The Trump administration this week circumvented the process for how health agencies recommend who should receive COVID-19 vaccinations, and the top federal health official is no longer recommending that healthy children and pregnant women should get vaccinated.

The new guidance issued by Health and Human Service Secretary Robert F. Kennedy Jr. on Tuesday was sharply criticized by public health experts and has created confusion about what happens next.

A key committee that makes recommendations about vaccines is set to meet in June, but Kennedy, an anti-vaccine advocate, has already sidestepped the Advisory Committee on Immunization Practices with the new recommendations issued this week.

The ACIP — which includes independent, outside scientists — typically reviews evidence on vaccines and makes recommendations on how they are to be utilized.

But when Kennedy announced on the social media platform X that healthy children and pregnant women would no longer be recommended to receive COVID-19 vaccines, it went against what had been U.S. CDC guidance for years. The U.S. CDC has been urging vaccination for everyone 6 months and older.

The COVID-19 vaccines first became available to the public in 2021. Even after the worst stages of the pandemic had eased, the vaccines were typically being updated at least once a year.

So the U.S. CDC has for the entire time been recommending that people receive updated vaccines, typically in the fall and winter, coinciding with when people are getting their flu shots. The U.S. CDC also has said that people could get their updated COVID-19 shot and flu vaccine during their same appointment.

But Kennedy has promoted false anti-vaccine views, including the debunked claim that vaccines are linked to autism, and has also spread false conspiracy theories about COVID-19. Kennedy has hired other anti-vaccine activists to join him in the U.S. Department of Health and Human Services.

National media outlets are also reporting that the Food and Drug Administration is considering removing recommendations for future updated COVID-19 vaccines for everyone except those who are immune compromised and 65 and older.

The U.S. CDC changed its official guidance on Thursday evening, from saying healthy children “should” get the COVID-19 vaccine to they “may” get the vaccine, in consultation with a medical professional. The COVID-19 shot, as of Friday afternoon, was still listed among the recommended vaccines for children.

Some guidance for pregnant women was removed from the U.S. CDC website, but the website also said those who are pregnant “may” get the vaccine.

Should you still get an updated COVID-19 vaccine this fall? 

Dr. Puthiery Va, director of the Maine CDC, in a written statement to the Press Herald, said that “COVID-19 vaccines are safe and effective for children and adults” and that the vaccines help “prevent severe illness, hospitalization and death for those at risk.”

If you are pregnant, should you get the COVID-19 vaccine?

Yes, according to public health experts. Va said that “vaccinating while pregnant is safe, protects the pregnant parent, and protects the infant in the early months before they can get vaccinated.”

For pediatricians, what does all this mean?

Dr. Laura Blaisdell, a Portland pediatrician and immediate past president of the Maine chapter of the American Academy of Pediatrics, said “Kennedy’s comments reflect a dangerous circumventing of vaccine practices.”

“Vaccine science doesn’t change with new political appointees or administrations,” Blaisdell said.

She said as of now, she is able to administer the vaccine, and her patients have access to the vaccine. But she said the confusion sown by Health and Human Services will likely lead to fewer people getting the vaccine.

“I hope my patients will continue to have access this year,” Blaisdell said.

About 13% of children and 23% of adults in the U.S. got their updated COVID-19 vaccines in the fall and winter of 2024-25, according to The Associated Press. There are not state-by-state estimates, although historically Maine people have gotten vaccinated at higher rates than the U.S. average.

Will insurance continue to cover the COVID-19 vaccine for healthy children and pregnant women?

The Maine Bureau of Insurance did not have an immediate answer on Friday, and there was conflicting information in the national media about what the news means for insurance coverage.

The Associated Press reported that insurance will still have to cover the cost of the vaccine to patients, but USA Today reported that some patients may have to pay hundreds of dollars out-of-pocket for the COVID-19 vaccine depending on whether the patient was in a group the U.S. CDC was recommending to receive the vaccine, and their doctor’s recommendation.

Blaisdell said she’s not sure about the insurance implications.