Whatever CDC Says on COVID-19 Vaccinations for Kids, States to Decide


Parents, pay close attention.

An advisory committee has recommended unanimously that the Centers for Disease Control and Prevention include COVID-19 vaccines in its childhood immunization schedule for next year. The CDC is expected to adopt the recommendation.

The CDC’s immunization schedule is the standard list of vaccines used by pediatricians for childhood vaccines, including shots for diphtheria, measles, mumps, and other childhood diseases.

The 15-member Advisory Committee on Immunization Practices, appointed by Health and Human Services Secretary Xavier Becerra, recommends that children be fully vaccinated and boosted against COVID-19, beginning at the age of 6 months.     

To be clear: The Centers for Disease Control and Prevention, a federal agency, has no authority to mandate childhood vaccination as a condition for school attendance. Nor is CDC asserting such authority, as it did with the moratorium on evictions, the transportation mask mandate, and other matters.

CDC officials agree that this power rests solely with the states and, subject to state law, the public health authorities in various localities. Nonetheless, federal guidance—assuming the CDC accepts the advisory committee’s recommendation—carries great weight with state and local officials (including school officials), physicians, and other medical professionals.

The Mandate Issue

As a condition for school attendance, all 50 states and the District of Columbia require vaccination for diphtheria, measles, mumps, rubella, polio, and varicella. Beyond these, state laws vary.

Likewise, all states allow medical exemptions. Almost all states, with the notable exceptions of California and New York, allow for religious exemptions from school vaccine mandates, and some permit “philosophical” exemptions.

To date, only the District of Columbia and California have opted for a COVID-19 vaccine mandate for school attendance; both have delayed its enforcement.

By contrast, 21 states, including Florida, already have enacted bans on COVID-19 vaccination requirements for school admission. Before the advisory committee voted, Florida Surgeon General Joseph Ladapo remarked: “Regardless of what the CDC votes on whether COVID-19 vaccines are added to routine child immunizations, nothing changes in Florida.”

Medical treatments and procedures, including the injection of vaccines, all entail some degree of risk. For COVID-19, based on a growing body of professional literature, the degree of risk varies with age and sex.

Writing in the JAMA Network (from the Journal of the American Medical Association), researchers addressed the degree and frequency of adverse reactions from COVID-19 vaccination among 7,806 German children under age 5. They found that, compared with other vaccines, the three COVID-19 vaccines were “associated with significantly more frequent injection-site, musculoskeletal, dermatologic, or otolaryngologic symptoms but fewer general symptoms and fever after vaccination.”

Researchers also noted, however, that the “frequency” of adverse events was “comparable” to that of vaccines that aren’t for COVID-19. In the case of older children, recent evidence indicates that the incidence of myocarditis (heart inflammation) following vaccination against COVID-19 is low, but the risk is highest among young males ages 16 to 19.  

In consultation with their doctors, patients weigh the potential benefits and risks of medical interventions. With the advantage of informed consent (including parental consent), patients may agree to such interventions.

Concerning childhood COVID-19 vaccination, Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, observed late last month:

Some parents may argue, well, if there’s any benefit, then I’ll accept what I think is a low risk. And others may argue well, if there is any risk, I don’t want to risk that if the benefit is so low. So, I think—I just don’t think it’s going to make much of an impact in otherwise healthy young people.

An Unwise Decision

Although state officials will make final decisions concerning school vaccine requirements, the CDC advisory committee’s recommendation to add COVID-19 vaccines to the influential childhood immunization schedule is unwise.

In this writer’s Oct. 19 comments to the committee, I emphasized that including the COVID-19 vaccine was unnecessary, wouldn’t appropriately balance risk and benefit, and would further undermine public confidence in federal public health authorities.

Prominent members of America’s medical community highlight these concerns. For example, Dr. Marty Makary, a surgeon who is a professor of medicine at Johns Hopkins University, observed last week on Fox News Channel’s “Tucker Carlson Tonight”:

There has never been a vaccine added to the child immunization schedule without solid clinical evidence that it reduces disease significantly in the community. The COVID vaccine in children will be the first—it will be added with no clinical data.

So, the benefit of childhood vaccination against COVID-19 is unclear. In fact, the accumulated data showing that children face minimal risk from the disease is overwhelming.

As of October 2022, according to CDC data, the United States had recorded over 1 million deaths from COVID-19, and of that number only 1,310 were children under age 18. In a major analysis of international data, a team of medical researchers recently reported that the COVID-19 “infection fatality rate” was an infinitesimal 0.0003% from birth up to age 19.

Natural immunity to reinfection is even stronger in children than adults. According to a March 2022 study published in Lancet Child and Adolescent Health, researchers found that among 688,419 infected British children age 16 and younger, only 2,343 reinfections occurred.

And of the tiny number (109) of reinfected children who were hospitalized, 72% had other medical issues—what physicians call comorbidities.

Children Not at Risk

Public health officials should prioritize vaccination against COVID-19 among those most at risk. Those 65 and older, especially if they suffer certain comorbidities such as obesity, cardiovascular disease, or respiratory conditions, are most at risk.

With rare exceptions, children, most of whom already have been infected with COVID-19, are not at risk.

State public health officials will respond one way or another to the anticipated guidance from the CDC on childhood immunization. By accepting parental authority and the hard data on kids’ vulnerability, they would honor personal freedom and act on common sense.

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