Health Secretary Robert F. Kennedy Jr.’s decision to stop recommending COVID-19 vaccines for healthy children and healthy pregnant women continued a pattern of breaking with scientific precedent and leaving big segments of the medical community angry and confused.

Why it matters: The announcement on Tuesday offered more indications that Kennedy could be going back on a pledge he made during his Senate confirmation hearings not to make vaccination more difficult or discourage people from taking vaccines.

It also left key questions unanswered. For example, federal health officials last week cited pregnancy as a risk factor for developing severe COVID-19 when they announced steps to limit the shots to seniors and people with conditions that put them at higher risk of serious infections.

• Some young children who have not yet had a COVID vaccine will now likely not be covered and be at greater risk of being exposed to possible long-term effects of the virus, said Molly O’Shea, a board-certified pediatrician and member of the American Academy of Pediatrics.
• Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said dialing back the vaccine recommendation was another example of “on the fly” policymaking without consultation or new information that’s become a hallmark of Kennedy’s tenure.

Driving the news: The decision came on the heels of last week’s overhaul of COVID-19 vaccine standards that will require drugmakers to conduct more studies on the safety and efficacy of updated boosters for healthy adults under age 65.

• In a video posted to social media on Tuesday, Kennedy blamed the Biden administration for encouraging healthy children to get updated COVID shots “despite the lack of any clinical data to support the repeat booster strategy in children.”
• “We’re now one step closer to realizing President Trump’s promise to make America healthy again,” Kennedy said.

Between the lines: The move has ramifications for insurance coverage, since health plans often look to Centers for Disease Control and Prevention expert recommendations to guide their payment decisions.

• “This decision could make it significantly harder for millions of Americans to access vaccines they want for themselves and their families,” Tina Tan, president of the Infectious Diseases Society of America, said in a statement.
• Dropping the recommendations also breaks with the precedent of letting federal panels of experts publicly debate scientific evidence and vote on immunization practices. The CDC’s Advisory Committee on Immunization Practices, or ACIP, typically makes vaccine recommendations to the agency director, a post that’s currently vacant.
• “It is concerning that such a significant policy change was made unilaterally outside an open, evidence-based process with no regard for the negative impact this will have on millions of Americans,” Tan said.

What’s next: ACIP is due to meet on June 25-27 to review COVID-19 and other vaccine data.