said in a statement.

In May of this year, Health and Human Services Secretary, Robert F. Kennedy, Jr, announced in a video posted on X, that the CDC had dropped Biden era recommendations that all pregnant women and children be given the COVID-19 vaccine. The video came on the heels of the CDC’s announcement that only 13% of eligible children were up to date on their COVID-19 vaccine. In children aged 6 months to 23 months, that number was about 5%.

‘Evidence-Based’ vs ‘Conflict of Interest’

The AAP said its COVID-19 recommendations are “evidence-based” and that they “differ from recent recommendations of the Advisory Committee on Immunization Practices of the CDC, which was overhauled this year and replaced with individuals who have a history of spreading vaccine misinformation.”

Kennedy’s office shot back that the AAP is not acting in good faith.

“By bypassing the CDC’s advisory process and freelancing its own recommendations, while smearing those who demand accountability, the AAP is putting commercial interests ahead of public health and politics above America’s children,” Kennedy’s Communications Director, Andrew Simpson, said in a statement provided to Medscape Medical News.

Kennedy’s office continued, “The American people deserve confidence that medical recommendations are based solely on science and public health. We call on the AAP to strengthen conflict-of-interest safeguards and keep its publications free from financial influence, ensuring every recommendation reflects only the best interests of America’s children.”

COVID-19

The Academy noted that because it can be fatal in children, especially those aged 6 months through 23 months; it recommends a COVID-19 vaccine for this patient population, unless they have a known allergy to the ingredients of the vaccine.

An age-appropriate COVID-19 vaccine is recommended for all children and adolescents 2 through 18 years of age in the following risk groups:

• Persons at high risk for severe COVID-19
• Residents of long-term care facilities or other congregate settings
• Persons who have never been vaccinated against COVID-19
• Persons whose household contacts are at high risk for severe COVID-19

The most updated version of the vaccine should be made available to any parent or guardian who desires their child to be protected against COVID-19, according to the Academy’s recommendations.

The AAP’s COVID-19 vaccine guidelines are published online and will be published in the November issue of Pediatrics.

“Among the reasons we decided to move to a risk-based recommendation for healthy older children is the fact that the hospitalization rate for young children and children underlying medical conditions remains high, in line with rates for many of the other vaccine-preventable diseases for which we vaccinate,” O’Leary said.

Federal recommendations state that the COVID-19 shot is not universally recommended, but that physicians take a case-by-case approach in pediatric cases. Adults aged 18 years or older are still advised to receive the vaccine under this administration.

‘Rooted in Science’

The AAP’s other vaccine recommendations largely mirror those of ACIP. The new schedule also addresses recent updates on pentavalent meningococcal vaccine, the starting age of the human papilloma virus vaccine, and the removal of a hepatitis vaccine that is no longer available, according to the statement.

“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, MD, said in the statement. “Pediatricians know how important routine childhood immunizations are in keeping children, families, and their communities healthy and thriving.”

Insurance Coverage in Question

Insurance coverage for vaccinations is normally based on federal recommendations. Now that there is a schism in recommendations, coverage is in question.

“The AAP urges every insurer to cover all the vaccines that are included in this immunization schedule,” Kressly said in the statement. “AAP is committed to working with our partners at the local, state, and federal levels to make sure every child, in every community, has access to vaccines.”

Kennedy’s office, meanwhile, told Medscape Medical News, “The AAP is undermining national immunization policymaking with baseless political attacks. Secretary Kennedy has stood firm in his commitment to science, transparency, and restoring public trust.”