The nation’s top public health agency posted new recommendations that say healthy children and pregnant women may get COVID-19 vaccinations, removing stronger language that those groups should get the shots.

The change comes days after U.S. Health Secretary Robert F. Kennedy Jr. announced that COVID-19 vaccines will no longer be recommended for healthy children and pregnant women.

But the updated guidance on the Centers for Disease Control and Prevention’s (CDC) website sends a more nuanced message, saying shots “may” be given to those groups.

“The announcement from earlier this week sounded like CDC was going to fully withdraw any statement that could be construed as a recommendation for these vaccines in these populations,” said Jason Schwartz, a Yale University health policy researcher. “It’s not as bad as it could have been.”

Kennedy announced the coming changes in a 58-second video posted on the social media site X on Tuesday. No one from the CDC was in the video, and CDC officials have referred questions about the announcement to Kennedy and the U.S. Department of Health and Human Services.

On Thursday, the CDC updated its website. The agency said that shots may be given to children ages 6 months to 17 years who do not have moderate or severe problems with their immune systems. Instead of recommending the shots, the CDC now says parents may decide to get their children vaccinated in consultation with a doctor.

A subtle update to a CDC page on the adult immunization schedule indicated a similar change for the recommendation for pregnant women, excluding them from the routine recommendation made for other adults.

“The old COVID-19 vaccine recommendations for healthy children under 18 and for pregnant women have been removed from the CDC vaccine schedule,” a HHS spokesperson said in a statement. “The CDC and HHS encourage individuals to talk with their healthcare provider about any personal medical decision.”

That kind of recommendation, known as shared decision-making, still means health insurers must pay for the vaccinations, according to the CDC. However, experts say vaccination rates tend to be lower when health authorities use that language and doctors are less emphatic with patients about getting shots.

Childhood vaccination rates for COVID-19 are already low – just 13% of children and 23% of adults have received the 2024-25 COVID-19 vaccine, according to CDC data.

Talk of changing the recommendations has been brewing. As the COVID-19 pandemic has waned, experts have discussed the possibility of focusing vaccination efforts on people 65 and older – who are among those most as risk for death and hospitalization.

A CDC advisory panel is set to meet in June to make recommendations about the fall shots. Among its options are suggesting shots for high-risk groups but still giving lower-risk people the choice to get vaccinated. A committee work group has endorsed the idea.

But Kennedy, a leading anti-vaccine advocate before becoming health secretary, decided not to wait for the scientific panel’s review.

The new vaccine recommendation changes, their timing and the way they were announced have created confusion that can be “incredibly harmful to the success of vaccination programs,” Schwartz said.

“It would be understandable if the public is completely baffled in terms of what the federal government thinks and what the science suggests … about the evidence for the safety and value of these vaccines,” he added.

American Academy of Pediatrics President Dr. Susan Kressly said the organization is relieved that families wanting COVID-19 shots for their children will still be able to get them.

“However,” she added, “the deeply flawed process to reach the recommendation raises serious concerns about the stability of the nation’s immunization infrastructure and commitment by federal leaders to make sure families can access critical immunizations.”

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