RFK Jr. weighs overhaul of US vaccine recommendation categories
US Health Secretary Robert F. Kennedy Jr. is exploring changes to how vaccine recommendations are labeled and classified, opening a public comment period through September 20.
The US Department of Health and Human Services, led by vaccine skeptic Robert F. Kennedy Jr., is considering changes to how vaccine recommendations are categorized and worded. Vaccinations currently labeled "routine" or "universal" could eventually receive less definitive or more conditional designations.
Kennedy has not issued any new rules yet, but laid out his thinking in a Request for Information (RFI) posted online Friday and published in the Federal Register on Monday. The 10-page document raises questions about the existing categories and invites public feedback, with a comment deadline of September 20.
Current system
The Centers for Disease Control and Prevention, advised by the independent expert panel ACIP, currently uses three categories: routine or universal recommendations for everyone; risk-based recommendations for specific higher-risk groups; and "shared clinical decision-making" (SCDM), a flexible, rarely used category based on a patient's values and a provider's judgment.
The RFI gives particular attention to expanding or reshaping the SCDM category and floats possible new labels, such as "recommended with qualification," without specifying what such designations would actually mean in practice.
Background
The RFI follows an executive order signed two weeks earlier by President Donald Trump aimed at overhauling federal vaccine recommendations. Kennedy previously attempted to unilaterally cut CDC childhood vaccine recommendations and dismissed all 17 members of ACIP, replacing them with allies who share his views. Last year, the reconstituted panel also dropped the universal recommendation for a birth-dose hepatitis B vaccine.
A federal judge temporarily blocked many of Kennedy's vaccine recommendation changes and ACIP appointments in March, amid an ongoing lawsuit brought by the American Academy of Pediatrics.
