IMA Head of Medical and Scientific Affairs Dr. Ryan Cole joined The National News Desk to discuss the executive order reshaping federal childhood vaccine policy. The order sorts vaccines into three categories: those recommended for all children, those for certain high-risk groups, and those left to shared decision-making between families and their doctors. Dr. Cole describes the shift as a move away from one-size-fits-all policy toward an approach that weighs a child’s family history, immune status, and real-world disease risk.
The order sets direction, but the CDC still has to approve any change to the schedule pediatricians follow, and Dr. Cole expects many practices to keep the patterns they already have. What changes immediately is the conversation. He offers parents three questions to bring to the appointment: what is the actual disease risk for this child, what is the safety data for that specific shot or combination, and are there timing alternatives. A good doctor, he says, welcomes all three.
Check out these related resources from IMA below, followed by the full segment transcript.
Transcript
Angela Brown: The Trump administration is directing major changes to federal childhood vaccine policy. A new executive order divides vaccines into those recommended for all children, those for certain high-risk groups, and those left to shared decision-making between families and their doctors. It’s worth noting here that the order sets a new direction but cannot by itself rewrite the schedule that pediatricians actually follow. That has to go through the CDC. Joining us now is Dr. Ryan Cole, Head of Medical and Scientific Affairs and Senior Fellow in Pathology at the Independent Medical Alliance. Thank you so much for joining us. I know you’ve had a busy few weeks. Now, you’ve spent years looking at how public health policy translates into real-world care. When you look at this executive order, what stands out to you?
Dr. Ryan Cole: I think it’s a meaningful change in the sense that it’s going to shift things away from a one-size-fits-all policy to more shared decision-making, more opportunity to look at the actual risk of the child versus the environment in which they find themselves. This opens up the conversation again that not everybody needs everything. This universal thought that we’ve had in the past has been a little heavy-handed. So this changes in respect to both science and the reality that not all children are identical.
Angela Brown: Well, how is it going to look on the ground, the reality of that, because the CDC does have to make the final decision, right? So how will this executive order work, let’s say, in your doctor’s office?
Dr. Ryan Cole: Well, that’s a great question. I think what it will do is, to your point, it has to be approved by the CDC. A lot of doctors are still going to have the patterns they’ve had before, but I think what it gives the opportunity for is for the parent to start asking more questions. It’s now in the conversation. It’s in the zeitgeist. And not everyone is a statistical average.
So I think it opens up that better opportunity for informed consent, for the parent to be in charge, to ask the question: wait, why does my child need this versus a high-risk child in a high-risk setting? That may be a different equation altogether?
Angela Brown: Now, that’s a good point, because when you look at what’s happening here, one of the biggest shifts is moving away from treating every child’s vaccine recommendation the same way, and instead separating them into universal, high-risk, and shared decision-making categories. From a doctor’s perspective, how important is this to consider when you look at your own child’s individual health history?
Dr. Ryan Cole: Well, I think it’s essential, because you have to consider the family history, the immune status, the real-world disease risk. All these diseases don’t exist everywhere all at once. And so if I’m in a certain high-risk country, then the consideration would be far different than if you’re in a very clean sanitation environment and that child doesn’t need it. So it gives you an opportunity to look child by child, and in some cases, look, they may not need any of them. So this is where it brings things back to common sense.
Angela Brown: Now, some critics say that undermines decades of work by the CDC’s vaccine advisory committee, the independent expert panel that normally sets the vaccine schedule. How do you see it?
Dr. Ryan Cole: Well, a lot of their decisions in the past were, unfortunately, biased by influence, and they had conflicts of interest. A lot of decisions in the past weren’t based scientifically, but rather from a business point of view, or ways to combine things to improve compliance, but not based on science itself. So the demand in this executive order makes the CDC have to go back and look at the actual data and the actual science. I think this solidifies the science behind what’s being done.
Angela Brown: Well, the order calls for more space between vaccine visits in this case, but you have one former CDC official who says there’s no proven benefit to spacing them out. What do you think the science shows?
Dr. Ryan Cole: Well, the science in our peer nations in the Western world shows that they have better outcomes, less complications, and less long-term health problems in children that do have the injection schedule spaced out. So we have excellent evidence from peer nations, especially in Europe, that are very careful about how they space the shots and don’t do them all combined at once.
Angela Brown: Well, there’s also a broader push here for more safety research, greater transparency, and even stronger parental involvement in medical decisions. For parents trying to sort through what’s happening here, all of this information, what should they be asking their own doctors in order to truly understand what is best for their child, what the risks are, what the benefits are, what the options are?
Dr. Ryan Cole: That’s a great question, and it should be three simple questions. What’s the actual risk of this disease for my child? What’s the safety data for the specific shot or combination of shots? And is my child at risk or will they benefit from those? And are there timing options or alternate schedules, like you mentioned?
And so a good doctor will welcome those questions and walk through the evidence and not just recite a list. And that’s the essence of informed consent. It requires a conversation.
Angela Brown: And we want to tell our viewers this. For more independent medical information and resources, visit imahealth.org. Here it is right there on your screen. You can write it down. And thank you, Dr. Cole, for joining us this morning. He is the Head of Medical and Scientific Affairs and Senior Fellow in Pathology at the Independent Medical Alliance. Thanks once again for joining us.
Dr. Ryan Cole: Thanks, Angela.
