(The Hill) Health Secretary Robert F. Kennedy Jr.’s decision to fire the Centers for Disease Control and Prevention’s entire vaccine board, even as childhood vaccination rates drop, is setting off alarm bells for the next school year. 

Health officials worry about the ramifications of Kennedy’s recent decisions and philosophy towards vaccines more generally as schools prepare for their first year with him at the helm of the nation’s health.  

Diseases that had been eradicated from the U.S. are returning, and experts have warned of the need for schools to be vigilant and prepare for outbreaks among their student body. 

So far this year, there have been nearly 1,200 cases of measles reported in 34 states, four times the total from all of last year. And the CDC says vaccine coverage among kindergarteners for measles, mumps and rubella is below the target 95% threshold. 

“I think schools are going to have to rely on state-level and national experts to help guide their policies. This means that the current CDC recommendations for school-based vaccinations are still the most reliable and evidence-based,” said Lawrence Gostin, a global health law professor at Georgetown University. 

“If the secretary changes the childhood vaccination schedule, and I think he is all but certain to do that soon, states should hold fast on the current recommendations and consult their own health departments for future guidance,” Gostin added. 

Kennedy replaced the 17-member Advisory Committee on Immunization Practices with eight new voting members, some of whom are known for spreading vaccine misinformation. Robert W. Malone, one of the new members, also promoted the use of hydroxychloroquine and ivermectin during the COVID-19 pandemic.

“A clean sweep is needed to re-establish public confidence in vaccine science,” Kennedy wrote.  

“The public must know that unbiased science—evaluated through a transparent process and insulated from conflicts of interest—guides the recommendations of our health agencies,” he added in a subsequent statement. 

After the initial measles outbreak in Texas, Kennedy made multiple appearances on Fox News where he downplayed the severity of the disease and gave questionable advice on treatments, including emphasizing the use of vitamin A.

Kennedy at first suggested natural immunity gained from having measles is more useful than the vaccine, though he later conceded the MMR shot is the “most effective way” to prevent the disease.

“The changes at ACIP … were not unexpected, but they are jarring,” said Josh Michaud, senior expert in U.S. and global vaccine policy for KFF, a health policy research and news organization. 

Michaud fears that the firings and Kennedy’s vaccine skepticism will have a negative “effect on parents who might have been on the fence about vaccinations or allow more space for policy-makers at the state and local level to change the rules about vaccinations.” 

Schools only have a few months to prepare, as a reversal in vaccination trends is unlikely to occur in the near future.

Research published this month by Johns Hopkins University in JAMA showed 1,600 counties nationwide have vaccination rates below 91%, missing the 95% mark for herd immunity.  

The only states that have seen an increase in county-level immunizations are California, Massachusetts, Connecticut and New York.  

“I believe that most, if not all, blue states will continue to have rigorous science-based rules for vaccinating children as a condition of school entry. But many red states will follow RFK. Jr.’s advice,” Gostin said. 

“In those states, parents should make sure that their children and family members are all up to date on currently recommended vaccinations. I don’t think they should be reluctant to send their children to school or to have them wear masks. That is overkill,” he added. “If they are fully vaccinated, children will be protected. If the child is immunocompromised, then extra precautions may be needed.” 

Schools will also need to review their policies on dealing with outbreaks and potentially look at past advice and not future federal guidance for how to handle vaccine recommendations. 

“I think it’s really for schools as they are thinking about their policies, and the policies that many of these school districts have had for many, many years, in terms of the vaccination schedules, in terms of requirements around vaccinations to really think about the importance of vaccinations for children and to follow the policies that have worked for many years,” said Neil Maniar, professor of public health practice at Northeastern University.  

Along with the rise in measles and growing “risk for other infectious diseases,” schools may also have to contend with “higher rates of the flu and RSV and other communicable diseases” than in years past, Maniar said.

“So we really want to make sure that schools are putting forth policies that are designed to really promote the health and well-being of children and their families and others in the community,” he added.