A nurse prepares the Pfizer-BioNTech Covid-19 vaccine for children for distribution...

A nurse prepares the Pfizer-BioNTech Covid-19 vaccine for children for distribution in Montreal, Quebec, Nov. 24, 2021. Credit: AFP via Getty Images/ANDREJ IVANOV

On Tuesday morning, a Fox News contributor claimed on Twitter that the Centers for Disease Control and Prevention was set to mandate that schoolchildren get coronavirus vaccines. By Tuesday evening, the claim was being repeated by the nation's most popular cable news show, and had been amplified to millions more on social media online.

"The CDC is about to add the COVID vaccine to the childhood immunization schedule, which would make the vax mandatory for kids to attend school," host Tucker Carlson tweeted, sharing a segment from his show that has been viewed more than 1.5 million times online.

But the claim was wrong: The CDC cannot mandate that schoolchildren receive vaccines, a decision left up to states and jurisdictions, the agency and multiple public health officials said. The initial tweet by Nicole Saphier, a radiologist at Memorial Sloan Kettering Cancer Center, also misconstrued a planned meeting of CDC advisers, who voted Wednesday to add coronavirus vaccines to the federal Vaccines for Children program, a safety-net program that offers the shots at no cost. A separate meeting set for Thursday would address the agency's immunization schedule for children.

Public health experts say there is a legitimate debate over whether schoolchildren should be required to be vaccinated against coronavirus -- but the incendiary and erroneous claim by the Fox News personalities is the latest example of how critics can twist the facts about CDC and the coronavirus, potentially contributing to lower vaccination rates, fading trust in federal health officials and other consequences for public health.

"This is an all new level of dangerous misinformation," Jerome Adams, who served as U.S. Surgeon General during the Trump administration and as Indiana's top health official, wrote in a text message to The Washington Post. "It could both harm kids (by derailing the VFC program, which helps disadvantaged children access vaccines) and endanger health officials (due to angry misinformed parents). We need to be able to have honest conversations about pros and cons of vaccinating children, without resorting to blatant misinformation."

The episode also illustrates how health care misinformation can rapidly take hold, particularly around the coronavirus vaccine and fueled by many Americans' frustrations and confusion with pandemic policies. But public health experts often feel stymied in their response, uncertain when to engage with false claims spreading virally. And when officials do weigh in, they are often constrained by their more deliberate, sometimes bureaucratic processes.

"I've been doing vaccine work for more than two decades. And what I've seen, thanks to social media, misinformation and disinformation can spread so much more quickly now," said Julie Morita, executive vice president of the Robert Wood Johnson Foundation and Chicago's former public health commissioner. "There's no quick fix for this."

While some outspoken individuals, such as Kavita Patel, a physician and former Obama administration official, took to Twitter Tuesday evening criticizing the false claims and seeking to rebut them point-by-point, federal officials have been more muted in their response. In interviews on Tuesday evening, several administration officials said they had no plans to engage with the false claims, worried about amplifying them. But by Wednesday morning, the administration's calculation had changed, following Carlson's segment, amid mounting outrage toward federal health officials as vaccine critics seized on the wrongly reported claim that CDC was set to mandate the shots for schoolchildren.

"Thanks to @GovRonDeSantis, COVID mandates are NOT allowed in FL, NOT pushed into schools, & I continue to recommend against them for healthy kids," Joseph Ladapo, Florida's surgeon general, wrote on Twitter.

CDC took to Twitter around noon Wednesday, quoting Carlson's tweet and noting that its independent vaccine advisory committee would vote Thursday "on an updated childhood immunization schedule." The tweet also said: "States establish vaccine requirements for schoolchildren, not ACIP or CDC," and linked to a page that explains state vaccine requirements.

The CDC's response drew criticism from public health experts, who said the agency did not explicitly rebuff Carlson's claim or speak in plain language. Two administration officials who spoke on the condition of anonymity because they were not authorized to comment said they were uncomfortable that CDC -- by quoting Carlson's tweet -- had inadvertently amplified the falsehoods in his video.

Meanwhile, Saphier's original tweet was still posted Wednesday evening and had been retweeted more than 2,400 times as of 6 p.m. Asked about Saphier's tweet, Fox News pointed to a second tweet she sent, more than 9 hours later, that offered context that states did not always follow CDC's recommendations. That tweet had been retweeted 55 times. Saphier also appeared in a Fox News segment on Wednesday afternoon, clarifying her comments but reiterating her criticism that the children's vaccines needed further study.

Memorial Sloan Kettering said that Saphier did not speak for the institution.

In a statement Wednesday, CDC said the vaccine panel will be updating its 2023 childhood and adult immunization schedules, including whether to add approved or authorized coronavirus vaccines, as guidance to health care providers.

"It's important to note that there are no changes in COVID-19 vaccine policy, and this action would simply help streamline clinical guidance for health care providers by including all currently licensed, authorized and routinely recommended vaccines in one document," CDC spokesperson Kristen Nordlund said in an email.

The revised immunization schedules would not take effect until January 2023. Early next year is also when the federal government will no longer provide the vaccines free, federal health officials have said. The practical impact of including vaccines on the CDC's recommended immunization list means they are typically covered by insurance.

The updated schedule also "is the one place everyone can look to see exactly what all the recommendations are for all vaccines for all ages," said James Campbell, a professor of pediatrics at the University of Maryland School of Medicine and vice chair of the American Academy of Pediatrics committee on infectious diseases, who said the color-coded document is an essential tool for busy clinicians.

Public health experts noted that recommendations issued by the CDC's advisory panel do not necessarily translate to state-level mandates. For instance, few states have adopted the panel's 2006 recommendation that adolescents be vaccinated against Human Papillomavirus, or HPV.

CDC "has wanted to stay away" from vaccination mandates and consistently defers to local officials, said Jason Schwartz, a Yale University associate professor who specializes in vaccine policy.

Polling has found a significant partisan split in perceptions of the CDC and other agencies. Nearly three-quarters of Democrats say they rate officials at the CDC and other public health agencies positively, versus just one-third of Republicans who do so, according to a Pew Research poll conducted in September.

"This split is going to make it harder to get Republicans to take future Covid variant vaccines," said Robert Blendon, a longtime Harvard University pollster.

Health care leaders also said the episode underscored the challenge of informing the public about contentious public health issues. Drew Altman, head of the nonpartisan think tank Kaiser Family Foundation, said his organization was focusing on combating health care misinformation "as our next big thing."

"It just isn't enough for us to be in the business of putting out good information. We have to now also be in the business of countering misinformation and deliberate disinformation, as well," Altman sa

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