Trump administration seeks public comment on vaccine recommendations

The Trump administration is soliciting public comments on potential alterations to how vaccines are recommended, a move that experts fear could create confusion and hinder access to vaccinations. The Department of Health and Human Services (HHS) published a notice in the Federal Register seeking input on the current categories for vaccine recommendations: routine, risk-based, and shared clinical decision-making.

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Public input received in response to this notice will help inform consideration by the Department and the Task Force of whether the current category structure adequately serves the goals of scientific rigor, informed choice, and public trust

Officials stated that public input will help determine if the existing category structure adequately supports scientific rigor, informed choice, and public trust, and whether new or different categories should be adopted. Dorit Reiss, a vaccine law expert, called the request for public comments appropriate but found the notice itself unusual. She noted that such categorizations are typically handled by experts within the Centers for Disease Control and Prevention (CDC) or its advisory committee on immunization practices (ACIP).

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they haven’t been doing it anywhere near enough

Concerns have been raised about the clarity of terms like "shared clinical decision-making." Wendy Parmet, a public health law scholar, acknowledged that a review of current categories might be warranted, particularly the confusing nomenclature. However, she expressed concern that the process was initiated by HHS, supporting a task force led by Robert F. Kennedy Jr. (a long-time vaccine opponent and current HHS secretary), rather than by the CDC or ACIP.

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A review of the current categories may be appropriate – certainly the ‘shared clinical decision making nomenclature’ is confusing

This approach, Parmet warned, raises the possibility that final decisions could be made without the necessary expertise. Reiss echoed these concerns, suggesting that creating new categories could increase confusion about vaccine eligibility and recommendations, potentially aiming to limit access. The administration is also asking for input on how to evaluate scientific evidence, especially when randomized controlled trial data is limited or absent, further highlighting worries about bypassing established expert bodies like the CDC.

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raises the possibility that the final decision will be made without the benefit of relevant expertise