Major changes align U.S. policy with international peers; critics warn of risks to public health

Atlanta, Georgia — January 5, 2026

The Centers for Disease Control and Prevention announced a sweeping overhaul of the childhood immunization schedule Monday, reducing the number of vaccines universally recommended for all healthy children from 17 to 11 diseases, effective immediately.

The updated guidelines, approved by acting CDC Director Jim O’Neill, maintain routine recommendations for vaccines against measles, mumps, rubella (MMR), polio, pertussis (whooping cough), tetanus, diphtheria, Haemophilus influenzae type b (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella (chickenpox).

Vaccines for influenza, COVID-19, rotavirus, meningococcal disease, hepatitis A, hepatitis B, and respiratory syncytial virus (RSV) have been downgraded to categories requiring "shared clinical decision-making" with healthcare providers or limited to high-risk groups.

Health and Human Services Secretary Robert F. Kennedy Jr. described the changes as a response to a presidential memorandum from Donald Trump directing a review of U.S. practices compared to other developed nations. "After an exhaustive review of the evidence, we are aligning the U.S. childhood vaccine schedule with international consensus while strengthening transparency and informed consent," Kennedy said in a statement.

A 34-page HHS assessment, authored in part by officials including Tracy Beth Høeg and Martin Kulldorff, compared U.S. recommendations to 20 peer countries and concluded the U.S. was an "outlier" in the number of doses and diseases targeted. Many nations, such as Denmark, recommend fewer universal shots.

The changes bypassed the traditional process involving the CDC's Advisory Committee on Immunization Practices (ACIP) and public comment periods, drawing sharp criticism from public health experts and pediatric organizations.

The American Academy of Pediatrics called the move "unprecedented and dangerous," warning it could erode vaccination rates and increase outbreaks of preventable diseases. Epidemiologist Michael Osterholm echoed concerns, stating the lack of transparent data review and stakeholder input risks undermining trust and child health.

HHS officials emphasized that all vaccines previously recommended as of late 2025 remain fully covered by insurance without cost-sharing through at least the end of 2026, including Medicaid and Affordable Care Act plans. Private insurers have pledged to maintain coverage during this period.

Additional adjustments include recommending a single dose of HPV vaccine instead of two, and delaying certain early immunizations for non-high-risk infants.

The overhaul comes amid broader efforts by the Trump administration to address declining vaccination rates and public trust in health institutions following the COVID-19 pandemic. Officials said the focused schedule aims to prioritize "core" protections while allowing personalized decisions for others.

The CDC plans to monitor disease trends, vaccine uptake, and safety data closely, with education campaigns for parents and providers underway. State requirements for school entry, which often align with CDC recommendations, may vary in response.