He contemplated out loud the consequences of a potential decline in vaccination. “If we lose all herd immunity, does that then shift the balance in an adverse direction?” he speculated.
Backlash
In response, AMA Trustee Sandra Adamson Fryhofer criticized the question. “This isn’t just a theoretical issue—it’s a perilous regression,” she stated. “Vaccines have preserved millions of lives and nearly eradicated severe diseases like polio in the U.S. There’s no cure for polio. When vaccination rates drop, we see a resurgence of paralysis, lifelong disabilities, and fatalities. The science on this is conclusive.”
Fryhofer also targeted Milhoan’s ongoing stance that vaccination policy should shift from focusing on population health to prioritizing individual rights. She argued that stepping away from routine immunizations, which involve important patient-clinician conversations, “does not expand liberties—it amplifies suffering,” stressing that the relaxation of guidelines “will cost lives.”
Overall, Milhoan’s remarks seem to further undermine the importance of ACIP and federal vaccine guidelines within the medical community and state policies. As noted in a KFF policy brief, 27 states and Washington, DC, have declared they won’t adhere to the current CDC vaccine recommendations, which were dramatically revised recently without consulting ACIP. Instead, most states are defaulting to prior guidelines or recommendations from local sources or medical groups.
This past Monday, the American Academy of Pediatrics announced the updated vaccine schedule for 2026, which it presents as an alternative to the CDC’s version and has received strong support from pediatricians. In their announcement, the AAP highlighted that 12 other medical organizations have endorsed this schedule, including the AMA, the American Academy of Family Physicians, and others.
The AAP’s updated guidelines largely mirror last year’s schedule, yet diverge significantly from the CDC’s recommendations, which “depart from established medical evidence and no longer represent the best way to prevent childhood illnesses,” the AAP noted.
“The AAP will persist in providing recommendations for vaccinations grounded in science, prioritizing the health of infants, children, and adolescents across the country,” AAP President Andrew Racine stated in the announcement.
