Board members reviewed recent federal adjustments to the recommended immunization schedule and expressed concern about the process and potential downstream effects for children and Medicaid populations.

Director Dr. Areola asked Dr. Madrona and other staff to clarify the federal changes. A presenter summarized that the Advisory Committee on Immunization Practices (ACIP) moved from a 17-dose universal childhood schedule to guidance that effectively trims recommended universal immunizations to 10 and makes some doses or vaccines population-specific. The presenter said CDC adopted a birth-dose-only hepatitis B approach "if a mom is not tested or tests positive for hepatitis B," and that other changes included adjustments to HPV dosing and the removal of rotavirus from the universal recommendation.

Dr. McDonald said the HHS/CDC press release and the request from the secretary created confusion because it appeared to bypass the standard, transparent evidence-review process. "The press release said that it was reviewed by NIH and FDA. That was not public. It was not transparent," he said, adding that the change will likely increase confusion among patients and providers.

Board members discussed coverage implications: representatives of insurer trade groups (AHIP) have said they will continue to cover vaccines on the prior schedule for the next year; Medicaid vaccination for children is administered through the Vaccines for Children program (VFC), which presenters said will continue to provide covered vaccines. But presenters warned that how long insurers and programs continue to cover the previously recommended vaccines remains uncertain.

The board said it will point residents to American Academy of Pediatrics guidance and continue monitoring federal and state developments. Members expressed particular concern about how schedule changes could affect VFC-dependent populations (for example, rotavirus coverage and childcare impacts).