RFK Jr. may upend how vaccine recommendations are categorized

Robert F. Kennedy Jr., serving as Health Secretary, is proposing a potential overhaul of how vaccine recommendations are categorized and described by the US health department. The alteration would allow for less definitive or more conditional designations for vaccines that are currently classified as routine or universal. For instance, vaccinations could be labeled as 'recommended with qualification' or 'recommended based on shared clinical decision-making.'

Kennedy has not yet implemented any new rules or recommendations for these categories. However, he shared his ideas and possibilities in a Request for Information (RFI) published online on Friday and in the Federal Register on Monday. The RFI consists of 10 pages and includes questions about the current categories, inviting public input on potential changes or replacements.

The deadline for commenting on the questions and ideas is September 20. Presently, the Centers for Disease Control and Prevention, guided by a panel of independent expert advisors, the Advisory Committee on Immunization Practices (ACIP), assigns three categories to vaccination recommendations. These categories are: routine, otherwise considered universal (a recommendation for everyone to receive a vaccine); risk-based recommendations (only certain high-risk groups should receive a vaccine); and shared clinical decision-making (SCDM), a flexible but rare recommendation for vaccination based on patient characteristics, values, and preferences, and expert judgment.