2026年1月22日 上午10:09 UTC / 路透社
作者：Puyaan Singh 和 Sneha S K
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1月22日（路透社）——特朗普政府撤销了几十年的儿童常规流感和另外三种传染病疫苗接种指南，称这些疫苗的使用应由父母和医疗保健提供者决定。
这些变化是卫生部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）推动重塑美国疫苗政策的一部分，此举遭到主要医疗团体反对，且缺乏科学证据支持，此前于去年取消了儿童通用新冠和乙肝疫苗接种建议。
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领先的医疗机构和超过20个州卫生部门表示，他们将继续向美国儿童推荐这些疫苗，警告称从广泛使用转向不再推荐将导致更多感染、住院和死亡。以下是疾病控制与预防中心疫苗建议的变化情况：
轮状病毒
旧计划： 推荐婴儿常规接种口服液体疫苗，包括默克公司（MRK.N）的RotaTeq，在2、4和6个月时接种，或葛兰素史克公司（GSK.L）的Rotarix，在2和4个月时接种，首剂需在15周内完成。该系列接种需在8个月内完成。
新计划： 建议采用共同临床决策模式，即父母与医疗保健提供者协商是否为孩子接种疫苗。
采用时间及原因： 1998年，美国首个轮状病毒疫苗RotaShield（由惠氏公司研发，后被辉瑞公司收购）被推荐，但因可能导致致命性胃肠道副作用而迅速撤回。2006年美国开始推荐RotaTeq，2008年推荐Rotarix，当时研究显示这两种疫苗在预防严重胃肠炎方面安全性和有效性均较高。当时每年有5.5万至7万名儿童因轮状病毒住院，因此预防成为公共卫生优先事项。
美国表示，转向共同临床决策是为了与其他富裕国家保持一致。在欧洲，包括法国和德国在内的17个国家仍常规推荐接种该疫苗。
流感
旧计划： 建议6个月及以上人群常规接种流感疫苗，年幼儿童根据既往接种史和年龄适宜配方接种1或2剂。
新计划： 建议对普通人群采用共同临床决策模式，对高风险人群强烈推荐。
采用时间及原因： 2010年，CDC采用通用年度接种建议，以简化信息传达并扩大2009年H1N1流感大流行后的保护范围，取代了复杂的风险分层推荐。
最新疾病负担： CDC估计，截至2025年1月3日的2025-26流感季，美国成人和儿童中至少有1500万例流感感染、18万例住院和7400例死亡。公共卫生专家称，接种率低、假期旅行和错误信息是导致病例激增的原因。
美国称，这一变化是合理的，认为需要更强的证据支持通用接种，且国际上对此缺乏广泛共识。在欧洲，16个国家仍常规推荐接种流感疫苗。
脑膜炎球菌疾病
旧计划： 建议11-12岁儿童常规接种MCV4疫苗（由葛兰素史克等公司生产，商品名各异）以预防相关细菌引起的脑膜炎球菌疾病，并在16岁时加强接种。对于健康16-23岁人群，基于共同决策模式推荐MenB疫苗；对大学生等群居环境高风险人群常规接种。
脑膜炎球菌疾病由脑膜炎奈瑟菌引起，常表现为脑膜炎（脑和脊髓膜炎症）或败血症，通过呼吸道分泌物密切接触传播，即使经抗生素治疗，死亡率仍达10%-15%。
新计划： 建议基于共同临床决策模式，高风险人群仍需接种。
采用时间及原因： 1985年，CDC首次建议对高风险人群和暴发控制接种脑膜炎球菌疫苗。2005年开始推荐青少年常规接种MenACWY疫苗，2007年进一步扩大接种范围，因该病进展迅速、大学宿舍等场所暴发风险高、死亡率高。
最新疾病负担： CDC数据显示，2025年美国脑膜炎球菌疾病病例415例，较2024年的523例有所下降。
根据美国传染病学会期刊发表的研究，脑膜炎球菌疾病发病率从1998年的约0.92例/10万人降至2007年的约0.33例/10万人。
CDC称，基于这些低发病率和国际共识不足，取消MCV4常规接种。在欧洲，20个国家推荐接种MCV4或MenB疫苗中的一种或两种。
甲型肝炎
旧计划： 建议12个月至23个月的所有儿童接种两剂甲肝疫苗；对高风险人群（如前往流行区旅行者、吸毒者、慢性肝病患者）进行针对性补种。
新计划： 对高风险人群外，建议采用共同临床决策模式。
采用时间及原因： 2006年CDC开始推荐甲肝疫苗，研究表明儿童即使症状轻微或无症状也会传播病毒，而接种可减少社区暴发。
甲型肝炎通过受污染的食物或水或密切接触传播，可导致数周甚至数月的疲劳、恶心、黄疸、发热和腹痛。常规儿童接种使美国甲肝发病率到2006年降低约90%。
最新疾病负担： CDC称，2023年美国甲肝发病率为0.5例/10万人。
CDC表示，此前美国甲肝每年约2.1万例，儿童感染常见。在疫苗普及前，甲肝发病率为21,000例/年。
美国称，这一转变反映了国内发病率极低，且国际上缺乏对通用接种的共识。
欧洲仅少数国家常规推荐甲肝疫苗，而墨西哥（该病流行区）推荐接种。一项回顾性分析估计，2000-2019年美国甲肝平均发病率为14.7例/10万人。
报道：Puyaan Singh 和 Sneha S K 班加罗尔报道；编辑：Caroline Humer 和 Bill Berkrot
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Four US childhood vaccine recommendations: How have they changed?
January 22, 2026 10:09 AM UTC / Reuters
By Puyaan Singh and Sneha S K
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Item 1 of 2 The main campus of the Center for Disease Control and Prevention (CDC) in Atlanta, Georgia, U.S., August 27, 2025. REUTERS/Alyssa Pointer/File Photo
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Jan 22 (Reuters) – The Trump administration has rolled back decades-old guidance recommending routine childhood vaccination against influenza and three other infectious diseases, saying their use should instead be decided between parents and healthcare providers.
The changes, part of Health Secretary Robert F. Kennedy Jr.’s push to recast U.S. vaccine policy over objections of major medical groups and despite a lack of scientific evidence for the moves, follow last year’s removal of universal COVID‑19 and hepatitis B recommendations for children.
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Leading medical organizations and more than 20 state health departments have said they will continue to recommend these vaccines for U.S. children, warning that a shift from their widespread use will lead to more infections, hospitalizations and deaths. Here is how the Centers for Disease Control and Prevention vaccine recommendations have changed:
ROTAVIRUS
Old schedule: Recommended universal vaccination with oral liquid vaccines including Merck’s (MRK.N), opens new tab RotaTeq at 2, 4 and 6 months, or GSK’s (GSK.L), opens new tab Rotarix at 2 and 4 months, with the first dose due by 15 weeks. The series was to be completed by 8 months.
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New schedule: Recommends shared clinical-decision-making in which parents consult healthcare providers on whether the child should be inoculated.
When and why adopted: In 1998, the first U.S. rotavirus vaccine called RotaShield from Wyeth, later acquired by Pfizer (PFE.N), opens new tab, was recommended but soon withdrawn due to a potentially deadly gastrointestinal side effect. The U.S. began recommending RotaTeq in 2006 and Rotarix in 2008 after studies showed strong safety and efficacy at preventing severe gastroenteritis. At the time of the recommendations, there were 55,000 to 70,000 hospitalizations of children annually, making prevention a public‑health priority.
The U.S. said it was shifting to shared clinical-decision‑making to align with other similar wealthy countries. In Europe, 17 countries including France and Germany recommend the shot routinely.
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INFLUENZA
Old schedule: Recommended universal vaccination at ages six months and older, with one or two doses for young children depending on prior vaccination and age‑appropriate formulations.
New schedule: Recommends shared clinical-decision-making for the general population and strongly recommends for high-risk groups.
When and why adopted: CDC adopted universal annual vaccination in 2010 to simplify messaging and expand protection following the 2009 H1N1 flu pandemic, replacing complex risk-based recommendations.
Latest disease burden: The CDC estimates at least 15 million flu illnesses, 180,000 hospitalizations and 7,400 deaths through January 3 for the 2025–26 season among adults and children. Low vaccination rates, holiday travel, and misinformation are contributing to the spike, public health experts said.
The U.S. said the change was warranted, claiming it needed stronger evidence for its universal use and a lack of broad agreement internationally on the inoculations. In Europe, it is recommended in 16 countries.
MENINGOCOCCAL DISEASE
Old schedule: Recommended routine MCV4 vaccination – sold under various brand names by GSK (GSK.L), opens new tab and Sanofi (SASY.PA), opens new tab among others – to protect against meningococcal disease caused by related bacteria at ages 11 to 12 with a booster at 16.
Recommended MenB for meningococcal disease related to serogroup B under shared decision-making to healthy 16- to 23-year‑olds and routinely to high-risk groups, such as college students and others living in communal settings.
Meningococcal disease is caused by the Neisseria meningitidis bacterium and most often presents as meningitis, an inflammation of the membranes covering the brain and spinal cord, or as a bloodstream infection. It spreads through respiratory secretions during close contact and has a fatality rate of 10% to 15% even with antibiotic treatment.
New schedule: Recommends based on shared clinical-decision-making and for those in high-risk groups.
When and why adopted: In 1985, the CDC gave its first recommendation for vaccination for high‑risk groups and in outbreak control. It recommended routine adolescent MenACWY vaccination in 2005, expanding it in 2007, due to the disease’s rapid progression, outbreak risk in settings such as college dorms, and high fatality rates.
Latest disease burden: The CDC estimates 415 U.S. cases in 2025, down from 523 cases in 2024.
The incidence of meningococcal disease fell from around 0.92 cases per 100,000 people in 1998 to about 0.33 cases per 100,000 in 2007, according to a study published in an Infectious Diseases Society of America journal.
The CDC cited those low rates and lack of consensus internationally as the reason for dropping routine vaccination with MCV4. In Europe, 20 countries recommend either or both shots.
HEPATITIS A
Old schedule: Recommended two doses for all children aged 12 months to 23 months; and targeted catch-up vaccination for at-risk groups including travelers to regions of endemic disease, people who use drugs and those with chronic liver disease.
New schedule: Recommends shared clinical-decision-making except for groups at high-risk.
When and why adopted: The CDC began recommending the hep A shot in 2006 after studies showed children often transmit the virus despite mild or no symptoms, and that vaccination reduced community outbreaks.
Hepatitis A spreads through contaminated food or water or close contact and can cause weeks to months of fatigue, nausea, jaundice, fever, and abdominal pain. Routine childhood vaccination cut U.S. incidence by around 90% by 2006.
Latest disease burden: The CDC said there were 0.5 cases per 100,000 people reported in the U.S. in 2023.
Prior to the vaccine’s adoption, hepatitis A cases numbered around 21,000 annually, and infections were common among children, CDC said.
The U.S. said the shift reflects very low domestic incidence and limited peer‑nation consensus for universal vaccination.
Few European countries recommend it universally, while Mexico, where the disease is endemic, does. A retrospective analysis estimated an average 14.7 U.S. cases per 100,000 from 2000–2019.
Reporting by Puyaan Singh and Sneha S K in Bengaluru; Editing by Caroline Humer and Bill Berkrot
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