Vaccine hesitancy is on the rise, and recent policy changes have spurred the medical community to speak up in warning. The American Academy of Pediatrics says it will continue to recommend a vaccination schedule based on science and evidence, and has condemned a policy change issued by the CDC.
In the meantime, parents can find the massive amounts of information, misinformation, and disinformation being spread in the public sphere confusing and may arrive at their child’s well-checks unsure which vaccines the baby should receive and why they’re important.
Let’s break down the vaccines that the CDC has moved from the routine list to the “high-risk only” list.
Respiratory Syncytial Virus (RSV)
Previous CDC Recommendation: An archived copy of CDC guidance shows that just a few months ago, immunization against RSV was recommended during pregnancy, and for babies who would not have the benefit of maternal RSV protection (those whose mothers did not receive the vaccine, or who received it less than 14 days before giving birth).
Current Recommendation: RSV vaccination is now being recommended only for certain high-risk groups.
What Can RSV Do To A Child?
According to the American Lung Association, RSV is the leading cause of hospitalization of infants. For some, it will be mild and symptoms will be similar to those of a common cold. In others, symptoms can quickly become life-threatening.
Blueberry Pediatrics shares that, especially in babies under 12 months, the symptoms of severe RSV may differ from those of adults.
“These include short, shallow, and rapid breathing, difficulty breathing (indicated by flared nostrils, grunting sounds, and inward pulling of neck or chest muscles and skin with each breath), coughing, poor feeding, and heightened irritability or even difficulty waking up.”
Hepatitis A
Previous CDC Recommendation: The CDC recommended that all children receive a Hepatitis A vaccine between the ages of 12 and 23 months.
Current Recommendations: This immunization is now recommended for high-risk groups.
What’s The Real Risk Of Hepatitis A?
Some people who become infected with Hepatitis A may have mild or no symptoms and may not even know they have the virus, according to Kids Health. However, others may experience symptoms that don’t appear until 2-6 weeks after the initial infection. Outbreaks often are traced to childcare centers, and can stem from such actions as a provider coming into contact with poop, then touching a doorknob, faucet, or package of diapers.
HAV can cause vomiting and diarrhea, as well as fever, loss of appetite, darker than usual urine (pee), jaundice (when the skin and whites of the eyes look yellow), light or grey-colored stools (poop), joint pain, and abdominal (belly) pain.
Patients with Hepatitis A may feel better after a few months or continue to suffer symptoms for as long as 6 months. Fecal matter can still be contagious for months after the infection is gone.
In some cases, Hepatitis A can cause permanent liver damage, including liver failure and the need for a liver transplant.
Hepatitis B
Previous CDC Guidance: The CDC recommended Hepatitis B vaccination for all infants, and for older children and adults who had not already been vaccinated. The vaccination schedule is one dose at birth, a second in the first two months, and a third between 9 and 18 months of age.
New CDC Recommendation: Hepatitis B has been moved to the ‘high risk’ list.
The Risk In Children:
According to the Children’s Hospital of Pittsburgh, Hepatitis B primarily affects the liver. It can cause liver failure, but in children may present without obvious symptoms and instead cause slow but progressive liver damage. Children are more likely than adults to become chronic carriers, and even those without symptoms may pass the disease to others.
When symptoms appear, they include jaundice, abdominal pain, nausea, vomiting, widespread itching, rash, joint pain, low-grade fever, and fatigue that can last for weeks or months.
Some cases may progress and require a liver transplant. Patients with chronic Hepatitis B may not be able to take certain medications, dietary supplements, and even certain herbs, because of the additional damage they may do.
Meningococcal Diseases
Previous CDC Recommendation: The CDC recommended the MenACWY for all children at ages 11-12. The MenB vaccine was listed as an optional vaccine (shared decision-making) to be administered between ages 16 and 23, ideally between ages 16 and 18.
New CDC Guidance: Meningococcal ACWY is now listed for high-risk individuals only, and the CDC has placed a general “meningococcal disease” under its shared decision-making list.
Risk Of Meningococcal Disease In Children:
Meningitis is caused by a viral or bacterial infection in the membranes surrounding the brain and spinal cord. Viruses that can cause this include herpes simplex, mumps, West Nile virus, and the flu.
In the U.S., between 10 and 15% of those who become ill with meningococcal disease will die. Of those who survive, according to the National Meningitis Foundation(NMF), one in five will carry permanent disabilities for the rest of their lives, including brain damage, limb amputations, hearing loss, or loss of kidney function.
There are currently between 600 and 1000 documented cases annually in the U.S., but the NMF issues a dire warning:
Historically, the number of meningococcal disease cases went up and down over time. Now, the number of cases is at the lowest it has ever been. Health officials believe this is due, in part, to the increased use of meningococcal vaccines.
Influenza
Previous CDC Recommendation: Guidance from an archived copy of the CDC website reads as follows:
“Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza.”
Current CDC Guidance: Influenza has been moved to the shared decision-making list. The CDC now says:
“It is not always possible for public health authorities to clearly define who will benefit from an immunization, who has the relevant risk factors, or who is at risk for exposure. Physicians and parents, who know the child, are then best equipped to decide based on individual characteristics.”
Risk To Children:
On the CDC’s page about the dangers of flu in children, there’s currently a notice that the information will be updated soon. However, for now, it still warns about the serious risk of flu in young children. It warns, in part:
“Children younger than 5 years old—especially those younger than 2—and children of any age with certain chronic health conditions, like asthma and diabetes, are at higher risk of developing potentially serious flu complications.”
The CDC notes that in the past few decades (excluding 2020-2021), flu deaths in children have ranged from 37 to 199, and that these reported numbers are likely lower than the actual number because some may not be recognized as caused by flu.
Short of death, the CDC warns (for now) that flu in children can also result in pneumonia, brain dysfunction, ear and sinus problems, dehydration, and worsening of long-term or chronic health issues such as asthma.
Rotavirus
Previous CDC Recommendation: Rotavirus vaccination was recommended for most children, except for those with known allergies to vaccine components or other specific health conditions that contraindicate vaccination. The first dose would be given before the baby is 15 weeks old, with a second and sometimes third (depending on the vaccine used) before 8 months of age.
Current CDC Recommendation: Rotavirus vaccination is now included in the shared decision-making list.
Risk To Children:
Rotavirus causes diarrhea and vomiting. This can be relatively mild, and some adults may show no symptoms.
However, diarrhea and vomiting can have severe effects in small children, especially infants, who can quickly become dehydrated and may need intravenous fluids, according to the Mayo Clinic. If a child is not able to receive adequate hydration, it can result in organ damage and, in some cases, even death.
In rare cases, rotavirus can cause intussusception, in which a part of the intestine folds into itself, causing severe abdominal pain, vomiting, and bloody stools and requiring immediate medical care.
The disease spreads easily in childcare and medical settings, and is particularly contagious in stools, meaning that a caregiver who, for instance, changes a diaper, then touches a changing table, a doorknob, a faucet, and a soap dispenser on the way to washing her hands may spread the bacteria to all others who subsequently touch those items.