CDC Children's vaccine schedule

It’s a recommendation, not a dictate. But there are sure to be lots of conversations about the updated recommended childhood vaccines schedule released this week by the U.S. Centers for Disease Control and Prevention. Why? The agency has added COVID-19 vaccinations to the list.

The CDC is not a mandating organization – its recommendations are just that. The Washington State Board of Health is tasked with deciding which shots are required for children to attend schools and daycares, along with any religious or medical exemptions from those rules.

“The updated CDC child immunization schedule provides the most current information for healthcare providers on the use of recommended vaccines to prevent serious childhood illnesses,” said King County Health Officer Dr. Jeff Duchin of Public Health – Seattle and King County.

2023 update released February 9

The new children’s vaccine schedule, which includes the addition of COVID primary series and booster doses, was published in the CDC’s Morbidity and Mortality Weekly Report. MMR (measles, mumps and rubella), flu and pneumococcal vaccines are also part of the kids recommended vaccine schedule.

Additional updates

Along with getting the COVID-19 vaccines, the CDC is now also recommending that children get an extra MMR immunization in the case of a mumps outbreak.

But it’s the addition of COVID immunization to the schedule for children as young as 6 months of age that caused a stir when the update was released on February 9.

Normalizing the COVID-19 vaccine

Dr. Neil Murthy, CDC medical epidemiologist and infectious disease specialist Dr. A. Patricia Wodi, authors of the report weekly report announcing the changes, said this statement to CNN:

“This means COVID-19 vaccine is now presented as any other routinely recommended vaccine and is no longer presented in a special “call out” box as in previous years. This, in a sense, helps ‘normalize’ this vaccine and sends a powerful message to both healthcare providers and the general public that everyone ages 6 months and older should stay up to date with recommended COVID-19 vaccines (including a booster, when eligible), just as they would with any other routinely recommended vaccine.”

Here is Seattle, Public Health’s Youth and Childhood Immunization Lead Andie Lyons says there are several reasons for the CDC’s new recommendations:

COVID remains a serious public health threat. “Unvaccinated individuals remain at much greater risk of hospitalization and death than those who are fully vaccinated. This is true across all age groups, including children,” Lyons says.

COVID is likely here for the long haul. “Although we’ve come a long way since the pandemic began, COVID remains prevalent and there’s no indication it’s going away,” Lyons says. “Incorporating COVID vaccinations into the routine immunization schedules protects individuals and also creates a layer of protection for those too young to be vaccinated, people with immunocompromising conditions, seniors, and others who can’t fully benefit from vaccination.”

Removes cost as a barrier for children. The CDC Advisory Committee on Immunization Practices voted to add COVID vaccine to the Vaccines for Children Program, a federally funded program that makes routinely recommended vaccines available at no cost to children who would otherwise face financial barriers to vaccination. “This means that even as federal funding for COVID vaccines winds down this year, uninsured, underinsured, and Medicaid-eligible children will continue to be able to get COVID vaccines at no cost,” Lyons says. “Here in Washington State, the benefit will be even more widespread: all children under age 19 will be able to access COVID vaccine at no cost, regardless of insurance status.”

Current COVID-19 cases among kids

The report “COVID-19 Cases Among Children and Youth in Washington” compiled by the Washington State Department of Health and released February 8, provides COVID-19 case rates from January 14, 2023 to January 28, 2023. According to report findings:

There were 1,894 cases (100.4 cases per 100,000 population) of COVID-19
case rates are continuing to increase
The highest case rates were in ESD 189 Washington, which covers public school districts from Edmonds north to Bellingham.
0-3 year-olds had the highest case rates (151.3 cases per 100,000 population)
there were 26 hospitalizations (1.4 hospitalizations per 100,000 population)
hospitalization rates are decreasing.
There have been a total of 12 deaths in all children and youth in Washington state reported January 1, 2021 to Jan 28, 2023

Vaccination rates for kids in King County

In King County only 21.6 percent of kids ages 0-4, 53.8 percent of those aged 5 to11, and 76.7 percent of 12 to 17-year-olds have completed the primary COVID-19 vaccine series. The bivalent booster has made it into the arms of far fewer kids. Only 23 percent of kids 4 and under, 31.9 percent of kids 5-11 and 28 percent of those 12-17 have received the newest boost, far lower than health officials hope to see.

Continuing a holistic approach

Lyons says the health department is continuing to take a holistic, integrated and collaborative approach to ensuring children and adolescents have received COVID-19 vaccines, including recommended boosters.

“In just a few months, the federal Emergency Declaration for COVID-19 will be lifted, but that doesn’t signal an end to COVID transmission,” Lyons says. “COVID will likely continue to circulate in any setting where people gather. Vaccination is the most powerful tool we have to prevent serious illness and death (and) integrating COVID-19 vaccines – including recommended boosters – into the routine childhood vaccine recommendations may support more King County kids getting vaccinated and boosted.”

Lessons learned

That, said Lyons, is critical to ensuring the health of not just kids in the region, but all people.

“While children have had lower death and hospitalization rates from COVID-19 compared to older adults, there are still children and teenagers who get seriously ill from COVID-19, and some who will die from the disease,” Lyons says. “COVID-19 vaccines are safe and very effective at preventing severe disease and death. As we move away from the ‘emergency’ phase of this pandemic, we have the opportunity to integrate many of the lessons this crisis taught us — one of which is the importance of staying up to date on immunizations for vaccine preventable diseases.”