The Covid vaccine will no longer be recommended for healthy children or healthy pregnant women, ending a pandemic-era policy aimed at protecting all Americans from the coronavirus.
Health Secretary Robert F. Kennedy Jr. announced the new policy on Tuesday, saying the Centers for Disease Control and Prevention would drop its yearslong guidance that the vaccine be offered to children 6 months and older.
He also withdrew the additional recommendation for immunizing pregnant women intended to shield mothers and younger infants, who can be at higher risk of severe illness.
“I couldn’t be more pleased to announce that as of today, the Covid vaccine for healthy children and healthy pregnant women has been removed from the C.D.C. recommended immunization schedule,” Mr. Kennedy said in a video he posted on X.
Flanked by Dr. Marty Makary and Dr. Jay Bhattacharya, who lead the Food and Drug Administration and the National Institutes of Health, Mr. Kennedy said in the video announcement that there was no clinical data to support additional shots for healthy children. No C.D.C. official appeared in the video.
Overall, the absolute numbers of children who became seriously ill from Covid are low. Though children with medical conditions would still qualify for the vaccine, it is unclear whether government programs and private insurance will limit coverage for the shots.
Some public health experts immediately denounced the decision, pointing out that the risk of severe disease and hospitalization among infants is comparable to that among adults 65 and older. Others roundly condemned the decision to stop recommending the shots for pregnant women, who are at high risk of severe illness and complications from Covid.
The move is Mr. Kennedy’s latest salvo in dismantling decades of vaccine safety policies, especially those intended for children.
Before becoming part of the Trump administration, Mr. Kennedy had long campaigned against vaccinating children to protect them from Covid. During a Senate confirmation hearing, he refused to acknowledge that Covid vaccines had saved millions of lives, saying, “I don’t think anybody can say that.”
Since he became head of the Department of Health and Human Services, Mr. Kennedy has undermined vaccines for measles and other diseases, questioned the integrity of federal officials who recommended them and championed questionable therapies.
In making the announcement, Mr. Kennedy also seems to have reneged on a promise he made to Senator Bill Cassidy, Republican of Louisiana, not to alter the childhood immunization schedule.
Mr. Kennedy’s decision upends the standard process for vaccine recommendations, which are made by advisers to the C.D.C. after considering existing studies, data and possible side effects. The agency director can accept, modify or reject the advisers’ suggestions. The health secretary is typically not directly involved in these matters, but at present, the C.D.C. does not have a permanent director.
In recent months, the C.D.C.’s advisers have been debating whether to continue to recommend that all Americans 6 months and older be immunized, or to switch to a risk-based strategy targeting only the most vulnerable. The advisers were set to vote on the matter in June, but Mr. Kennedy’s decision effectively voids that official step.
The new policy follows last week’s decision by the F.D.A. to require new data before approving the Covid shots for children. It also rolled back eligibility for this fall’s Covid vaccine, saying it should be administered only to people over 65 and those with certain medical conditions.
The C.D.C. list of medical conditions that put people at high risk of Covid includes pregnancy, an apparent contradiction to Tuesday’s announcement.
Mr. Kennedy did not address whether the vaccines would still be offered to children who had never received a shot. In the year ending in August, the C.D.C. reported 150 pediatric deaths, a number comparable to deaths among children in a typical flu season.
From October 2022 to April 2024, among children ages 6 months to 2 years hospitalized with Covid, 58 percent had no underlying medical conditions, according to data presented by the C.D.C. in April. The vaccines have also been shown to offer modest protection against the long-term effects of Covid in some children.
Still, Covid vaccinations have fallen sharply in recent years, as risk from the virus has receded from public awareness, people have gained layers of immunity and misinformation about dangers from the vaccine has escalated.
As of November 2023, about one in five children ages 6 months to 4 years, and about half of older children, had received at least one dose of the Covid vaccine, according to data collected by KFF, a nonpartisan health policy, polling and news nonprofit. More than half of pregnant women erroneously believed that the vaccine was unsafe for them, KFF polling showed.
According to C.D.C. data, about 13 percent of children and just over 14 percent of pregnant women have received the updated Covid shot offered since last fall.
Although the C.D.C. recommends vaccines for certain age groups and for people with medical conditions, the states have the authority to mandate certain shots for children who wish to attend schools or day care, for example. It’s unclear whether the new policy would prevent states from continuing to recommend Covid shots.
The Department of Health and Human Services did not immediately respond to a request for clarification.
Dr. Denise Jamieson, who is on the immunization committee of the American College of Obstetricians and Gynecologists and an adviser to the C.D.C. on vaccines, noted that pregnant women were at higher risk of hospitalization, including intensive care, and of dying.
Covid infection during pregnancy is also “associated with a number of adverse pregnancy outcomes including pre-eclampsia, preterm birth and stillbirth,” especially among women with severe disease, according to the C.D.C.
“With Covid still circulating, pregnant women and their babies who are born too young to be vaccinated are going to be at risk for Covid and for the severe complications,” Dr. Jamieson said.
“I’m disappointed that this won’t remain an option for pregnant women who would like to protect themselves,” she added.
Vaccinating pregnant women extends the protection to their unborn until the babies are about 6 months old. From birth to 6 months, those youngest infants face a risk of hospitalization on par with adults ages 65 to 74, according to Dr. Sean O’Leary, a pediatric vaccine expert for the American Academy of Pediatrics.
The C.D.C. had also recommended a series of Covid shots beginning at 6 months for children who had never had Covid.
“The youngest infants, they haven’t seen Covid before,” he said. “The reason we think that risk has fallen in the last year or two for some of the older age groups is because we’ve all seen Covid so many times,” through vaccination and immunity from infection.
“But that’s not true for those youngest kids — they remain essentially naïve to Covid,” he added.
About three-quarters of the mothers of infants who were hospitalized for Covid had not received an updated vaccine, said Dr. Naima Joseph, a maternal-fetal medicine specialist and expert in perinatal infectious diseases.
“That just goes to show that infants really remain at high risk for hospitalization, and that the only source of protective immunity is through vaccination,” she said.
Such risks and benefits tend to be carefully weighed by advisory panels that make recommendations. Subverting that process erodes trust in the medical profession, Dr. Joseph said.
“It’s really unfortunate that this is the way that recommendations are being made,” she said.
Dr. Steven J. Fleischman, president of the American College of Obstetricians and Gynecologists, condemned the decision in a statement on Tuesday, saying the group was concerned and “extremely disappointed.”
“It is very clear that Covid infection during pregnancy can be catastrophic and lead to major disability, and it can cause devastating consequences for families,” Dr. Fleischman said. “The Covid vaccine is safe during pregnancy, and vaccination can protect our patients and their infants.”
Federal health officials did not offer an explanation for removing the vaccine from the list of shots recommended for pregnant women, focusing instead on children.
“It’s common sense and it’s good science,” Dr. Bhattacharya said.
Dr. Makary added that there was “no evidence healthy kids need it today, and most countries have stopped recommending it for children.”
The World Health Organization recommends a single shot for children and adolescents with medical conditions that may increase their risk from Covid. In Europe, many countries do not recommend the vaccines for healthy children under 5, but the shots are approved for everyone 6 months and older.
“At this stage, we have not seen really a significant burden of disease in young kids, and particularly with the new version of the virus,” said Marco Cavaleri, who heads the office of biological health threats and vaccines strategy at the European Medicines Agency. “Vaccination of pregnant women is still very relevant, and I would push for that, but vaccination of kids, for me, is less important.”
Mr. Kennedy has been an ardent opponent of vaccines for decades, and filed a petition with the F.D.A. demanding that it revoke authorization of the Covid shots during a deadly phase of the pandemic. He also threatened to sue the F.D.A. if it authorized Covid vaccines for children.
The move throws insurance coverage of the vaccines for children or pregnant women into question, and is likely to create confusion among pharmacists who now largely administer the shots. Commercial insurers rely on the advice of C.D.C. advisers for coverage decisions, which the health secretary can override.
“I would say it’s a legal gray area,” said Richard Hughes, a lawyer who has represented vaccine companies.
About 38 million children are covered by the Vaccines for Children program for low-income families. The impact of the decision is unclear on that program, though the health secretary has broad authority over contracting with vaccine makers for the shots purchased by federal officials. Though uncertain, “the decision could strip families of choice,” Dr. O’Leary said in a statement.
Medicare and Medicaid are unlikely to cover the cost, but even if other insurance carriers do, pregnant women may have difficulty finding a pharmacist willing to administer a shot that is not on the recommended list, Dr. Jamieson said.
“At the very least, there’ll be barriers to pregnant women’s being able to access these vaccines based on both costs and logistics,” she said.
