ByAmanda Greenwood
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President Donald Trump signed an executive order on Monday backing a major overhaul of the U.S. childhood immunization schedule, reducing the number of <a href="https://healthylife7.com/every-disease-is-a-policy-failure/” title=”Every disease is a policy failure”>diseases for which vaccines are universally recommended for children from 18 to 11
Instead, vaccines for COVID-19, rotavirus, influenza, hepatitis A, hepatitis B and bacterial meningitis would be administered through “shared clinical decision-making” between parents and healthcare providers
The order largely mirrors changes previously advanced by Health and Human Services Secretary Robert F. Kennedy Jr., which were later blocked in court. The White House said the goal is to increase parental choice and align U.S. recommendations more closely with some other developed nations
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The executive order doesn’t eliminate access to the vaccines. Rather, it changes how they are recommended, potentially shifting them from routine immunizations to individualized decisions based on a child’s circumstances and risk factors
The order is likely to face continued scrutiny from medical organizations and public health experts, many of whom argue that universal vaccine recommendations have played a critical role in reducing childhood illness and death over the past several decades
Below is a ranking of the vaccines affected by the order, based on the potential severity of the diseases they prevent, including mortality risk, long-term complications, and the burden of severe illness
Newsweek has contacted the Infectious Diseases Society of America (IDSA) by email to get comment on the disease severity, vaccine effectiveness, and likely public health implications
1. Bacterial Meningitis
Topping the list is bacterial meningitis, including meningococcal disease, which, according to the U.S. Centers for Disease Control and Prevention (CDC), can progress rapidly and become fatal within hours. Even with treatment, survivors can experience permanent disabilities including hearing loss, neurological damage or limb amputations
The CDC says that even with antibiotic treatment, 10 to 15 percent of people with meningococcal disease die, while about one in five survivors experiences long-term disabilities such as brain damage, deafness, nervous system problems or limb loss
2. Hepatitis B
Hepatitis B ranks near the top of the list because infection can lead to chronic disease, cirrhosis, liver failure and liver cancer. According to the CDC, the risk of chronic infection is greatest when the virus is contracted in infancy, with about 90 percent of infected infants developing long-term infection compared with a small minority of adults
Because chronic hepatitis B can persist for years before causing serious liver damage, public health officials consider it one of the most significant vaccine-preventable diseases in terms of long-term health consequences
3. COVID-19
COVID-19 generally causes less severe illness in children than in older adults, but it has still resulted in pediatric hospitalizations, deaths and cases of multisystem inflammatory syndrome in children (MIS-C), a rare but serious complication that can affect the heart, lungs, kidneys, brain and other organs, according to the CDC
The CDC also recognizes that some children can experience post-COVID conditions, commonly known as long COVID, with symptoms that persist after infection. Children with certain underlying medical conditions remain at increased risk of severe outcomes from COVID-19
4. Influenza (Flu)
Influenza is often viewed as a routine seasonal illness, but the virus can cause severe disease and even death
According to the CDC, millions of children contract flu each year, with thousands requiring hospitalization. Serious complications can include pneumonia, dehydration, inflammation of the heart or brain, and worsening of underlying medical conditions
The CDC notes that children younger than 5 years old, particularly those under 2, face an elevated risk of severe flu-related complications, which is why public health officials continue to recommend the annual vaccination
5. Rotavirus
Before the introduction of rotavirus vaccines, rotavirus was the leading cause of severe gastroenteritis among infants and young children in the United States, according to the CDC
The virus can cause severe diarrhea, vomiting and dehydration, sometimes resulting in hospitalization and, in rare cases, death
Health officials say widespread vaccination has dramatically reduced serious rotavirus illness, but the disease can still pose a significant risk to babies and toddlers because of the danger of severe dehydration
6. Hepatitis A
Hepatitis A causes inflammation of the liver and can leave infected individuals ill for several weeks or, in some cases, several months
According to the CDC, most people recover completely without lasting liver damage
Severe outcomes, including liver failure and death, are rare but occur more frequently among older adults and people with chronic liver disease or other serious health conditions
Children who contract Hepatitis A generally recover fully, making the disease less likely to cause long-term health consequences than some of the other infections affected by the executive order
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Under the executive order, a separate group of childhood vaccines would continue to be recommended for all children. These include immunizations against measles, mumps, rubella, diphtheria, tetanus, pertussis (whooping cough), polio, Hemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV) and chickenpox
Many of these vaccines protect against diseases that have historically caused widespread outbreaks, permanent disability or death. Measles, for example, can lead to pneumonia and brain swelling, while polio can cause permanent paralysis. Pneumococcal disease and Hib were once major causes of childhood meningitis before vaccination became routine
Contact Newsweek editors on this story: John Fitzpatrick and Tony Phillips
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