Providers fear illness uptick

Federal agencies for decades have issued widely respected recommendations for a series of childhood vaccines based on scientific evidence.

Pediatricians, county health departments and public schools were among those who followed the guidelines, and health insurance providers have routinely paid for the vaccines.

New guidance from the Centers for Disease Control and Prevention has frayed that safety net around children's health, however, by changing seven routine vaccinations to "shared clinical decision making" status. That classification can be interpreted by vaccine skeptics as validating their concerns about the shots that prevent flu, COVID 19 and hepatitis B, which is traditionally given to newborns.

Local providers are among the many physicians nationwide who are worried about an expected uptick in illness and the possibility that insurance companies could cut costs by rolling back coverage of vaccines that were previously federally recommended. A local nonprofit that provides shots to low-income families also worries it could see grant funding dry up.

Schools that are struggling to increase reading and math scores could see those numbers plummet if more children get sick from illnesses that were previously rare. Educators have long made it clear that student absences negatively affect learning.

Connie Heflin, executive director of Super Shot, said she is "absolutely" worried that rolling back federal recommendations will result in less support for the vaccines her organization provides with dire outcomes.

"The federal vaccine changes are going to have deadly consequences for children," she said.

A federal program provides the local nonprofit with free vaccines that are used to inoculate about half the children the clinic serves, she said. The future of that program could be in jeopardy.

"All of these changes affect low-income families the most," she said during a phone interview. "It really puts children at risk."

Clear evidence

Local health officials are so concerned about the new federal vaccine guidance that competing providers have collaborated on a public service announcement video that urges parent to trust their pediatricians. Heflin described the partnership as proof that the issue is critical.

The collaborating organizations are the Allen County Department of Health, Fort Wayne Pediatrics, IU Health Medical Group, Lutheran Health Physicians, Parkview Health, Pediatric Associates Inc. and Super Shot Inc.

The video, which was released to the public this week, "speaks with honesty, compassion and clarity about vaccines," Heflin said. "We hope this PSA encourages families to pause, ask questions and seek out reliable, evidence-based guidance from people they know and trust."

Super Shot provides in-school clinics where required immunizations are offered to students who are not up to date on vaccinations. Immunizations are also available at many doctors' offices and the county health department.

Dr. Tom Gutwein, Allen County health commissioner, made his support for childhood vaccines clear.

"We know vaccines are effective. They work," he said in a statement. "I don't want to speculate on what-ifs, but the fact is that immunizations changed the course of human history, protecting countless people from harmful - sometimes deadly - diseases. The evidence is clear."

Dollars and cents

The American Association of Pediatrics addresses the vaccines controversy on its website. "There's no new information about these vaccines that has raised concern about safety or how well they work. Pediatricians stay on top of the latest science related to vaccines, and the CDC's decision was not based on new science," the organization says.

The pediatrics association continues to promote the federal vaccine recommendations from before the CDC's recent changes. The Allen County Department of Health has chosen to follow the American Association of Pediatrics' recommendations.

The issue can be expressed in dollars and cents, Gutwein said, adding that it makes financial sense for insurance companies and employers to keep cover the cost despite the change in federal recommendations.

"Vaccination is also cost-effective and lowers the cost of health care," he said. "Beyond protecting yourself, family, friends and the community, vaccines have a profound, positive economic benefit. Vaccines lessen the fiscal burden of treating and paying for illnesses as well as for lost work days and school days."

Even if it makes sense, insurance coverage is not guaranteed, according to one expert in the health care insurance benefits field.

Paul Ford is the CEO of Quilt Benefits, a Kentucky firm that processes health insurance paperwork for employer clients.

"Any time the government mandates any health coverage or changes health standards, there are costs and additional risk introduced into a health plan both actuarially and practically, sometimes leading to exclusion of coverage," Ford said in a statement.

More than half of the American population is covered by health insurance sponsored by an employer, he said, adding that could result in vaccine coverage remaining unchanged.

"Employers are increasingly looking at self-funding their employer-sponsored health plans because in doing so, they are afforded the flexibility to cover otherwise excluded treatments and design programs that fit for their employees and their families," Ford said.

'Misleading claims'

Fort Wayne Community Schools, like other public school districts, requires students to receive the immunizations list adopted by the Indiana Department of Health, according to state law, said to Candis Deisler, FWCS director of Health and Wellness Services.

Required vaccines for Indiana public school students include those for measles, mumps, rubella, chicken pox, polio, diphtheria, tetanus and pertussis. The state health department's vaccine chart also lists some recommended immunizations, including those for flu and COVID-19. The only exception is for students whose parents or guardians submit a religious objection forms to their school, as provided by state law, Deisler said.

Homeschooled and private school students are also allowed to forgo routine childhood vaccinations. After vaccine hesitancy spread online during the coronavirus pandemic, more parents have opted out of getting their children immunized.

The trend escalated after vaccine skeptic Robert Kennedy Jr. was appointed U.S. secretary of health and promoted the debunked theory that childhood vaccines cause autism. The choices parents make regarding vaccines have significant consequences.

The South Carolina Department of Public Health, for example, was reporting 789 confirmed cases of measles centered around Spartanburg County as of Tuesday. The outbreak has been growing rapidly since October. Texas last year reported 990 confirmed cases last year, according to Texas Health and Human Services.

Deadly disease

At least 45 states - including Indiana and Ohio - experienced measles outbreaks last year, according to CDC data. Eight cases were diagnosed in Allen County in April. Although the outbreak was contained to people who had direct contact with each other, it could have been much worse. The measles is a highly contagious disease that can lead to severe health problems and even death, experts say.

Scientific skepticism - and the resulting falloff in vaccination rates - puts the public at risk, Dr. Richard Feldman, a former Indiana state health commissioner, said in an essay published in September. He wrote it in response to the measles outbreak happening at the time, calling it "the canary in the coal mine."

"With declining vaccination rates from growing vaccine opposition, hesitancy and complacency, it makes sense that the measles outbreak would be the first to emerge; measles is one of the most contagious viruses known," he wrote.

Feldman said that vaccines protect more than the recipient. They also protect the most vulnerable in society from being exposed to the virus.

The American Medical Association has attempted to dispel misinformation that has been spread by vaccine skeptics and led some well-meaning parents to request religious exceptions for their children.

The AMA issued a statement in November that said, in part, "An abundance of evidence from decades of scientific studies shows no link between vaccines and autism."

The statement went on to say: "The AMA is deeply concerned that perpetuating misleading claims on vaccines will lead to further confusion, distrust, and ultimately, dangerous consequences for individuals and public health."

In stark terms

FWCS won't change its vaccine requirements and recommendations for enrolled students unless the Indiana Department of Health changes its guidelines, Deisler said in an email.

Heflin of Super Shot is among those who worry that Indiana's Republican governor, Mike Braun, and supermajority in the Statehouse will force the state health department to adopt the vaccine recommendations issued by the Trump administration.

Deisler dodged a question asking whether FWCS officials are concerned that fewer students being vaccinated will lead to more illness and absences, ultimately leading to lower performance on state-required tests.

"The health and well-being of our students and school community are a priority," Deisler said. "FWCS relies on guidance from state public health authorities and complies with state law in all matters related to student health requirements. Families are encouraged to consult their health care providers regarding any individual questions or concerns about immunization schedules."

Gutwein addressed the question directly, however.

"Required immunizations for school protect children," he said. "Wholesale changes would lead only to risk: More sick kids, more lost time for teachers, students and families, etc."

The county's health commissioner expressed his position in stark terms.

Gutwein described vaccines as "one of the greatest public health achievements in history."

Vaccines have saved an estimated 154 million lives worldwide over the last 50 years, according to a World Health Organization study. Before vaccines became widely available, almost 1 in 5 children in the U.S. died before their fifth birthday.

At a glance

The American Academy of Pediatrics has posted answers to frequently asked questions about vaccine recommendations on its website: aap.org.

The academy continues to recommend that all children receive the five vaccines now classified by the Centers for Disease Control and Prevention as optional, based on risk and after consultation with the primary care provider.

The illnesses those immunizations protect against are:

Rotavirus: Before the rotavirus vaccine was available, about 50,000 children in the U.S. would end up in the hospital every year with severe dehydration from rotavirus.

RSV: A recent study shows that respiratory syncytial virus immunization reduced RSV-associated hospitalization rates in infants by up to half when compared to previous years.

Influenza: Tens of thousands of children are hospitalized with flu every year. In the U.S., 289 children died from flu during the 2024-25 flu season, one of the worst on record. The flu vaccine prevents the most serious forms of illness.

Meningococcal disease: Although rare, meningococcal disease, which can cause meningitis, a serious brain infection, is fatal in 10% to 15% of cases and can cause serious long-term health issues.

Hepatitis B: Children infected between 1 and 5 years old have up to a 50% chance of becoming chronically infected. About 25% of children who develop chronic hepatitis B infection will die from the disease.

Source: American Academy of Pediatrics