"Callous and Careless": Doctors Pushed to Vaccinate Hospitalized Children
This is the kind of thing people will never forget.
This article originally appeared on The Defender and was republished with permission.
Guest post by Jill Erzen
A series of reports from the American Academy of Pediatrics encourages doctors to offer vaccines during pediatric hospital stays and surgeries. Critics say the approach pressures vulnerable families and conflicts with long-standing guidance to defer vaccination during illness. A hospital stay “may not be the best time to inject them with toxins, adjuvants and antigens,” said Children’s Health Defense Senior Research Scientist Karl Jablonowski.
As federal health agencies revisit childhood vaccine schedules and emphasize shared clinical decision-making, the American Academy of Pediatrics (AAP) is encouraging hospitals to use pediatric admissions as a “unique opportunity” to vaccinate more children.
A series of AAP publications released in March and April promotes offering routine, catch-up and seasonal vaccines during children’s hospital stays and around surgeries and medical procedures.
But some physicians and vaccine safety advocates say the approach raises medical and ethical concerns, particularly for children already sick enough to require hospitalization.
A March 9 article in AAP News described “perioperative or periprocedural vaccination” as “a novel way to vaccinate children who are in a hospital environment for other reasons.”
Another March report in Hospital Pediatrics stated that “pediatric inpatient hospital admissions are opportunities for catch-up vaccination.”
The push comes as the AAP and the Centers for Disease Control and Prevention (CDC) have diverged on some vaccine recommendations, creating what an April AAP Publications report called “a more complex landscape for parental vaccine decision-making.”
Children’s Health Defense (CHD) Chief Scientific Officer Brian Hooker sharply criticized the AAP’s approach.
“The AAP’s callous and careless attitude regarding massive vaccination of anything that breathes at any time in infancy/childhood is dangerous,” Hooker said. “This is another instance where children come in for a procedure or hospitalization during, frankly, the worst time for an additional medical intervention, and the AAP wants them vaccinated.”
Hooker said he believes the policy “will lead to additional vaccine injuries and deaths.”
‘Honest reading of the data’ would give equal weight to parental concerns
The Hospital Pediatrics study surveyed 100 English- and Spanish-speaking parents of hospitalized children at a mid-Atlantic tertiary care center between February and August 2023 to assess attitudes toward inpatient vaccination.
Researchers reported that 66% of parents said they were comfortable with routine vaccination during hospitalization. Similar numbers said they were comfortable with flu vaccination (67%) and COVID-19 vaccination (61%) during a hospital stay.
However, nearly half of parents surveyed — 49% — cited concerns about the safety of vaccinating a child who was acutely ill. Another 33% worried about side effects.
The study’s authors wrote that even when vaccines are refused or not appropriate, “the hospital stay itself presents an excellent opportunity to educate parents about vaccine side effects and the role of vaccination in preventing future admissions.”
Critics of the approach said parents’ concerns should carry at least as much weight as parental acceptance.
Dr. Remington Nevin, an epidemiologist and former U.S. Army preventive medicine officer, said the AAP’s messaging emphasizes vaccine uptake while downplaying potential risks.
The survey reports “both that 66% of parents were comfortable with inpatient routine vaccination and that the most commonly cited concern (49%) was the safety of vaccinating an acutely ill child,” Nevin told The Defender.
“Both findings come from the same instrument, in the same sample, with the same generalizability limits, and they deserve equal weight in any honest reading of the data.”
CHD Senior Research Scientist Karl Jablonowski agreed, arguing that the study is misleading. He said:
“Parents comfortable administering routine vaccines represented 66%, yet 49% of parents cited concerns ‘around the safety of administering vaccines while a child is acutely ill,’ and 33% ‘about potential side effects,’ leaving 28% with ‘no concerns about inpatient vaccination.’ By my count, 28% are comfortable.”
‘It used to be common sense … to discourage vaccines when a child was sick’
Critics questioned whether hospitalization is an appropriate time for routine vaccination at all.
Dr. Paul Thomas said vaccinating hospitalized children contradicts what many pediatricians once considered standard practice.
“Data show that vaccine side effects and harm seem to be greater the more vaccines that are given, and it used to be common sense for pediatricians to discourage vaccines when a child was sick,” Thomas said. “It just makes sense not to further stimulate the immune system while it is dealing with something significant enough to require hospitalization.”
Nevin said the CDC’s current guidance, based on recommendations from its Advisory Committee on Immunization Practices (ACIP), allows vaccination during hospitalization only when a patient is not moderately or severely ill.
The same guidance recommends delaying vaccination in children with moderate or severe acute illness to avoid confusing vaccine reactions with symptoms of the underlying condition, he said.
“The clinical question is not whether inpatient vaccination is ever appropriate, but rather how often the inpatient population actually meets the threshold of ‘not moderately or severely ill’ at which point the best-practice recommendation applies,” he said.
Thomas similarly questioned whether hospitalized children are in a condition to handle additional immune stimulation.
“In my opinion, the only hospitalized child who could theoretically have a normal immune response would be one hospitalized for a broken bone,” Thomas said. “However, even in that situation … that is not an ideal time to add stress to the body.”
He said fevers following vaccination could also complicate hospital care.
“If a child in the hospital developed a high fever, this would trigger a work-up for infections,” Thomas said. “That could result in unnecessary procedures and antibiotics.”
Jablonowski agreed that hospitalization is the wrong time for additional immune-system challenges.
“Whatever landed the child in the hospital, it may not be the best time to inject them with the live viruses of measles, mumps, rubella, varicella and five different rotaviruses,” he said. “It may not be the best time to inject them with toxins, adjuvants and antigens to stimulate and dysregulate their immune system.”
AAP targeting ‘vulnerability of parents of hospitalized children’
Critics also questioned whether parents can freely consent to vaccination decisions while coping with a child’s hospitalization.
“This article is a demonstration of vaccine salesmanship — the kind that slithers,” Jablonowski said. “The targets — parents — can’t run away.”
He said parents caring for hospitalized children may feel especially vulnerable to messaging that frames vaccination as a way of “preventing future admissions.”
Nevin called “the integrity of informed consent” the central ethical issue, citing “the recognized vulnerability of parents of hospitalized children.”
He said parents in hospitals may feel pressure because they depend on the medical team caring for their child and may worry that refusing a vaccine recommendation could affect that relationship.
He argued that reframing parental hesitation “as a problem to be overcome through bedside ‘education’” starts from the wrong premise.
“Parents who decline or wish to defer inpatient vaccination are tracking the same precaution language that CDC publishes,” Nevin said. “They are exercising a long-recognized right to make medical decisions for their children.”
Nevin also warned that hospitals may add vaccines to discharge paperwork without extensive discussion, while exhausted parents may be asked to make decisions quickly and without the involvement of the child’s regular pediatrician.
“None of these concerns argues against making a clear recommendation when one is clinically appropriate,” Nevin said. “They argue for ensuring that a parent who hesitates or declines can do so without penalty, and that the decision is made under conditions in which a ‘no’ is just as easy to say as a ‘yes.’”
Thomas raised similar concerns, saying hospital physicians often lack the time or familiarity with families needed for informed consent discussions.
“Basically, hospital-based physicians would rarely have the time or inclination to prioritize individualized vaccine decisions, as this would require truly knowing the family and having the time to thoroughly go through the pros, cons and alternatives,” he said.
AAP messaging shift suggests hospitalization a tool to increase vaccine uptake
Critics also argued that the AAP’s current messaging marks a shift in emphasis from vaccination as an available option during hospitalization to hospitalization itself becoming a tool to increase vaccine uptake.
According to Nevin, inpatient vaccination itself is not new.
Nevin said the AAP has spent nearly 20 years encouraging hospitals and pediatricians to view hospitalization as a chance to vaccinate children who are behind on shots. He also said the CDC, reflecting ACIP’s recommendations, has long viewed hospitalization as an opportunity to vaccinate children who are stable enough to receive shots safely.
Yet “none of these documents instructs clinicians to vaccinate every hospitalized child as a default,” he said.
Actual inpatient vaccination rates have historically remained low, according to Nevin.
A 2022 analysis in Pediatrics that reviewed 1.5 million pediatric hospitalizations at 49 U.S. children’s hospitals found that fewer than 2% involved administration of routine childhood vaccines other than hepatitis B birth doses or flu shots, he said.
“What appears to be newer, and what makes the current AAP messaging notable, is the rhetorical framing,” Nevin said.
He pointed to recent AAP language describing inpatient vaccination as “an important and unique opportunity to increase vaccine uptake” and hospitalization itself as a chance to influence “receptive” parents through education.
“The current AAP framing — ‘don’t throw away your shot’ — is a rhetorical posture, not a change to the underlying clinical guidelines,” Nevin said. “It should not be allowed to substitute for the careful, child-by-child assessment those guidelines require.”
AAP’s financial ties to vaccine makers prove ‘clear conflicts of interest’
The push for inpatient vaccination is unfolding alongside broader legal and political fights over federal vaccine policy and the AAP’s role in shaping it.
In 2025, the AAP and other medical groups sued the U.S. Department of Health and Human Services and U.S. Health Secretary Robert F. Kennedy Jr. over changes to COVID-19 vaccine recommendations for children and pregnant women. The groups later expanded the lawsuit to challenge additional federal vaccine policy changes.
The Trump administration in April 2026 appealed a federal court ruling that blocked some of Kennedy’s changes to the childhood immunization schedule and a key federal vaccine advisory committee.
Meanwhile, CHD and five other plaintiffs filed a separate federal lawsuit in January, accusing the AAP of violating federal racketeering laws by allegedly making “false and fraudulent” claims about the safety of the CDC childhood immunization schedule while receiving funding from vaccine manufacturers.
Thomas said those conflicts undermine the organization’s credibility on vaccine policy.
“The AAP has consistently shown that it represents the interests of the pharmaceutical companies from which it receives significant funding,” he said. “They should no longer be considered an authority on vaccines as they have clear conflicts of interest.”
Nevin said parents and clinicians should keep the broader policy context in mind as the AAP promotes inpatient vaccination more aggressively.
“The appropriate venue for a routine vaccination decision, when a child is well enough for outpatient follow-up, is the medical home,” he said. That setting gives families more time to ask questions and make decisions “without the pressures of an active hospitalization.”
Related articles in The Defender
More Parents Seek Out ‘Vaccine-Friendly’ Pediatricians Who Will ‘Simply Answer Their Questions’
Federal Government Appeals Ruling in AAP Lawsuit that Struck Down RFK Jr.’s Vaccine Policies
Breaking: Children’s Health Defense Hits AAP With RICO Suit Over Fraudulent Vaccine Safety Claims
AAP Rejects New Hep B Recommendation, Claims Kids Will ‘Die’ if Newborns Don’t Get the Shot
Donate to Children’s Health Defense
