The Vaccine Intelligence Report: February 4-10

The Vaccine Intelligence Report—brought to you by Vaccinate Your Family—provides clear, fact-based updates on vaccine policy, research, and public health each week. This report is part of Viral Truths, a resource designed to cut through the noise, offering concise information to help navigate the evolving immunization landscape.

THIS WEEK AT A GLANCE

  • Iowa advanced legislation to eliminate K–12 school immunization requirements, a major policy break that public health experts warn could increase preventable outbreaks; similar rollback efforts are gaining traction in Florida and New Hampshire
  • States moved to preserve outbreak surveillance after the U.S. exited the WHO, with California, Illinois, and New York joining the WHO’s outbreak network amid concerns about weakened early-warning systems
  • Medical groups and lawmakers are pushing back on ACIP’s hepatitis B birth-dose shift: pediatricians reaffirmed the vaccine’s safety and effectiveness, and the GAO launched a review of the public health and economic impacts of ending the universal recommendation
  • Vaccine confidence remains strong despite eroding trust in federal guidance, with most Americans still viewing vaccines as essential and favoring insurance coverage for vaccines recommended by their doctor—even as confidence in the CDC declines
  • Measles continues to spread nationwide, and new data shed light on flu and Covid vaccination rates and disease risks among older adults
  • Medical organizations suing HHS over recent changes to federal vaccine guidance are seeking to pause ACIP proceedings, which would block the scheduled February 25-27 meeting

NEED TO KNOW

Iowa Moves to End School Immunization Requirements, as Other States Weigh Similar Legislation 

  • Last week (February 4) Iowa House lawmakers advanced legislation that would eliminate the state’s longstanding K-12 school-entry immunization requirements—marking a sharp break from the current policy requiring routine childhood immunizations for school attendance.
    • According to current Iowa law, K-12 students must be vaccinated against diphtheria, tetanus, pertussis, polio, measles, rubella, hepatitis B, varicella and meningococcal disease, unless they qualify for a medical or religious exemption.
  • If passed, the bill (HF2171) would strike relevant language from state code, effectively eliminating all current K-12 school immunization requirements in the state. As written, however, legislation would leave requirements for childcare and preschool settings in place.
    • Bill sponsor Rep. Zach Dieken (R-Granville), noted that the distinction was “an unintended oversight” that may be addressed later in the legislative process.
  • While supporters of the bill frame the move as an issue of parental choice and an opposition to childhood vaccine mandates, opponents—including pediatricians and public health experts—warn that removing school vaccine requirements would increase the risk of preventable disease outbreaks and undermine protections for children who cannot be vaccinated for medical reasons.
    • Notably, school entry immunization requirements are not—and have never been—compulsory medical “mandates.” Families are not forced to vaccinate; rather, vaccination is a condition for attending many public schools, with medical exemptions available in all states.
  • As the legislation has advanced out of a House committee, it will now move forward for additional consideration by the full Iowa House.
  • Iowa is not alone in considering a rollback of school immunization requirements. Lawmakers and state officials in several other states—including Florida and New Hampshire—are advancing or debating similar proposals.
    • Following Florida Surgeon General Dr. Joseph Ladapo’s public push last year to end all vaccine requirements, state lawmakers have advanced a bill (SB 1756) in early 2026 to expand non-medical exemptions for school-age children. The bill narrowly passed the State Senate Health Policy Committee in a 6-4 vote.
    • In New Hampshire, a February 4 hearing examined legislation that would repeal existing vaccine requirements for students attending public schools and childcare facilities and would prevent state and local governments from imposing future vaccine requirements.

States Join WHO Outbreak Network in Latest Split From Federal Government

  • California, Illinois, New York, and New York City have independently joined the World Health Organization’s (WHO) Global Outbreak Alert and Response Network (GOARN) following President Donald Trump’s official withdrawal from WHO in January.
    • GOARN is a global partnership of over 360 institutions that provides international public health resources to help prevent and control infectious disease outbreaks and public health emergencies.
  • The U.S. withdrawal from WHO means the country will have less access to data from other countries that can provide early warnings of outbreaks or potential pandemics. Experts have warned that the move will hamper the global response to infectious disease, including our ability to develop vaccines and medicines to combat new threats.
  • While the states’ steps may help ensure some continuity in surveillance and monitoring, concerns remain: “Infectious diseases know no boundaries,” stated New York City Acting Health Commissioner and Chief Medical Officer Michelle Morse.
  • The withdrawal and subsequent state actions have been the latest in a series of vaccine policy changes that have led to increased division between federal and state governments.

Medical Groups, Lawmakers Move to Reaffirm Hepatitis B Birth Dose Following ACIP Shift

  • Following the Advisory Committee on Immunization Practices’s (ACIP’s) decision to end the longstanding recommendation for universal hepatitis B vaccination at birth, medical organizations and lawmakers have taken steps to reaffirm the vaccine’s importance.
    • The Centers for Disease Control and Prevention (CDC) now recommends shared clinical decision-making (SCDM) for hepatitis B vaccination of infants born to women who test negative for the virus or whose status is unknown—meaning parents should consult with their healthcare provider and make an individual decision. The agency also suggests that the first dose not be administered before two months of age for those who do not receive the birth dose.
    • The American Academy of Pediatrics (AAP), however, continues to recommend that newborns receive the vaccine within 24 hours of birth, and AAP’s 2026 childhood immunization schedule has been endorsed by 12 major medical organizations.
    • Infant vaccination has resulted in a 99% reduction in hepatitis B infections among children.
  • Last week (February 5), AAP published a comprehensive review of hepatitis B vaccination at birth, finding “strong evidence for the safety and effectiveness of the birth dose, and no improved safety or effectiveness with a delayed first dose.”
    • The review also noted that ACIP’s decision was not based on “any new safety signals related to the hepatitis B vaccine nor evidence of improved protection from a delayed first dose.”
  • Also last week, the U.S. Government Accountability Office (GAO) confirmed it will review the public health, economic, and equity impacts of eliminating the universal hepatitis B birth-dose recommendation.
    • The review was requested by over 100 Representatives, led by Reps. Judy Chu (D-CA) and Dr. Kim Schrier (D-WA), who stated that the hepatitis B birth dose is “simple, safe, cost-effective, and lifesaving” and raised health and safety concerns around eliminating the universal recommendation.

Public Support for Vaccines Remains High Despite Declining Trust in Federal Guidance

  • New surveys of U.S. adults underscore that while trust in the CDC and federal vaccine guidance has significantly declined, overall confidence in vaccines remains high.
  • A KFF poll found that less than half of Americans (47%) now trust the CDC at least “a fair amount” to provide reliable vaccine information—down more than 10 points since April 2025 (59%), shortly after Robert F. Kennedy Jr. was confirmed as Secretary of Health and Human Services (HHS).
    • Among people who have heard of recent changes to the federal recommended childhood vaccine schedule (about half of those surveyed), the significant majority believe it will have a negative impact on children’s health (54% negative impact vs. 26% positive).
  • 9 in 10 voters still believe vaccines are essential for public health, according to a recent Partnership to Fight Infectious Disease (PFID) survey of more than 1,000 U.S. voters.
    • Additionally, 92% both agree that vaccines should be accessible and affordable and believe that policymakers should ensure Americans have health insurance coverage of vaccines recommended by their doctor.
  • Both KFF and PFID (pg. 3) found that significant majorities still have high confidence in key routine vaccines, including measles, mumps, rubella (MMR), polio, and hepatitis B.
  • The surveys (KFF and PFID, pg. 2) also show that doctors, including both family doctors and the AAP, remain the most trusted source of vaccine information.

OUTBREAK OUTLOOK

Measles Continues to Spread Nationwide as CMS Administrator Urges Vaccination

  • As of February 6, the U.S. has recorded 866 measles cases so far in 2026—more than four times the number of cases typically seen in an entire year, according to CDC data.
    • Prior to the then-record 2,276 cases recorded in 2025, the U.S. averaged about 180 cases annually since measles was declared eliminated in 2000.
  • Several states remain key areas to watch:
    • South Carolina’s ongoing upstate outbreak added 57 cases from February 3 to February 10, bringing total case numbers to 933 since last October.
      • Ongoing spread and heightened public health outreach efforts prompted a 72% rise in measles vaccination statewide, and a 162% jump in Spartanburg County compared to this time last year.
      • Amid continued transmission, a state senator introduced a bill that would end religious exemptions to school MMR immunization requirements.
    • Arizona and Utah have recorded 34 and 56 cases in 2026, respectively. Recent cases are concentrated in counties along the border between the two states, and are part of the outbreak that began in August 2025.
    • California officials have now reported two cases connected to a Disneyland visitor last month, adding to the state’s nine total cases this year.
    • Florida has confirmed 15 measles cases this year, though reporting lags by more than one week.
    • Maine confirmed its first measles case since 2019 in a patient who had recently traveled to a state with measles transmission.
    • Virginia reported its sixth measles case so far this year.
  • Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz on Sunday urged the public to get their MMR vaccine, adding that “there will never be a barrier” for Americans to receive the vaccine.
  • Last Wednesday (February 4), the Pan American Health Organization (PAHO) issued an epidemiological alert for measles in the Americas, urging countries to strengthen surveillance, vaccination, and outbreak response as regional transmission, including in the U.S., continues.

Respiratory Illness Activity Similar to Last Week; Data Shed Light on Flu and Covid Risk for Older Adults

  • CDC data for the week ending January 31 show that flu activity remains elevated, but similar to levels reported the previous week.
  • More broadly, national respiratory illness activity is moderate as of February 6.
    • RSV activity is elevated and growing in Western U.S. states, and hospitalizations remain elevated.
    • Covid activity is elevated in some areas and rising in some areas of the U.S., though hospitalizations continue to decline.
  • Recent reports suggest that fewer older adults are being vaccinated against flu, Covid, and pneumonia, despite the severity of these diseases for older populations.
    • A recent University of Michigan poll found that 42% of adults over age 50 have not received a flu or Covid vaccine in the past six months; nearly half reported not receiving a Covid vaccine in more than a year.
    • CDC data show flu and pneumonia vaccination rates among adults 65 and older in 2024 were lower compared to 2019 rates, with coverage in 2024 below pre-pandemic levels.
  • Older adults continue to bear the greatest burden of severe respiratory disease. Evidence shows that older adults face higher risks of respiratory diseases due to weakening immune systems and are more likely to have underlying health conditions, which can increase the severity of these conditions if contracted.
    • Adults ages 65 and older have the highest rates of flu-related hospitalizations this season, and the majority of respiratory illness deaths occur in this age group.
    • In North Carolina alone, 185 of the state’s 236 flu deaths this season occurred among people age 65 and older.

REALITY CHECK

These fact checks respond to several recent claims made by different groups and individuals.

CLAIM: Vaccine safety signals and adverse event data are routinely overlooked, ignored, or dismissed by regulators and public health agencies.

  • REALITY: U.S. vaccine safety monitoring is incredibly robust and specifically designed to detect potential safety signals quickly, investigate them thoroughly, and update guidance or product use swiftly when evidence points towards real risk.
  • The U.S. relies on multiple, overlapping vaccine safety systems designed to detect any rare or unexpected adverse events after vaccines are in widespread use. Two examples include:
    • The Vaccine Adverse Event Reporting System (VAERS) serves as a national early warning system to rapidly detect potential safety signals following vaccination.
    • The Vaccine Safety Datalink (VSD) is an active surveillance program that uses electronic health record data from millions of people to assess vaccine safety and detect adverse events in near real-time.
  • When a potential safety signal is identified, it is treated as a prompt for further scientific evaluation and leads to epidemiological studies, clinical review, and regulatory assessment to ensure the potential risk is thoroughly evaluated.
  • This process has repeatedly led to real-world action when genuine risks were identified. For example:
    • In the late 1990s, post-license surveillance identified an increased risk of an intussusception (a rare intestinal blockage condition) linked to the first available rotavirus vaccine. This led to ACIP withdrawing its recommendation and the vaccine was quickly removed from the market.
    • Through surveillance, rare cases of vaccine-related paralytic poliomyelitis were found to be linked to the oral polio vaccine, prompting the U.S. to transition to the inactivated polio vaccine by 2000—eliminating the risk while maintaining protection against polio.
    • During the Covid vaccine rollout, safety monitoring detected a rare risk of thrombosis with thrombocytopenia (a blood clotting condition that is uncommon but that can be serious or life-threatening) associated with the J&J vaccine, leading to a pause in use, updated warnings, and ultimately the removal of the vaccine from the U.S. market.
  • In other instances, early safety concerns—such as those related to flu vaccination during pregnancy and the use of thimerosal—were rigorously evaluated through large-scale studies and causal risk was ruled out by extensive evidence, leading to continued use.
  • In short, decades of surveillance and response demonstrate that vaccine safety signals are closely monitored, thoroughly investigated, and acted upon when risk is detected—reflecting a system built to minimize harm, prioritize patient safety, and continuously reassess guidance based on the full weight of real-world scientific evidence.

CLAIM: VAERS shows concerning safety signals related to Covid vaccines, which may be linked to childhood deaths.

  • REALITY: Claims that VAERS data demonstrate Covid vaccine safety problems—or link vaccines to pediatric deaths—misrepresent how the system works and are not supported by scientific evidence.
  • VAERS reports do not establish causation. It is a passive surveillance system designed to detect potential safety signals, not to determine whether a vaccine caused an adverse event.
    • As the CDC states, “A report to VAERS does not mean the vaccine caused the event.” Reports are accepted regardless of seriousness or plausibility, and anyone—including members of the public—may submit one.
  • VAERS data alone cannot be used to assess vaccine safety or deaths. While VAERS plays an important early-warning role by flagging unusual or unexpected patterns, its data are unverified and subject to reporting biases.
    • Anyone can submit a report to VAERS, including patients, family members, healthcare providers and vaccine manufacturers.
    • Determining whether a vaccine caused an outcome requires follow-up investigation, medical record review, and analysis using controlled epidemiologic studies—none of which VAERS performs on its own.
  • There is no evidence that Covid vaccines cause pediatric deaths. Neither the Food and Drug Administration (FDA), CDC, nor independent researchers have identified credible, peer-reviewed evidence linking Covid vaccination to deaths in children. Assertions to the contrary rely on unsubstantiated VAERS reports rather than validated scientific analyses.
  • Robust evidence shows that Covid vaccination reduces children’s risk of severe illness, hospitalization, and rare complications such as multisystem inflammatory syndrome in children (MIS-C), which occurs only after infection.
    • Pediatric and public health experts consistently conclude that, for children in eligible age groups, the benefits of vaccination far outweigh potential risks.
  • Covid infection—not vaccination—has caused pediatric deaths. Covid itself has resulted in thousands of pediatric deaths in the U.S. since 2020 and continues to pose a risk of severe illness and death in children. Staying up to date with recommended vaccinations significantly reduces these risks.

WHAT TO WATCH

Medical Groups Ask Court to Freeze Vaccine Policy Changes as Litigation Proceeds (Feb. 13)

  • AAP and other leading medical organizations are suing HHS and CDC over changes to federal vaccine policy, and a hearing is scheduled in the District of Massachusetts for this Friday (February 13).
  • The groups have asked a federal judge to restore the recently changed recommended childhood immunization schedule to its April 2025 form and to pause ACIP proceedings while litigation is ongoing, which could impact the scheduled February meeting.
  • On February 6, several medical and public health organizations and over 100 experts filed an amicus brief in support of the plaintiffs (i.e., the medical organizations), alleging “Defendants’ actions will depress vaccination rates and cause increased vaccine-preventable outbreaks, preventable hospitalizations, and unnecessary deaths.”
    • The brief was filed by the Robert Wood Johnson Foundation, American Academy of Allergy, Asthma & Immunology (AAAAI), American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Network For Public Health Law, and 119 Deans, Chairs, and public health and health policy scholars.

Medical Societies to Brief Congress on Conflicting Vaccine Recommendations (Feb. 24)

  • To address these discrepancies, AAP will join the American College of Obstetricians and Gynecologists (ACOG), the Infectious Diseases Society of America (IDSA), and Vaccinate Your Family (VYF) for a congressional briefing to explain differences in recommendations.

Agenda for Upcoming ACIP Meeting (Feb. 25-27) Expected Soon

  • In the event the Massachusetts judge doesn’t block the upcoming ACIP meeting, it is scheduled for February 25-27, meaning a Federal Register Notice is expected by February 11.
    • This will mark the committee’s first meeting since recent federal actions altered several long-standing vaccine recommendations.
  • The agenda is not yet known, but ACIP Vice Chair Dr. Robert Malone has signaled that Covid vaccines may be a topic of discussion.
  • Kennedy and ACIP Chair Dr. Kirk Milhoan have also indicated that the committee’s focus has been reoriented to focus more on the potential harms of vaccination, with efficacy as “secondary,” which could change what future meetings look like.

Lawmakers Request Information on CDC-Funded Hepatitis B Vaccine Study

  • Democratic members of the House Energy & Commerce Committee sent a letter on Friday (February 6) to CDC Acting Director Jim O’Neill requesting further information on the controversial study of hepatitis B newborn vaccination in Guinea-Bissau.
    • The $1.6 million grant, awarded by the CDC to Danish researchers, has been highly criticized, with experts raising concerns about the award process, the researchers’ credibility, the study’s scientific rigor, and its ethical implications.
    • The study is currently suspended pending further review, according to country officials, who said it had not received proper ethical approval.
  • Lawmakers have requested that O’Neill clarify the trial’s status, provide documentation related to the study proposal, protocol, and award process, and answer questions regarding scientific and ethics concerns.

HHS Developing AI Tool on Vaccine Injury Claims

  • HHS is developing an internal generative AI tool designed to analyze reports submitted to VAERS and generate hypotheses about potential vaccine-related harms.
    • VAERS is intended as a hypothesis-generating system and does not establish causation, a limitation that experts say could be exacerbated by large language models prone to false positives.
  • The initiative follows broader efforts by Kennedy to overhaul vaccine safety monitoring and implement changes that could make it easier to sue over alleged vaccine injuries.
  • Although this tool—which has been in development since late 2023—has not yet been deployed, its outputs could be used to support policy decisions in the near term without sufficient scientific validation.

Vaccinate Your Family is a nonpartisan organization dedicated to protecting people of all ages from vaccine-preventable diseases. To learn more, visit us at: vaccinateyourfamily.org

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