The United States has taken a dramatic and contentious step away from global public health norms after its top health official unilaterally ended Covid-19 vaccine recommendations for healthy children and pregnant people, a move now shown to have been based on internal assessments that ignored vast swathes of scientific evidence.
The decision, announced by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. via social media in May 2025, has triggered lawsuits, seen major medical bodies walk out of government advisory meetings, and placed American policy at odds with international health guidance.
Internal memos missing ‘99% of the data’
Central to the controversy are two internal agency memos, dated 12 May 2025, which circulated before Kennedy’s announcement and have since been made public through a lawsuit filed by the American Academy of Pediatrics (AAP). Experts who have reviewed the documents describe them as fundamentally flawed.
“I was blown away by those memos,” said Kevin Ault, an obstetrician and gynaecologist who formerly served as an expert for government advisory working groups. He stated officials “missed 99% of the data on the topic” they analysed. Dr. Naima Joseph, a maternal foetal medicine specialist who served on a Covid vaccine working group, said the citations in the memos were “not evidence-based, but more like biased perspectives.”
One memo on pregnancy, authored by former FDA senior adviser Tracy Beth Høeg, contained just 12 citations and pointed out that initial clinical trials excluded pregnant women. It failed to note, however, that some participants became pregnant during trials with no adverse effects, and overlooked the existence of at least 258 subsequent studies showing the safety and effectiveness of Covid vaccination in pregnancy.
Data from the US Centers for Disease Control and Prevention (CDC) shows no increased risk of short- or long-term complications from vaccination for pregnant women or their babies. Pfizer has published data showing the vaccines are effective in pregnant women and reduce infection and hospitalisation risk in infants, with no evidence of reproductive toxicity.
Established benefits set aside
Public health experts stress that the risks of Covid-19 during pregnancy are significant, as the virus can infect the placenta, leading to poor foetal growth, prematurity, and stillbirth. Vaccination lowers the risk of severe complications, keeping pregnant people out of intensive care and preventing pre-term delivery.
The benefits extend to newborns. Babies under six months cannot be vaccinated and have high hospitalisation rates for Covid; maternal vaccination helps protect them. Dr. Joseph warned that ending the recommendation “puts pregnant women and their infants at higher risk for complications that are preventable.”
The memo targeting childhood vaccines, co-authored by NIH’s Matt Memoli and the FDA’s Sara Brenner, argued there was “no clear evidence” benefits outweighed risks for under-18s. This conclusion was reached despite citing a study acknowledging that Covid deaths in children fell significantly partly due to vaccination, and omitting other studies showing vaccination reduces long-term symptoms, myocarditis, and hospitalisation in children.
For the 2024-2025 season, CDC data estimated the vaccines were 76% effective against Covid-related emergency visits for children aged 9 months to 4 years, and 56% effective for those aged 5-17.
Advisory panel purged and reconstituted
Secretary Kennedy’s approach has extended beyond internal memos to a sweeping overhaul of the independent committee traditionally responsible for vaccine advice. In June 2025, he dismissed all 17 members of the CDC’s Advisory Committee on Immunization Practices (ACIP), replacing them with new appointees many of whom have histories of anti-vaccine rhetoric or lack vaccine expertise.
While Kennedy claimed the move was to eliminate industry influence, research from the USC Schaeffer Center indicates reported conflicts of interest on ACIP had been at historic lows for years. Public health experts have labelled the new committee a “hand-selected group of unqualified vaccine skeptics,” and meetings have reportedly been contentious, featuring “racial innuendo and anti-vaccine talking points.”
This reconstitution followed the exclusion of outside obstetric and paediatric experts from working group discussions. In response, the AAP ceased participating in ACIP meetings, and the American College of Obstetricians and Gynaecologists (ACOG) also withdrew, citing concerns about the “undermining of the committee’s scientific integrity.” Both organisations continue to recommend Covid-19 vaccination for pregnant individuals and routine childhood immunisation, directly contradicting the revised federal guidance.
A nation out of step
The US shift places it distinctly at odds with international health authorities. The World Health Organization recommends vaccination for pregnant women with underlying medical conditions. Dr. Joseph noted the US move is “not aligned with international recommendations” and puts the country “out of step with other nations.”
The lawsuits against HHS, including the AAP’s, argue the changes were arbitrary, capricious, and driven by bias rather than science. Critics, pointing to Kennedy’s long history of promoting debunked claims linking vaccines to autism, allege the policy is shaped by ideology and is undermining decades of established public health process and public trust.
The repercussions extend beyond public health messaging. Changes in federal recommendations can affect insurance coverage, potentially imposing new costs on patients and exacerbating health disparities. The definitive break from evidence-based practice, experts warn, sets a dangerous precedent for how future health policy may be formed.
