Jackie Fortiér, Author at KFF Health News

In Hepatitis B Vaccine Debate, CDC Panel Sidesteps Key Exposure Risk

Jackie Fortiér — Mon, 29 Sep 2025 09:00:00 +0000

The Trump administration is continuing its push to revise federal guidelines to delay the hepatitis B vaccine newborn dose for most children. This comes despite a failed attempt to do so at the most recent meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.

Both President Donald Trump and some newly appointed ACIP members have mischaracterized how the liver disease spreads, according to medical experts, including those working at the CDC. The ACIP panel’s recommendations can determine insurance coverage for immunizations.

At a White House press conference on Sept. 22, Trump, in advocating for delaying the newborn vaccine dose, falsely claimed that hepatitis B is solely a sexually transmitted infection.

“Hepatitis B is sexually transmitted. There’s no reason to give a baby that’s almost just born hepatitis B. So I would say wait till the baby is 12 years old and formed and take hepatitis B,” Trump said.

Hepatitis B is a highly infectious virus that attacks the liver and is transmitted through contact with infected bodily fluids, including blood. It can also be passed from mother to baby.

A reporter asked if Trump had spoken with Health and Human Services Secretary Robert F. Kennedy Jr., who oversees the CDC, about making the change, and Trump said he had, as Kennedy looked on.

Although hepatitis B is often associated with high-risk behaviors such as injection drug use or having multiple sexual partners, health experts, including career CDC scientists, note that the virus can be transmitted in ordinary situations too, including among young children.

At the latest ACIP meeting, held Sept. 18 and 19, members debated postponing the hepatitis B newborn dose until 1 month of age.

CDC scientist Adam Langer outlined research showing incidences of unvaccinated children born in the U.S. to mothers who tested negative, later becoming infected with hepatitis B. Langer serves as acting principal deputy director for the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention.

Langer told the vaccine advisory panel that the virus can survive for over seven days outside the body on surfaces. During that time, contact with even microscopic traces of infected blood on a school desk or on playground or sporting equipment is enough for a child to be infected. This means unvaccinated children not considered at high risk can still be exposed in everyday environments, or by an infected caregiver.

“We do have data that says that it can happen and that it is likely to happen,” he said. Though the exact cause of infection may not be clear in documented cases of children of hepatitis B-negative mothers becoming infected, “I can tell you that it didn’t come from the mother and it didn’t come from injection drug use and it didn’t come from sexual contact, so that means that it had to have been some kind of casual contact,” Langer said.

Yet during the debate, some members gave little credence to the risk of transmission to children through household contact.

“This is a very, very important vaccine that should be given to the high-risk populations,” said ACIP voting member Retsef Levi, a professor of operations management at the MIT Sloan School of Management. “The high-risk populations seem to be babies born to hep B-positive mothers, drug addicts, and other populations at high risk,” he said, despite Langer’s presentation highlighting other avenues of possible transmission.

Contrary to research that was presented, Levi later said the risk of not vaccinating children of hepatitis B-negative mothers was “probably close to zero” in the first few years of life.

The CDC estimates 2.4 million people in the U.S. have hepatitis B and half do not know they are infected. The disease can range from an acute, mild infection to a chronic infection, often with few to no symptoms. The disease has no cure and, if left untreated, can lead to serious conditions like cirrhosis, liver failure, and liver cancer later in life.

During debate on the vote to delay the newborn dose, ACIP member Joseph Hibbeln said that the proposed one-month gap would leave some children vulnerable to the virus, even if their mothers test negative for hepatitis B.

“This assumes implicitly that all the infections are coming from moms,” Hibbeln said. “You can’t decide on that simply by the mother’s status. You would have to look at the entire household’s status.”

ACIP member Evelyn Griffin, an obstetrician and gynecologist, asserted that doctors could ascertain an entire household’s hepatitis B status by asking the mother.

“How are they going to know?” Hibbeln said. “If 50% of people don’t know that they are hepatitis B-positive, you can ask all you want, and nobody knows.”

The committee members, all handpicked by Kennedy, ultimately decided to table the vote on whether to delay the newborn dose after Hibbeln brought up inconsistencies in the wording of the text of the resolution.

“The notion that hepatitis B is only confined to transmission for prostitutes, drug users, etc. is such an ignorant and uninformed way of approaching infectious disease,” internist Jason Goldman, the president of the American College of Physicians and its liaison to ACIP, said when reached after the meeting.

“The virus does not care what your behavior or lifestyle is. The virus goes from person to person through bodily fluids,” Goldman said. It can be transmitted when an unvaccinated person touches infected bodily fluids on common surfaces and then accidentally touches the eyes or mouth. “What if someone was in a car accident and got exposed to blood?”

“It is not only mother-to-fetus transmission, it is not only certain risk groups,” he said. “This is why it’s universal; everyone should get this for their protection, and it is unfortunate that it is being politicized into a sexually transmitted disease and that’s it. That’s not an appropriate way to evaluate science.”

Pediatric vaccination recommendations are widely credited with nearly eliminating the virus in American-born children.

Babies infected at birth have a 90% chance of developing chronic hepatitis B, and a quarter of those children go on to have severe complications, like liver cancer, or to die from the disease.

In 1991, federal health officials determined newborns should receive their first dose of a hepatitis B vaccine within 24 hours of birth, which can block the virus from taking hold if transmitted during delivery. From 1990 to 2022, case rates of hepatitis B declined by more than 99%. While parents may opt out of the shots, many day care centers and school districts require proof of hepatitis B vaccination for enrollment.

The next meeting of the ACIP is scheduled to begin Oct. 22. Agendas are usually posted weeks in advance, but so far, no information on the substance of the upcoming meeting has appeared on the CDC’s website. The agenda for the September meeting was posted less than a week before the meeting’s start.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Listen: The Surprising Power of Pushback When Health Insurance Won’t Pay

Jackie Fortiér — Fri, 19 Sep 2025 09:00:00 +0000

Being denied insurance coverage can be both confusing and, at times, enraging. But mounting a skillful challenge can turn a “no” into “yes.”

From confusing policy language to coding errors to shifting insurer rules, a new episode of NPR’s “Life Kit” podcast explores why denials happen and how to avoid common pitfalls.

KFF Health News reporter Jackie Fortiér and “Life Kit” host Marielle Segarra discuss the intricate and sometimes infuriating process of dealing with denied health claims. It’s an issue lots of people run into — but don’t necessarily talk about.

Fortiér and Segarra offer tips backed by real-life examples and expert advice, so you’ll know whom to call, what to say, and how being a pest in the right way might save you money.

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RFK Jr.’s Vaccine Panel Expected To Recommend Delaying Hepatitis B Shot for Children

Jackie Fortiér — Tue, 16 Sep 2025 09:00:00 +0000

A key federal vaccine advisory panel whose members were recently replaced by Health and Human Services Secretary Robert F. Kennedy Jr. is expected to vote to recommend delaying until age 4 the hepatitis B vaccine that’s currently given to newborns, according to two former senior Centers for Disease Control and Prevention officials.

“There is going to likely be a discussion about hepatitis B vaccine, very specifically trying to dislodge the birth dose of hepatitis B vaccine and to push it later in life,” said Demetre Daskalakis, former director of the National Center for Immunization and Respiratory Diseases. “Apparently this is a priority of the secretary’s.”

The vote was expected to take place during the next meeting of the CDC’s Advisory Committee on Immunization Practices, scheduled for Sept. 18-19.

For more than 30 years, the first of three shots of hepatitis B vaccine has been recommended for infants shortly after birth. In that time, the potentially fatal disease has been virtually eradicated among American children. Pediatricians warn that waiting four years for the vaccine opens the door to more children contracting the virus.

“Age 4 makes zero sense,” pediatrician Eric Ball said. “We recommend a universal approach to prevent those cases where a test might be incorrect or a mother might have unknowingly contracted hepatitis. It’s really the best way to keep our entire population healthy.”

In addition to the hepatitis B vaccine, the panel will also discuss and vote on recommendations for the combined measles, mumps, rubella, and varicella vaccine and covid-19 vaccines. Pediatricians worry changes to the schedules of these vaccines will limit access for many families, leaving them vulnerable to vaccine-preventable diseases.

Typically, ACIP would undertake an analysis of the data before recommending a change to vaccine guidelines. As of the end of August, this process had not begun for the hepatitis B vaccines, Daskalakis and another former official said.

“This is an atypical situation. There’s been no work group to discuss it,” Daskalakis said.

The second former senior official spoke to NPR and KFF Health News on the condition of anonymity.

In response to questions from KFF Health News, HHS spokesperson Andrew Nixon wrote, “ACIP exists to ensure that vaccine policy is guided by the best available evidence and open scientific deliberation. Any updates to recommendations will be made transparently with gold standard science.”

The draft agenda for the upcoming ACIP meeting was released to the public less than a week before it is scheduled to begin.

At the last ACIP meeting, in June, Martin Kulldorff, the chair and one of seven new members handpicked by Kennedy, questioned the need to vaccinate every newborn, citing only two of the many ways the virus can spread. Kulldorff is a former Harvard Medical School professor who became known for opposing some public health measures during the pandemic.

“Unless the mother is hepatitis B positive, an argument could be made to delay the vaccine for this infection, which is primarily spread by sexual activity and intravenous drug use,” he said.

The virus spreads via direct exposure to an infected bodily fluid like blood or semen. The disease has no cure and can lead to serious conditions like cirrhosis and liver cancer later in life. The CDC advisory panel may maintain the recommendation to inoculate newborns whose mothers have hepatitis B or are considered at high risk of the disease, the former officials said.

Protection From Birth

In 1991, federal health officials determined it was advisable for newborns to receive their first dose of the hepatitis B vaccine within 24 hours of birth, which blocks the virus from taking hold if transmitted during delivery. While parents may opt out of the shots, many day care centers and school districts require proof of hepatitis B vaccination for enrollment.

The prospect of ACIP’s altering the recommendation has left some people living with the virus deeply unsettled.

“I am goddamn frustrated,” said Wendy Lo, who has lived with the liver disease, likely since birth. Years of navigating the psychological, monetary, medical, and social aspects of chronic hepatitis B has touched almost every aspect of her life.

“I would not want anyone to have to experience that if it can be prevented,” she said. Lo learned she had the disease due to a routine screening to study abroad in college.

Lo credits the vaccines with protecting her close family members from infection.

“I shared with my partner, ‘If you get vaccinated, we can be together,’” she said. He got the vaccine, which protects him from infection, “so I’m grateful for that,” she said.

The CDC estimates half of people with hepatitis B do not know they are infected. It can range from an acute, mild infection to a chronic infection, often with few to no symptoms. Most people with chronic hepatitis B were born outside of the U.S., and Asians and Pacific Islanders followed by Black people have the highest rates of newly reported chronic infections.

When her children were born, Lo was adamant that they receive the newborn dose, a decision she says prevented them from contracting the virus.

The earlier an infection occurs, the worse the consequences, according to the CDC. When contracted in infancy or early childhood, hepatitis B is far more likely to become a chronic infection, silently damaging the liver over decades.

Those who become chronic carriers can also unknowingly spread the virus to others and face an increased risk of long-term complications including cirrhosis and liver cancer, which may not become evident until much later in life.

“Now I’m in my 50s, one of my big concerns is liver cancer. The vaccine is safe and effective, it’s lifesaving, and it protects you against cancer. How many vaccines do that?” Lo said.

Thirty Years of Universal Vaccination

Treatments like the antivirals Lo now takes weren’t available until the 1990s. Decades of the virus’s replicating unchecked damaged her liver. Every six months she gets scared of what her blood tests may reveal.

After a vaccine was approved in the 1980s, public health officials initially focused vaccination efforts on people thought to be at highest risk of infection.

“I, and every other doctor, had been trained in medical school to think of hepatitis B as an infection you acquired as an adult. It was the pimps, the prostitutes, the prisoners, and the health care practitioners who got hepatitis B infection. But we’ve learned so much more,” said William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine and a former voting member of ACIP.

As hepatitis B rates remained stubbornly high in the 1980s, scientists realized an entire vulnerable group was missing from the vaccination regime — newborns. The virus is often transmitted from an infected mother to baby in late pregnancy or during birth.

“We may soon hear, ‘Let’s just do a blood test on all pregnant women.’ We tried that. That doesn’t work perfectly either,” Schaffner said.

Some doctors didn’t test, he said, and some pregnant women falsely tested negative while others acquired hepatitis B after they had been tested earlier in their pregnancies.

In 1991, Schaffner was a liaison representative to ACIP when it voted to advise universal vaccination for hepatitis B before an infant leaves the hospital.

“We want no babies infected. Therefore, we’ll just vaccinate every mom and every baby at birth. Problem solved. It has been brilliantly successful in virtually eliminating hepatitis B in children,” he said.

In 1990, there were 3.03 cases of hepatitis B per 100,000 people 19 years old or under in the U.S., according to the CDC.

Since the federal recommendation to vaccinate all infants, cases have dramatically decreased. CDC data shows that in 2022 the rate among those 19 or under was less than 0.1 per 100,000.

While hepatitis B is often associated with high-risk behaviors such as injection drug use or having multiple sexual partners, health experts note that it is possible for the virus to be transmitted in ordinary situations too, including among young children.

The virus can survive for up to seven days outside the body. During that time, even microscopic traces of infected blood on a school desk or playground equipment can pose a risk. If the virus comes into contact with an open wound or the mucous membranes of the eyes, an infection can occur. This means that unvaccinated children not considered at high risk can still be exposed in everyday environments.

Future Access Uncertain

If the CDC significantly alters its recommendation, health insurers would no longer be required to cover the cost of the shots. That could leave parents to pay out-of-pocket for a vaccine that has long been provided at no charge. Children who get immunizations through the federal Vaccines for Children program would lose free access to the shot as soon as any new ACIP recommendations get approved by the acting CDC director.

The two former CDC officials said that plans were underway to push back the official recommendation for the vaccine as of August, when they both left the agency, but may have changed.

Schaffner is still an alternate liaison member of ACIP, and hopes to express his support for universal newborn vaccination at the next meeting.

“The liaisons have now been excluded from the vaccine work groups. They are still permitted to attend the full meetings,” he said.

Schaffner is worried about the next generation of babies and the doctors who care for them.

“We’ll see cases of hepatitis B once again occur. We’ll see transmission into the next generation,” he said, “and the next generation of people who wear white coats will have to deal with hepatitis B, when we could have cut it off at the pass.”

We’d like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what’s happening within the federal health bureaucracy. Please message KFF Health News on Signal at (415) 519-8778 or get in touch here.

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Listen: As Kids Head Back to School, Parents Sort Out Confusion Over Vaccine Access

Jackie Fortiér — Tue, 02 Sep 2025 09:00:00 +0000

LISTEN: Measles. Chickenpox. Meningitis. Many vaccines can run more than $100 a dose out-of-pocket. Jackie Fortiér tells WAMU’s “Health Hub” how Trump administration changes to the federal vaccine guidelines could make some routine shots too expensive for families.

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, replaced the members of a federal vaccine advisory committee in June. The committee plays an important role in recommending vaccines, and its guidance influences the coverage decisions insurance companies make.

KFF Health News reporter Jackie Fortiér appeared on WAMU’s “Health Hub” on Aug. 27 to explain why confusion over federal immunization policy has left parents and pediatricians uncertain about future access to childhood immunizations, especially for those on Medicaid.

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Try This When Your Doctor Says ‘Yes’ to a Preventive Test but Insurance Says ‘No’

Jackie Fortiér and Oona Zenda — Thu, 21 Aug 2025 09:00:00 +0000

Health Care Helpline helps you navigate the hurdles between you and good health care. KFF Health News reporter Jackie Fortiér spoke with NPR’s Ari Shapiro about a Minnesota family facing big bills for their infant son’s hearing tests.

“My son was diagnosed with congenital CMV, a virus that can cause hearing loss. As part of this diagnosis, he will be required to have routine hearing tests every few months until he is 10 years old. I reached out to you because I wanted to know why my son’s hearing tests weren’t covered by our insurance and why we needed to pay for it.”

— Anna Deutscher, 29, from Minnesota, writing about her infant son, Beckham

Trying to figure out why her claim was denied took Anna Deutscher a lot of time and work.

Baby Beckham’s hearing screenings were preventive care, which is supposed to be covered by law. Every hearing test cost them about $350 out-of-pocket. Between those bills and Beckham’s other health costs, the family maxed out two credit cards.

“Everything just immediately goes right to trying to pay that debt off,” Deutscher said.

At times, she felt overwhelmed by her son’s medical needs, on top of working. Deutscher said she “didn’t know what else to do” when her insurance company kept saying no to her requests that it pay for the hearing tests.

No one wants to spend time fighting their health insurance company. Many people feel they don’t have the knowledge or stamina to do it. But if, like Deutscher, you’re denied for a preventive service, it may be worth it.

Here are a few tips — a slingshot and a few stones, so you can be David when facing a health care Goliath.

1. Check Your Policy

Read your plan documents to confirm whether the treatment or service is covered. Pay attention to any exclusions or limitations. Deutscher’s plan documents say hearing tests are not covered. But even when a sought-after benefit is excluded, that might not be the end of the line.

2. Is the Service Preventive?

Many types of preventive care are supposed to be covered without additional cost under the Affordable Care Act. If you receive a recommended preventive screening and have private insurance, including through the Affordable Care Act marketplace, there should be no copayment at the time of service, and you shouldn’t get a bill later. A small number of insurance plans are “grandfathered in,” which means you may not have the same rights and protections as the ACA provides. Check with your employer’s human resources benefits manager to find out for sure.

Here’s a list of preventive services health plans must cover and the list specific to children and young adults.

A physician recommended regular hearing screenings for the Deutschers’ baby, which the healthcare.gov list indicates should be considered preventive and covered by insurance. But JoAnn Volk, an insurance expert and a research professor at Georgetown University, said real life often doesn’t match what the law requires.

“It really does come down to everyone sort of being on their best behavior on the provider and plan side to truly interpret and follow what should be covered,” Volk said.

3. Peel Apart the Denial

If you’ve been denied coverage, you need to know why. Health insurance companies are required to explain every denial. The denial letter or your explanation of benefits should state the reason, which may be a coverage exclusion, incorrect coding, or a determination that the service was deemed not medically necessary. Follow up and ask for specific details about the denial and the criteria used, and request an explanation of benefits. Then use that information to build an appeal, being sure to address the reason for the denial.

4. File the Appeal

There are a few steps to know, but you don’t have to be a lawyer to figure them out. Usually there’s an appeal form to fill out. Visit your insurer’s website, check your explanation of benefits, or call your insurer and ask how to get started. The process typically includes writing a letter saying why you disagree with the denial. Include any medical records or test results that support your case and a copy of the federal guidelines that show the care is a covered, preventive service. If you can, ask your physician to write a letter explaining why the service is preventive and necessary.

Your insurance company has 30 to 60 days to respond, depending on your state and health plan. If your appeal is denied, try again. Some people win on the second go-round.

If your appeal is denied a second time, you can request an external medical review. That process is led by a medical professional who is supposed to make an unbiased decision. In California, for instance, many health plans fall under the jurisdiction of the Department of Managed Health Care.

“In 2023, 72% of health plan members that came to us and filed an independent medical review ended up getting the service that they requested,” said Mary Watanabe, who leads the department.

Keep deadlines in mind. How much time you have to file should be on your explanation of benefits. Your insurer is required by law to accept the external reviewer’s decision.

For more help starting an appeal or asking for an external review, visit healthcare.gov or your state insurance department.

5. Ask Human Resources for Help

If you get coverage through your job and you’re hitting roadblocks, consider emailing your human resources department. HR folks have contacts with the insurance companies you don’t and may save you a few calls to the 800 number on the back of your insurance card. Legally, HR is under no obligation to help, and covering a health service may not be in your employer’s financial interest. But sending HR the documents you prepared for the insurance appeal may prompt them to push the insurance company to take another look.

“The whole point of employers offering benefits is to attract and retain a solid workforce, right?” Volk said.

Making a case to HR may be a ramp toward getting the treatment or service covered the next time your company revises its health plan offerings, said Rhonda Buckholtz, a consultant who advises businesses on medical billing.

She said consumers can do a quick online search to see whether other large insurance companies in their area cover the health care service they need. That information can give you leverage, Buckholtz said.

Going to HR helped Deutscher. Eventually, her employer said it would cover the cost of hearing tests for baby Beckham for the current plan year. Deutscher’s employer has a self-funded plan, which gives companies the ability to customize benefits. It ultimately decided to add hearing tests as a standard benefit for all employees.

“It’s been like this constant cloud hanging over my head, so for that to suddenly be lifted, it didn’t feel real. I also have never gone to my HR for something like this before. I didn’t even know this was an option,” Deutscher said.

Health Care Helpline helps you navigate the health system hurdles between you and good care. Send us your tricky question and we may tap a policy sleuth to puzzle it out. Share your story. The crowdsourced project is a joint production of NPR and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Fearing Medicaid Coverage Loss, Some Parents Rush To Vaccinate Their Kids

Jackie Fortiér — Fri, 25 Jul 2025 09:00:00 +0000

For two decades, Washington, D.C., pediatrician Lanre Falusi has counseled parents about vaccine safety, side effects, and timing. But this year, she said, the conversations have changed.

“For the first time, I’m having parents of newborns ask me if their baby will still be able to get vaccines,” Falusi said.

Throughout the country, pediatricians say anxious parents are concerned about access to routine childhood immunizations, especially those with children on Medicaid, the government insurance program for low-income families and people with disabilities. Medicaid covers 4 in 10 children in the U.S.

“It really became an issue when RFK Jr. stepped into the role of HHS secretary,” said Deborah Greenhouse, a pediatrician in South Carolina.

The concern accelerated after the shake-up of a key Centers for Disease Control and Prevention vaccine advisory body in June, raising fears that millions of American families could soon have to pay out-of-pocket for shots now covered by their health insurance.

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, removed all 17 members of the CDC’s Advisory Committee on Immunization Practices, the panel responsible for recommending which shots are included in the nation’s adult and childhood immunization schedules.

Kennedy replaced the panelists with new members aligned with his views, prompting alarm among medical professionals and public health experts.

“People should be worried about what’s going to happen to the availability of vaccines for children,” said Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured at KFF, a national health information nonprofit that includes KFF Health News.

Under the Affordable Care Act, health insurers are required to cover all ACIP-recommended vaccines. States and other jurisdictions use the childhood vaccine schedule to set immunization requirements for schoolchildren. ACIP’s recommendations also determine which vaccines get covered by the Vaccines for Children Program, a CDC-funded initiative that provides free immunizations to low-income and uninsured children. Half of children in the U.S. are eligible for the VFC program.

If the new ACIP members withdraw support for a particular vaccine and the CDC director agrees, Tolbert said, the consequences would be immediate. “It would automatically affect what is covered and therefore which vaccines are available to children on Medicaid,” she said.

Health insurance companies have not yet said how they would alter coverage, but Tolbert said such a move would open the door for private insurers to refuse to cover the vaccine.

Pediatricians worry about a future where parents might have to choose — pay hundreds of dollars out-of-pocket for shots or leave their kids unprotected.

The health insurance industry group AHIP said that health plans “continue to follow federal requirements related to coverage of ACIP-recommended vaccines and will continue to support broad access to critical preventive services, including immunizations.”

Pediatricians say news about President Donald Trump’s new budget law, which is expected to reduce Medicaid spending by about $1 trillion over the next decade, also prompted questions from parents.

While parents may be worried about losing their Medicaid, the law doesn’t mention vaccines or change eligibility or benefits for children’s Medicaid, Tolbert said. But less federal funding means states will have to make decisions about who is covered and which services are offered.

To raise the revenue needed to pay for Medicaid, states could raise taxes; move money earmarked for other spending, such as education or corrections; or, more likely, reduce Medicaid spending.

“And they may do that by cutting eligibility for optional populations or by cutting services that are optional, or by reducing payments to providers in the form of provider rates,” Tolbert said. “It’s unclear how this will play out, and it will likely look different across all states.”

In May, Kennedy announced in a post on X that the CDC is no longer recommending the covid-19 vaccine for healthy children and pregnant women. The move prompted a lawsuit by the American Academy of Pediatrics and other physician groups that seeks to freeze Kennedy’s directive.

In June, the new ACIP members appointed by Kennedy voted to recommend that adults and children no longer receive flu vaccines with thimerosal, a preservative rarely used in some flu vaccines. Anti-vaccine activists, including Kennedy, have rallied against thimerosal for decades, alleging links to autism despite no evidence of any association.

“There is no cause for concern,” Department of Health and Human Services spokesperson Emily Hilliard said in a statement. “As Secretary Kennedy has stated, no one will be denied access to a licensed vaccine if they choose to receive one.”

“When the ACIP committee met last month, they reaffirmed that flu vaccines will remain accessible and covered, and they emphasized safety by ensuring these vaccines are mercury-free,” Hilliard wrote. “The Vaccines for Children (VFC) program continues to provide COVID-19 vaccines at no cost for eligible children when the parent, provider, and patient decide vaccination is appropriate. Medicaid will continue to reimburse the administration fee.”

But the possibility that a vaccine could be restricted or no longer covered by insurance is already changing how parents approach immunization. In Falusi’s practice, parents are scheduling appointments to coincide precisely with their child’s eligibility, sometimes making appointments the same week as their birthdays.

Melissa Mason, a pediatrician in Albuquerque, New Mexico, has evaluated some patients who contracted measles during the multistate outbreak that started in neighboring Texas.

She’s concerned that any new limitations on access or reimbursement for childhood vaccines could lead to even more preventable illnesses and deaths.

Nationally, there have been more than 1,300 measles cases since January, including three deaths, according to the CDC. “We’re seeing this outbreak because vaccination rates are too low and it allows measles to spread in the community,” Mason said.

Children and teens account for 66% of national measles cases. Mason has begun offering the measles vaccine to infants as young as 6 months old, a full six months earlier than standard practice, though still within federal guidelines.

Last year, overall kindergarten vaccination rates fell in the U.S. At the same time, the number of children with a school vaccination exemption continued to rise.

Pertussis, or whooping cough — another disease that can be deadly to young children — is spreading. As of July 5, more than 15,100 cases had been identified in U.S. residents this year, according to the CDC.

Mason said pertussis is especially dangerous to babies too young to receive the vaccine.

For now, pediatricians are trying to maintain a sense of urgency without inciting panic.

In Columbia, South Carolina, Greenhouse used to offer families a flexible age range for routine vaccinations.

“I’m not saying that anymore,” the pediatrician said.

She now urges parents to get their children vaccinated as soon as they are eligible.

She described anxious parents asking whether the HPV vaccine, which helps prevent cervical cancer, can be administered to children younger than the recommended age of 9.

“I actually had two parents today ask if their 7- or 8-year-olds could get the HPV shot,” Greenhouse said. “I had to tell them it’s not allowed.”

With the vaccine requiring multiple doses months apart, Greenhouse fears time may run out for families to get the series covered by insurance. If they have to pay out-of-pocket, she’s afraid some families may choose not to get the second dose. A second dose could cost about $300 if no longer covered by insurance.

“I cannot be 100% sure what the future looks like for some of these vaccines,” Greenhouse said. “I can tell you it’s a very scary place to be.”

Kennedy’s newly appointed vaccine advisory committee is expected to hold its next public meeting as soon as August.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Por temor a perder la cobertura de Medicaid, padres se apresuran a vacunar a sus hijos

Jackie Fortiér — Fri, 25 Jul 2025 08:43:00 +0000

Durante dos décadas, la pediatra Lanre Falusi, de Washington D.C., ha asesorado a los padres sobre el calendario de vacunas que deben recibir sus hijos, la seguridad de la vacunación y sus efectos secundarios.

Pero dijo que este año las charlas han cambiado.

“Por primera vez, los padres de recién nacidos me preguntan si en el futuro sus bebés podrán seguir recibiendo las vacunas”, contó Falusi.

A lo largo del país, pediatras dicen que padres ansiosos están preocupados por si continuará habiendo acceso a las vacunas infantiles de rutina. Los más intranquilos son aquellos con hijos en Medicaid, el programa del gobierno que ofrece seguro médico para familias de bajos ingresos y personas con discapacidades.

Medicaid cubre a 4 de cada 10 niños en el país.

“El problema realmente surgió cuando RFK Jr. asumió el cargo de secretario de Salud y Servicios Humanos (HHS)”, afirmó Deborah Greenhouse, pediatra de Carolina del Sur.

La preocupación aumentó tras la reestructuración, en el mes de junio, de un órgano asesor clave sobre vacunas de los Centros para el Control y Prevención de Enfermedades (CDC). Millones de familias temen que en un futuro cercano tengan que pagar de su bolsillo las vacunas que actualmente están cubiertas por su seguro médico.

El secretario de Salud y Servicios Humanos, Robert F. Kennedy Jr., conocido activista antivacunas, destituyó a los 17 miembros del Comité Asesor sobre Prácticas de Inmunización (ACIP), el grupo responsable de recomendar las vacunas que deberían ser incluidas en los calendarios nacionales de inmunización para niños y adultos.

Kennedy sustituyó a los miembros del panel por otros nuevos, afines a sus puntos de vista, lo que generó alarma entre profesionales médicos y los expertos en salud pública.

“La gente debería preocuparse por lo que va a pasar con la disponibilidad de vacunas para los niños”, afirmó Jennifer Tolbert, directora adjunta del Programa sobre Medicaid y Personas sin Seguro Médico de KFF.

En virtud de la Ley de Cuidado de Salud a Bajo Precio (ACA), las aseguradoras médicas actualmente están obligadas a cubrir todas las vacunas recomendadas por el ACIP. Además, los estados y otras jurisdicciones utilizan el calendario de vacunación infantil para establecer los requisitos de inmunización de los escolares.

Las recomendaciones del ACIP también determinan qué vacunas están cubiertas por el programa Vaccines for Children (VFC), una iniciativa financiada por los CDC que proporciona dosis gratuitas a niños de familias de bajos ingresos y sin seguro médico.

La mitad de los niños del país son elegibles para este programa.

Si los nuevos miembros del ACIP retiraran su apoyo a una vacuna concreta y el director de los CDC estuviera de acuerdo, las consecuencias serían inmediatas, aseguró Tolbert. “Eso afectaría automáticamente qué vacunas están cubiertas y, por lo tanto, cuáles se encuentran disponibles para los niños beneficiarios de Medicaid”, explicó.

Las aseguradoras aún no han dicho cómo modificarían la cobertura, pero Tolbert afirmó que una medida de ese tipo abriría la puerta a que los planes de salud privados se negaran a cubrir la vacuna.

Los pediatras temen que en el futuro los padres se vean obligados a elegir entre pagar cientos de dólares de su bolsillo por las vacunas o dejar a sus hijos desprotegidos.

Por su parte el AHIP, la asociación nacional que agrupa a la industria de seguros médicos, dijo que los planes “siguen cumpliendo los requisitos federales relacionados con la cobertura de las vacunas recomendadas por el ACIP y seguirán apoyando el amplio acceso a servicios preventivos críticos, incluidas las vacunas”.

Los pediatras también dicen que las noticias sobre la nueva ley presupuestaria del presidente Donald Trump, que se espera que reduzca el gasto en Medicaid en aproximadamente $1.000 millones durante la próxima década, también han generado mucha inquietud entre los padres.

En realidad, aunque pueden estar preocupados por perder su Medicaid, Tolbert advirtió que la ley no menciona las vacunas ni cambia los requisitos de elegibilidad o las prestaciones de Medicaid para los niños. Sin embargo, menos financiación federal significa que los estados tendrán que tomar decisiones sobre a quiénes seguirán cubriendo y qué servicios se les ofrecerá.

Para tener los fondos necesarios para pagar Medicaid, los estados podrían aumentar los impuestos y destinar a este programa fondos destinados a otras áreas, como la educación o el sistema penitenciario. Pero lo más probable es que opten por reducir el gasto en Medicaid.

“También podrían hacerlo recortando la elegibilidad de poblaciones opcionales, recortando servicios que son opcionales o reduciendo los pagos a los proveedores”, argumentó Tolbert. “No está claro cómo se desarrollará esto, y es probable que sea diferente en cada uno de los estados”.

En junio, Kennedy anunció en una publicación en X que los CDC ya no recomiendan la vacuna contra covid-19 para niños sanos y embarazadas. La medida provocó una demanda judicial por parte de la Academia Americana de Pediatría y otras asociaciones de médicos que buscan frenar la directiva de Kennedy.

También ese mes, los nuevos miembros del ACIP nombrados por Kennedy votaron a favor de recomendar que los adultos y los niños ya no reciban vacunas contra la gripe con timerosal, un conservante que rara vez se utiliza en vacunas contra la gripe.

Los activistas antivacunas, entre ellos Kennedy, llevan décadas manifestándose contra el timerosal, alegando que está relacionado con el autismo, a pesar de que no existe evidencia científica que respalde esa relación.

“No hay motivo de preocupación”, afirmó en un comunicado Emily Hilliard, vocera del Departamento de Salud y Servicios Humanos. “Como ha declarado el secretario Kennedy, no se negará a nadie el acceso a una vacuna autorizada si decide recibirla”.

“Cuando el comité del ACIP se reunió en junio, reafirmó que las vacunas contra la gripe seguirán siendo accesibles y estarán dentro de la cobertura. Por otra parte, hizo hincapié en la seguridad garantizando que estas vacunas no contienen mercurio”, escribió Hilliard.

“El programa Vaccines for Children sigue proporcionando vacunas contra covid-19 sin costo alguno para los niños que cumplen los requisitos cuando los padres, el proveedor y el paciente consideren que la vacunación es adecuada. Medicaid seguirá reembolsando los gastos de administración”.

Sin embargo, la posibilidad de que una vacuna sea restringida o deje de estar cubierta ya está cambiando la forma en que los padres abordan la inmunización. En el consultorio de Falusi, están programando citas para que la vacunación coincida exactamente con los requisitos de elegibilidad de sus hijos, a veces incluso en la misma semana de su cumpleaños.

En Albuquerque, Nuevo México, la pediatra Melissa Mason, ha atendido algunos pacientes que contrajeron sarampión durante el brote en varios estados que comenzó en Texas.

Teme que nuevas limitaciones a la vacunación derive en más enfermedad y muertes.

Desde enero, se han registrado a nivel nacional más de 1.300 casos de sarampión, según los CDC. “Estamos viendo este brote porque las tasas de vacunación son demasiado bajas y eso permite que el sarampión se propague en la comunidad”, dijo Mason.

Los niños y adolescentes representan el 66% de los casos de sarampión, indican los CDC. En respuesta, Mason ha comenzado a ofrecer la vacuna contra el sarampión a bebés de tan solo 6 meses, medio año antes de lo habitual, aunque dentro de las directrices federales.

El año pasado, las tasas generales de vacunación en los jardines de infantes descendieron en el país, y el número de niños con exención de vacunación escolar siguió aumentando.

Mason teme que, si se restringe el acceso a las vacunas, las comunidades vean el regreso de otras enfermedades prevenibles que se han mantenido bajo control durante mucho tiempo, especialmente en estados como Nuevo México, donde el 61% de los niños están bajo Medicaid.

La tos ferina, otra enfermedad que puede ser mortal para los niños más pequeños, también se está propagando. Según informaron los CDC, hasta el 5 de julio se habían identificado más de 15.100 casos. Mason explicó que la tos ferina es especialmente peligrosa para los bebés demasiado pequeños para recibir la vacuna.

Por ahora, los pediatras están tratando de subrayar la urgencia sin provocar pánico en la población.

En Columbia, Carolina del Sur, Greenhouse solía ofrecer a las familias un rango de edad flexible para las vacunas de rutina.

“Ya no digo eso”, expresó la pediatra.

Ahora, la médica recomienda a los padres a vacunar a sus hijos tan pronto como puedan hacerlo.

Muchos de ellos le han preguntado si la vacuna contra el VPH, que ayuda a prevenir el cáncer de cuello uterino, se puede administrar a niños menores de la edad recomendada, que es de 9 años.

“De hecho, hoy mismo dos padres me han preguntado si sus hijos de 7 u 8 años podían recibir la vacuna contra el VPH”, contó Greenhouse. “Tuve que responderles que no está permitido”.

Dado que la vacuna requiere varias dosis aplicadas con meses de diferencia, Greenhouse teme que se acabe el tiempo para que las familias puedan cubrir la serie con el seguro de salud. Algunas familias pueden decidir no comprar la segunda dosis si tienen que pagarla de su bolsillo. Si ya no está cubierta por el seguro, esa segunda dosis podría costar alrededor de $300.

“No puedo estar 100% segura de cómo será el futuro de algunas de estas vacunas”, reflexionó Greenhouse. “Lo que sí puedo decir es que es una situación muy aterradora”.

Se espera que el comité asesor sobre vacunas que nombró recientemente el secretario Kennedy realice su próxima reunión pública en agosto.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Expertos dicen que el secretario de Salud envió “ciencia basura” a congresistas para defender cambios en las vacunas contra covid

Jackie Fortiér — Fri, 13 Jun 2025 09:00:00 +0000

Para apoyar la decisión del secretario Robert F. Kennedy Jr. de cambiar la política nacional sobre las vacunas contra covid-19, el Departamento de Salud y Servicios Humanos (HHS) envió a los legisladores un documento que cita estudios científicos inéditos o controversiales, y tergiversa otros.

Un experto en salud calificó el documento de “desinformación médica deliberada” sobre la seguridad de las vacunas contra covid para niños y embarazadas.

“Es tan descabellado que me parece insultante para nuestros congresistas que les den algo así. Ellos confían en que estas agencias les proporcionen información válida, y simplemente no la tienen”, expresó Mark Turrentine, profesor de Obstetricia y Ginecología en el Baylor College of Medicine.

Kennedy, quien fue un activista antivacunas antes de asumir el cargo en la administración Trump, anunció el 27 de mayo que los Centros para el Control y Prevención de Enfermedades (CDC) ya no recomendarían las vacunas contra covid para mujeres embarazadas ni niños sanos, eludiendo así el proceso formal de la agencia para ajustar sus calendarios de vacunación para adultos y niños.

El anuncio, posteado en la red social X, ha generado indignación entre muchos pediatras y científicos.

El documento del HHS —que buscaba respaldar la decisión de Kennedy y que obtuvo KFF Health News— se envió a congresistas que cuestionaron la base científica y el proceso detrás de su decisión, según un funcionario federal que pidió no ser identificado por no tener permiso para hablar del tema públicamente.

Aunque el documento no se publicó en el sitio web del HHS, es la primera explicación detallada que ofrece la agencia sobre el anuncio de Kennedy.

Titulado “Preguntas frecuentes sobre las recomendaciones para covid-19”, el documento distorsiona algunos estudios legítimos y cita otros que son controversiales y no se han publicado, según aseguran expertos médicos.

Andrew Dixon, director de comunicaciones del HHS, dijo a KFF Health News: “Este documento no distorsiona los estudios. Los datos subyacentes hablan por sí solos y plantean preocupaciones legítimas de seguridad. El HHS no ignorará esa evidencia ni la minimizará. Seguiremos los datos y la ciencia”.

El HHS no respondió al pedido de identificar al autor del documento.

Uno de los estudios citados en el documento del HHS está siendo investigado por su editor debido a “posibles problemas con la metodología y las conclusiones de la investigación, así como conflictos de intereses de los autores”, según un enlace en la página web del estudio.

“Esta es la estrategia de RFK Jr.”, declaró Sean O’Leary, presidente del Comité de Enfermedades Infecciosas de la Academia Americana de Pediatría y profesor adjunto de Pediatría en la Facultad de Medicina de la Universidad de Colorado. “O bien seleccionar lo que más le convenga de la buena Ciencia, o bien usar ciencia basura para respaldar su premisa: ha sido su estrategia durante 20 años”.

Otro estudio citado en el documento es una preimpresión que no ha sido revisada por otros científicos.

La bajada del título de este estudio advierte que “informa sobre nuevas investigaciones médicas que aún no se han evaluado y, por lo tanto, no deben utilizarse para orientar la práctica clínica”.

Aunque la preimpresión se publicó hace un año, todavía no ha aparecido en una revista científica con artículos revisados por colegas.

Las preguntas frecuentes que respaldan la decisión de Kennedy afirman que los “estudios luego de la comercialización” de las vacunas contra covid han identificado efectos adversos graves, como un mayor riesgo de miocarditis y pericarditis, afecciones en las que el músculo cardíaco o su membrana, el pericardio, sufren inflamación.

En redes sociales circularon afirmaciones falsas de que la preimpresión de 2024 mostraba miocarditis y pericarditis solo en personas vacunadas contra covid, y no en personas infectadas. Uno de los coautores del estudio rechazó públicamente esta idea, ya que el estudio no comparó los resultados entre las personas vacunadas y las infectadas. Además, este estudio se centró únicamente en niños y adolescentes.

El documento del HHS omitió numerosos estudios revisados por pares que han demostrado que el riesgo de miocarditis y pericarditis es mayor después de contraer covid, tanto para las personas vacunadas como para las no vacunadas, que el riesgo de las mismas complicaciones después de haberse solamente vacunado.

O’Leary afirmó que, si bien se reportaron algunos casos de miocarditis en adolescentes y hombres jóvenes vacunados al comienzo de la pandemia, las tasas disminuyeron después que las dos dosis iniciales de las vacunas contra covid se administraran de manera más espaciada.

Ahora, los adolescentes y adultos que no se han vacunado previamente reciben solo una dosis, y la miocarditis ya no aparece en los datos, afirmó O’Leary, refiriéndose al Vaccine Safety Datalink de los CDC. “En este momento, no hay un aumento del riesgo que podamos identificar”, afirmó.

En dos partes, el memorando del HHS hace afirmaciones que son refutadas activamente por los documentos que cita para respaldarlas. Ambos documentos respaldan la seguridad y eficacia de las vacunas contra covid para mujeres embarazadas.

El documento del HHS indica que otro texto que cita encontró “un aumento en la coagulación sanguínea placentaria en madres embarazadas que recibieron la vacuna”. Sin embargo, el documento no contiene ninguna referencia a coágulos sanguíneos placentarios ni a mujeres embarazadas.

“Lo he leído tres veces. Y no lo encuentro en ninguna parte”, dijo Turrentine, profesor de Obstetricia y Ginecología.

Si tuviera que calificar el documento del HHS, “le ponría una F”, dijo Turrentine. “Esto no está respaldado por nada y no utiliza evidencia médica”.

Si bien los miembros del Congreso que son médicos deberían poder verificar las referencias del documento, es posible que no se tomen el tiempo para hacerlo, dijo Neil Silverman, profesor de Obstetricia y Ginecología Clínica que dirige el Programa de Enfermedades Infecciosas en el Embarazo en la Facultad de Medicina David Geffen de la UCLA.

“Van a asumir que esto proviene de una agencia científica. Así que los están engañando, al igual que a todos los demás que tuvieron acceso a este documento”, agregó Silverman.

Las oficinas de tres republicanos en el Congreso que son médicos y prestan servicios en comités de salud de la Cámara de Representantes y el Senado, incluido el senador Bill Cassidy (republicano de Louisiana), no respondieron a las solicitudes de comentarios sobre si habían recibido el memorando.

Emily Druckman, directora de comunicaciones de la representante Kim Schrier (demócrata de Washington), médica del Comité de Energía y Comercio de la Cámara de Representantes, confirmó que la oficina de Schrier sí recibió una copia.

“El problema es que muchos legisladores, e incluso sus empleados, no tienen la experiencia necesaria para analizar esas referencias”, dijo O’Leary. “Pero esta… francamente, he visto propaganda antivacunas mucho mejor que esta”.

C.J. Young, subdirector de comunicaciones del Comité de Energía y Comercio de la Cámara de Representantes, confirmó que el personal demócrata del comité recibió el documento del HHS. Antes, documentos similares habrían ayudado a aclarar la justificación y el alcance de un cambio de política gubernamental, y se podría asumir que son científicamente precisos, expresó Young.

“Esto parece ser innovador. No creo que hayamos visto este nivel de descuido, falta de atención al detalle ni consideración del mérito científico durante la primera administración Trump”, agregó.

El 4 de junio, el representante Frank Pallone (demócrata de Nueva Jersey) y Schrier presentaron un proyecto de ley que exigiría a Kennedy adoptar las decisiones oficiales sobre vacunas del Comité Asesor sobre Prácticas de Inmunización (ACIP).

Young explicó que la motivación detrás del proyecto de ley fue la decisión de Kennedy de cambiar el calendario de vacunación contra covid sin la participación de los expertos en vacunas del ACIP, los que cumplen un papel clave en la definición de las políticas de los CDC sobre calendarios de vacunación y acceso.

Kennedy anunció el 9 de junio en X que destituiría a los 17 miembros del ACIP, alegando presuntos conflictos de intereses que no detalló, y que los reemplazaría. El 11 de junio anunció ocho de esos reemplazos, incluyendo a personas que habían criticado los mandatos de vacunación durante la pandemia de covid.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Kennedy’s HHS Sent Congress ‘Junk Science’ To Defend Vaccine Changes, Experts Say

Jackie Fortiér — Fri, 13 Jun 2025 09:00:00 +0000

A document the Department of Health and Human Services sent to lawmakers to support Secretary Robert F. Kennedy Jr.’s decision to change U.S. policy on covid vaccines cites scientific studies that are unpublished or under dispute and mischaracterizes others.

One health expert called the document “willful medical disinformation” about the safety of covid vaccines for children and pregnant women.

“It is so far out of left field that I find it insulting to our members of Congress that they would actually give them something like this. Congress members are relying on these agencies to provide them with valid information, and it’s just not there,” said Mark Turrentine, a professor of obstetrics and gynecology at Baylor College of Medicine.

Kennedy, who was an anti-vaccine activist before taking a role in the Trump administration, announced May 27 that the Centers for Disease Control and Prevention would no longer recommend covid vaccines for pregnant women or healthy children, bypassing the agency’s formal process for adjusting its vaccine schedules for adults and kids. The announcement, made on the social platform X, has been met with outrage by many pediatricians and scientists.

The HHS document meant to support Kennedy’s decision, obtained by KFF Health News, was sent to members of Congress who questioned the science and process behind his move, according to one federal official who asked not to be identified because he wasn’t authorized to discuss the matter publicly.

The document has not been posted on the HHS website, though it is the first detailed explanation of Kennedy’s announcement from the agency.

Titled “Covid Recommendation FAQ,” the document distorts some legitimate studies and cites others that are disputed and unpublished, medical experts say.

HHS director of communications Andrew Nixon told KFF Health News, “There is no distortion of the studies in this document. The underlying data speaks for itself, and it raises legitimate safety concerns. HHS will not ignore that evidence or downplay it. We will follow the data and the science.”

HHS did not respond to a request to name the author of the document.

One of the studies the HHS document cites is under investigation by its publisher regarding “potential issues with the research methodology and conclusions and author conflicts of interest,” according to a link on the study’s webpage.

“This is RFK Jr.’s playbook,” said Sean O’Leary, chair of the Committee on Infectious Diseases for the American Academy of Pediatrics and an assistant professor of pediatrics at the University of Colorado School of Medicine. “Either cherry-pick from good science or take junk science to support his premise — this has been his playbook for 20 years.”

Another study cited in the document is a preprint that has not been peer-reviewed. Under the study’s title is an alert that “it reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.” Though the preprint was made available a year ago, it has not been published in a peer-reviewed journal.

The FAQ supporting Kennedy’s decision claims that “post-marketing studies” of covid vaccines have identified “serious adverse effects, such as an increased risk of myocarditis and pericarditis” — conditions in which the heart’s muscle or its covering, the pericardium, suffer inflammation.

False claims that the 2024 preprint showed myocarditis and pericarditis only in people who received a covid vaccine, and not in people infected with covid, circulated on social media. One of the study’s co-authors publicly rejected that idea, because the study did not compare outcomes between people who were vaccinated and those infected with the covid virus. The study also focused only on children and adolescents. The HHS document omitted numerous other peer-reviewed studies that have shown that the risk of myocarditis and pericarditis is greater after contracting covid for both vaccinated and non-vaccinated people than the risk of the same complications after vaccination alone.

O’Leary said that while some cases of myocarditis were reported in vaccinated adolescent boys and young men early in the covid pandemic, the rates declined after the two initial doses of covid vaccines were spaced further apart.

Now, adolescents and adults who have not been previously vaccinated receive only one shot, and myocarditis no longer shows up in the data, O’Leary said, referring to the CDC’s Vaccine Safety Datalink. “There is no increased risk at this point that we can identify,” he said.

In two instances, the HHS memo makes claims that are actively refuted by the papers it cites to back them up. Both papers support the safety and effectiveness of covid vaccines for pregnant women.

The HHS document says that another paper it cites found “an increase in placental blood clotting in pregnant mothers who took the vaccine.” But the paper doesn’t contain any reference to placental blood clots or to pregnant women.

“I’ve now read it three times. And I cannot find that anywhere,” said Turrentine, the OB-GYN professor.

If he were grading the HHS document, “I would give this an ‘F,’” Turrentine said. “This is not supported by anything and it’s not using medical evidence.”

While members of Congress who are physicians should know to check references in the paper, they may not take the time to do so, said Neil Silverman, a professor of clinical obstetrics and gynecology who directs the Infectious Diseases in Pregnancy Program at the David Geffen School of Medicine at UCLA. “They’re going to assume this is coming from a scientific agency. So they are being hoodwinked along with everyone else who has had access to this document,” Silverman said.

The offices of three Republicans in Congress who are medical doctors serving on House and Senate committees focused on health, including Sen. Bill Cassidy (R-La.), did not respond to requests for comment about whether they received the memo. Emily Druckman, communications director for Rep. Kim Schrier (D-Wash.), a physician serving on the House Energy and Commerce Committee, confirmed that Schrier’s office did receive a copy of the document.

“The problem is a lot of legislators and even their staffers, they don’t have the expertise to be able to pick those references apart,” O’Leary said. “But this one — I’ve seen much better anti-vaccine propaganda than this, frankly.”

C.J. Young, deputy communications director for the House Energy and Commerce Committee, confirmed that Democratic staff members of the committee received the document from HHS. In the past, he said, similar documents would help clarify the justification and scope of an administration’s policy change and could be assumed to be scientifically accurate, Young said.

“This feels like it’s breaking new ground. I don’t think that we saw this level of sloppiness or inattention to detail or lack of consideration for scientific merit under the first Trump administration,” Young said.

On June 4, Rep. Frank Pallone (D-N.J.) and Schrier introduced a bill that would require Kennedy to adopt official vaccine decisions from the Advisory Committee on Immunization Practices, or ACIP. Young said the motivation behind the bill was Kennedy’s decision to change the covid vaccine schedule without the input of ACIP’s vaccine experts, who play a key role in setting CDC policies around vaccine schedules and access.

Kennedy announced June 9 on X that he would remove all 17 members of ACIP, citing alleged conflicts of interest he did not detail, and replace them. He announced eight replacements June 11, including people who had criticized vaccine mandates during the covid pandemic.

We’d like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what’s happening within the federal health bureaucracy. Please message KFF Health News on Signal at (415) 519-8778 or get in touch here.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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El secretario de Salud dice que las embarazadas no necesitan un refuerzo de covid. Qué dice la ciencia.

Jackie Fortiér — Mon, 02 Jun 2025 18:37:48 +0000

Estás embarazada, sana y recibes mensajes contradictorios: el secretario de Salud y Servicios Humanos, Robert F. Kennedy Jr., quien no es científico ni médico, afirma que no necesitas la vacuna contra covid-19, pero para expertos de los Centros para el Control y Prevención de Enfermedades (CDC) aún formas parte de un grupo de alto riesgo que debería recibir refuerzos.

La ciencia apoya las vacunas.

Las mujeres embarazadas que desarrollaron covid-19 fueron más proclives a enfermar gravemente y ser hospitalizadas que las mujeres no embarazadas de la misma edad y grupo demográfico, especialmente al inicio de la pandemia.

Un meta análisis de 435 estudios reveló que las embarazadas, con embarazos avanzados o no, que se infectaron con el virus que causa covid tuvieron más probabilidades de terminar en terapia intensiva, estar conectadas a un respirador mecánico, y morir, que aquellas no embarazadas con un perfil de salud similar. Esto ocurrió antes que las vacunas contra covid estuvieran disponibles.

Neil Silverman, profesor de obstetricia y ginecología clínica, y director del Programa de Enfermedades Infecciosas en el Embarazo de la Facultad de Medicina David Geffen de la UCLA, afirmó que aún observa más resultados adversos en pacientes embarazadas con la infección.

Silverman afirmó que el riesgo de covid-19 grave fluctuó con la aparición de nuevas variantes y la disponibilidad de vacunas, pero la amenaza sigue siendo significativa. “No importa lo que digan los políticos, la ciencia es la ciencia, y sabemos que, de manera objetiva, las pacientes embarazadas tienen un riesgo sustancialmente mayor de sufrir complicaciones”, agregó.

Una solicitud de comentarios sobre la literatura científica que respalda la vacunación contra la COVID-19 para mujeres embarazadas, enviada a la oficina de asuntos públicos del HHS, generó un correo electrónico sin firma, no relacionado con la pregunta. La oficina no respondió cuando se le pidió un comentario oficial.

Kennedy, activista antivacunas de larga trayectoria antes de unirse a la administración Trump, anunció el 27 de mayo que las vacunas contra covid-19 se eliminarían del calendario de vacunación de los CDC para mujeres embarazadas y niños sanos. Su anuncio, publicado en un video en la red social X, sorprendió a los funcionarios de los CDC y eludió los procesos científicos establecidos por la agencia para agregar y eliminar vacunas de sus calendarios recomendados, informó The Washington Post.

Aún se desconoce mucho sobre cómo afecta covid-19 a una persona embarazada. La relación fisiológica entre estas infecciones y las madres y los fetos en las diferentes etapas del embarazo es compleja, explicó Angela Rasmussen, viróloga de la Universidad de Saskatchewan. El mayor riesgo para las embarazadas se debe en parte a que el embarazo altera el sistema inmune, explicó.

“Existe una supresión inmunitaria natural para que el cuerpo de la madre no ataque al feto en desarrollo”, apuntó Rasmussen. “Si bien la madre aún tiene un sistema inmune funcional, no está funcionando a plena capacidad”.

Las embarazadas son más propensas a enfermarse y, como resultado, les resulta más difícil combatir cualquier infección.

Además de alterar el funcionamiento del sistema inmunitario, el embarazo también multiplica por cinco la probabilidad de que las mujeres presenten coágulos sanguíneos. Ese riesgo aumenta si desarrollan covid-19, afirmó Sallie Permar, directora de pediatría en Weill Cornell Medicine.

El virus que causa covid-19 puede afectar el endotelio vascular, las células especializadas que recubren los vasos sanguíneos y contribuyen al flujo sanguíneo, explicó Rasmussen.

En una persona sana, el endotelio ayuda a prevenir la formación de coágulos sanguíneos mediante la producción de sustancias químicas que alteran el sistema vascular para mantenerlo en funcionamiento. En una persona infectada con el virus que causa covid-19, el equilibrio se altera y la producción de esas moléculas se Vuelve disfuncional, lo que, según las investigaciones, puede provocar coágulos sanguíneos u otros trastornos de la sangre.

Permar señaló que estos coágulos pueden ser especialmente peligrosos tanto para las mujeres embarazadas como para los fetos. La inflamación y los coágulos sanguíneos en la placenta podrían estar relacionados con un mayor riesgo de muerte fetal, especialmente debido a ciertas variantes de covid, según estudios publicados en revistas médicas y por los CDC.

Cuando la placenta se inflama, es más difícil que la sangre que transporta oxígeno y nutrientes llegue al bebé en desarrollo, explicó Mary Prahl, profesora asociada de Pediatría en la Facultad de Medicina de la Universidad de California-San Francisco.

“Si algo interrumpe esas funciones (inflamación, coagulación o diferencias en el flujo sanguíneo), eso afectará seriamente el funcionamiento de la placenta y su capacidad para permitir que el feto crezca y se desarrolle adecuadamente”, enfatizó.

Es lógico que observemos los efectos de covid-19 en la placenta, aseveró Silverman. “La placenta no es más que un conjunto hiperespecializado de vasos sanguíneos, por lo que es como un polo magnético para el virus”.

Los vasos sanguíneos de la placenta son más pequeños y pueden coagularse con mayor facilidad que en el sistema circulatorio de la madre, explicó.

Permar dijo que datos recientes sugieren que las mujeres embarazadas con covid-19 aún tienen un mayor riesgo de complicaciones durante el embarazo, como preeclampsia, parto prematuro y aborto espontáneo, incluso con inmunidad previa por una infección o vacunación. El virus puede hacer que las mujeres terminen en el hospital por complicaciones durante el embarazo.

Prahl agregó que la conexión entre la muerte fetal intrauterina y covid podría estar cambiando, dada la inmunidad que muchas personas han desarrollado por la vacunación o una infección previa. Es un área en la que le gustaría que hubiera más investigación.

Ya hay evidencia sólida de que tanto las vacunas contra covid-19 basadas en ARNm como las que no lo están son seguras para las mujeres embarazadas.

Prahl fue coautora de un pequeño estudio preliminar que no encontró resultados adversos y demostró que la protección de anticuerpos persistía tanto para la madre como para el bebé después del nacimiento.

“Lo que aprendimos rápidamente es que las mujeres embarazadas buscan respuestas y muchas de ellas desean participar en la investigación”, afirmó. Estudios posteriores, incluyendo uno publicado en la revista Nature Medicine que muestra que recibir una dosis de refuerzo durante el embarazo reducía las hospitalizaciones de recién nacidos en los primeros cuatro meses de vida, respaldaron los hallazgos de su equipo.

Prahl espera que pronto haya más evidencia disponible que respalde los beneficios para las embarazadas de recibir los refuerzos.

“Puedo decir que, aunque sea entre bastidores, estoy viendo muchos de estos datos preliminares”, afirmó.

Prahl atribuye el retraso en parte que la administración Biden disminuye los esfuerzos para rastrear el virus. “Se retiró gran parte de la vigilancia de estos datos”, afirmó. La administración Trump está recortando aún más los fondos destinados a este rastreo.

Pero dado que las vacunas refuerzan el sistema inmune de la embarazada al aumentar los anticuerpos neutralizantes, la viróloga Rasmussen confía en que recibir una vacuna durante el embarazo reduce la probabilidad de que la mujer termine en el hospital si desarrolla covid.

“Protegerá a la embarazada de una enfermedad más grave”, afirmó.

Vacunarse contra covid-19 durante el embarazo también ayuda a proteger a los recién nacidos después del parto. Las mujeres embarazadas que se vacunan transmiten esa protección a sus bebés pequeños, quienes no pueden recibir sus propias vacunas hasta que tengan al menos 6 meses.

Según datos publicados por los CDC en 2024, casi el 90% de los bebés que tuvieron que ser hospitalizados por covid fueron de madres que no habían recibido la vacuna durante el embarazo.

Ya en abril de 2024, una investigación había demostrado que los bebés demasiado pequeños para ser vacunados tenían la tasa de hospitalización por covid más alta de cualquier grupo de edad, a excepción de las personas de 75 años o más.

La decisión de la administración Trump de eliminar la vacuna contra covid de la lista de vacunas recomendadas para embarazadas significa que las aseguradoras podrían dejar de cubrirla. Las mujeres embarazadas que quieran recibirla de todos modos podrían tener que pagar cientos de dólares de su propio bolsillo.

“No quiero ser ese médico que simplemente dice: ‘Bueno, es muy importante. Tienes que vacunarte, tú y tus hijos pase lo que pase, incluso si tienes que pagarlo de tu bolsillo’, porque cada uno tiene sus propias prioridades y preocupaciones presupuestarias, especialmente en la situación económica actual”, dijo Silverman. “No puedo decirle a una familia que la vacuna es más importante que alimentar a sus hijos”.

Pero él y sus colegas seguirán aconsejando a las mujeres embarazadas que intenten vacunarse de todas formas.

“Los recién nacidos serán completamente vulnerables a la exposición a covid-19”, afirmó. “Vacunar a las embarazadas para proteger a sus recién nacidos sigue siendo una razón válida para continuar con este esfuerzo”.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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