The United States on Monday dropped its recommendation that all children be vaccinated against influenza and three other diseases, a move that advances one of Health Secretary Robert F. Kennedy Jr.’s long-term goals.

The decision to remove the vaccines came a month after President Donald Trump called for reducing the number of vaccines in children’s schedules, saying the U.S. needed to align with other developed nations.

Acting CDC Director Jim O’Neill approved the updated guidelines, the Department of Health and Human Services said on Monday. The move was outside the typical process for vaccine recommendations in which an outside panel of expert advisers to the Centers for Disease Control and Prevention considers the merits of each vaccine with an eye toward public health.

The U.S. dropped its recommendation for rotavirus, influenza, meningococcal disease, and hepatitis A, and said parents should consult healthcare providers under what it calls shared clinical-decision-making.

Dr. Sean O’Leary, chair of the American Academy of Pediatrics, said that the other developed countries face different disease risks and have different healthcare systems than the United States. Unlike the U.S., which depends on private healthcare, most countries provide basic universal healthcare that is paid for by the government.

“Any decision about the U.S. childhood vaccination schedule should be grounded in evidence, transparency and established scientific processes, not comparisons that overlook critical differences between countries or health systems,” he said.

Immunization Policy of 20 Nations Considered

Two top HHS officials, Martin Kulldorf and Tracy Beth Hoeg, reviewed vaccine protocols in 20 other developed countries — all of which have universal healthcare unlike the U.S. — and made the recommendations to change the U.S. schedule, the agency said. In a report, HHS wrote that the level of risk varies by disease and child.

Hoeg is acting director for the FDA’s Center for Drug Evaluation and Research and FDA ex officio member to the CDC’s vaccine advisory panel. Kulldorf is the HHS chief science and data officer and a former member of the Advisory Committee on Immunization Practices. The report was done in consultation with experts at CDC, FDA, National Institutes of Health and Centers for Medicare & Medicaid Services, HHS said.

The vaccine schedules of the 20 reviewed countries show that the flu shot is recommended universally in 4 countries and a shot against hepatitis A is universal only in Greece. The rotavirus shot is recommended for all children in 17 countries and shots against meningococcal disease are recommended in 16 of the countries.

The updated recommendations maintain immunizations for 11 diseases, including measles, mumps, and varicella, while categorizing others as either targeted for high-risk groups or subject to the shared-decision-making category, HHS said.

Insurance providers will continue covering immunization costs regardless of the category, senior HHS officials told reporters on a call. Among the changes, the CDC now recommends a single dose of the human papillomavirus vaccine instead of two.

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(Reporting by Ahmed Aboulenein in Washington and Michael Erman in New York; Editing by Caroline Humer and Bill Berkrot)