Trump administration seeks public comment on overhauling vaccine recommendation categories
The Trump administration has opened a public comment period on whether to restructure how vaccines are recommended, a move experts warn could deepen confusion and restrict access. Critics say the process bypasses the CDC and its expert advisory panel.
The US Department of Health and Human Services (HHS) published a notice in the Federal Register on Friday inviting public comments on the existing framework for vaccine recommendations, which currently divides them into routine, risk-based, and shared clinical decision-making categories. The notice states that feedback will help the department and an associated task force determine whether the current structure meets goals of scientific rigor, informed choice, and public trust, and whether new or different categories should be introduced.
Dorit Reiss, a vaccine law expert and professor at UC Law San Francisco, said seeking public input is generally appropriate, though she criticized HHS for rarely doing so in the past. She noted the notice is unusual because this type of categorization work is normally handled by experts at the Centers for Disease Control and Prevention (CDC) or its Advisory Committee on Immunization Practices (ACIP) — as occurred when the shared clinical decision-making category was created and when the Grade evidence-evaluation system was adopted.
Wendy Parmet, a public health law scholar at Northeastern University, agreed that reviewing the categories could be reasonable, since the term "shared clinical decision-making" is genuinely confusing to many. However, she said it is troubling that the process was initiated by HHS in connection with a childhood vaccine safety task force led by Robert F Kennedy Jr, rather than by ACIP or CDC, raising the risk that final decisions could be made without proper expert input.
Reiss added that introducing new categories could increase confusion over who qualifies for vaccines and suggested the effort appears aimed at limiting access rather than clarifying it. The notice follows an executive order Trump signed earlier this month directing agencies to scale back vaccine recommendations, echoing a January HHS change that a federal judge blocked in March. The public has 30 days to submit comments, a timeframe Reiss described as notably short.
