Cleveland doctors ignore new federal guidelines reducing vaccine recommendations for kids

CLEVELAND, Ohio — Cleveland-area physicians, joining with health systems and caregivers across the country, are ignoring new federal guidelines that reduce the number of recommended vaccines for children.

That’s because the vaccines themselves — and decades of data showing they are safe and effective — have not changed, doctors said.

Describing the new recommendations as motivated by politics and not science, local physicians said they will stick with the previous U.S. policy. But the uncertainty is causing confusion and hesitancy surrounding vaccines.

“It’s OK to ignore it,” Dr. David Margolius, director of the Cleveland Department of Public Health, said about the Trump administration’s new pediatric vaccine schedule.

“My sense is that universally, every physician society, healthcare system, provider and physician we engage with — nobody has changed” how they administer vaccines, Margolius said.

Confusion over why the federal government thinks fewer childhood vaccines are necessary may make more families say no to all immunizations, said Dr. Candis Platt-Houston, director of general pediatrics at MetroHealth.

“Instead of fostering trust, (the changes) may foster confusion and distrust,” Platt-Houston said.

Pediatrician Dr. Deanna Barry, who is based in Bath, echoed that opinion.

“It’s not that families aren’t willing or even disagreeing with me,” said Barry.

“They’re confused, and it’s so understandable why they’re confused right now, because of what’s going on in the news,” Barry continued. “I almost feel like confusion is a bigger risk than if we just disagreed. So my job is to kind of cut through that confusion, and offer clarity.”

The U.S. Centers for Disease Control and Prevention on Jan. 5 cut the number of universally recommended childhood vaccines from 17 to 11. Nationally, medical experts slammed the move, saying it could lead to increased vaccine hesitation and spread of diseases.

The new guidance recommends that all children be immunized against polio, measles and mumps, but leaves flu and COVID-19 shots up to “shared clinical decision-making.”

The CDC still lists 11 diseases and vaccinations as as routine for all kids: diphtheria, tetanus, pertussis (whooping cough), polio, measles, mumps, rubella, Hib, pneumococcal disease, HPV, and varicella (chickenpox), Barry explained.

The six vaccines that the CDC moved out of the universal-for-all-kids category are rotavirus, influenza, COVID-19, hepatitis A, hepatitis B and meningococcal disease, Barry said.

Vaccines for diseases that are no longer recommended for all children will still be covered by federal health insurance programs and Affordable Care Act insurance plans, health experts said.

Health and Human Services Secretary Robert F. Kennedy Jr. said the changes were meant to restore trust in public health and bring this country’s recommendations closer to those in other developed nations.

Vaccination remains one of the most effective tools to prevent disease, reduce health inequities, and protect vulnerable populations, immunization experts say.

But immunization rates have been declining across the United States. The Pan American Health Organization, which tracks infectious disease in the Americas, is set to review the United States’ and Mexico’s measles elimination status this spring, due to the measles outbreaks that began in this country in early 2025.

Measles vaccination coverage among U.S. kindergartners has decreased from 95.2% during the 2019–2020 school year to 92.5% in the 2024–2025 school year. That’s under the threshold necessary for effective herd immunity, according to the CDC.

Education, not coercion

The new federal guidelines say “shared clinical decision-making” should determine whether children receive some immunizations. The term simply refers to conversations between families and their doctors — something physicians say they have always done.

“Clinicians provide clear, unbiased information, and patients are supported in asking questions and expressing their preferences and concerns,” said Dr. Melanie Golembiewski, chief medical officer for Neighborhood Family Practice, a Cleveland primary healthcare provider.

“When shared decision-making is done well, it strengthens trust, improves understanding, and ultimately supports higher-quality, more sustainable health outcomes,” Golembiewski said.

Barry has always had guided conversations with her patients, explaining how serious certain illnesses can be for infants and kids, and the risks if vaccines are skipped or delayed.

However, she doesn’t allow non-vaccinating families to join her practice, in order to protect children who are too young to be immunized.

MetroHealth’s Platt-Houston has worked with families who chose not to follow the recommended vaccine schedule. If parents only wanted two vaccines administered during a visit that usually involved several shots, Platt-Houston helped them decide which two vaccines the child should receive.

“I don’t see my role as trying to coerce them into getting the vaccines,” Platt-Houston said. “If you have that relationship with your families and they trust you, they’re going to take your advice when they’re trying to figure out these confusing times.”

The federal government’s new recommendations eliminate the hepatitis B shot as a universally recommended vaccine for newborns. Since the change was announced, most parents have still opted to give the hepatitis B vaccine to their babies, local pediatricians said.

Families who say no to the hepatitis B vaccine are usually choosing not to vaccinate at all, Platt-Houston said.

Illnesses that were dropped from the universal vaccination list are still circulating, and spread could increase if vaccination rates drop, health experts said.

The American Academy of Pediatrics called the changes “dangerous and unnecessary.” The American Medical Association also criticized the move.

“When families hear these recommendation changes and assume the vaccines suddenly are unsafe, we just have to explain that’s not true,” Barry said.