How Should We Interpret the Changes to the Childhood Vaccine Schedule?

Yesterday, the Department of Health and Human Services (HHS) announced it had accepted recommendations to update the nation’s childhood immunization schedule. With the updated framework, the Centers for Disease Control and Prevention (CDC) will move individual vaccines into 3 categories, which include the following:

Vaccines recommended for all children. Vaccines in this category will include those protecting against measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella.¹

Vaccines for specific high-risk groups. The immunizations recommended for this group are for respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B.¹

Vaccines offered through shared clinical decision-making. The immunizations in this category are for rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B.¹

The changes now recommend universal immunizations for 11 diseases downsizing immunization protection from the previous list of 18 diseases (including RSV, if mothers have not been vaccinated while pregnant). Some of these previously universal immunization recommendations such as influenza and COVID-19 are now under the shared clinical decision-making category.

In terms of justifying these changes, Jesse L. Goodman, MD, MPH, director of Center on Medical Product Access, Safety and Stewardship (COMPASS), Georgetown University, says there is no new information or scientific data to support the new immunization guidelines.

“The government presented a 34 page document written by 2 recent appointees of this administration to both the FDA and HHS that sort of cherry pick studies that may raise questions about this or that vaccine and raise issues about how adequately they've been studied, but essentially present no data whatsoever—that in my mind—changes the clear benefit of any of these vaccines to children and families,” Goodman said.

In the HHS announcement, federal officials used Denmark as an example in aligning that country’s vaccine schedule with the US. However, there was pushback to this idea from several professional medical societies. For example, the American Academy of Pediatrics and the National Foundation for Infectious Diseases both made statements criticizing the new recommendations. They point out that Denmark has a more homogenous population, is much smaller, and has universal healthcare.

In terms of the consequences of these new recommendations, Goodman is concerned this will lead to more uncertainty and mistrust about vaccines.

“I'm really concerned that essentially, what's being done is to sow confusion when somebody suddenly says something isn't recommended anymore. But if you want it, you can have it. The implication is there's no strong feeling or consensus that this helps your children, when in fact, as I said, pediatricians and the scientific community agree that these vaccines can prevent serious disease in children,” he said.

“People who are already potentially hearing things on social media or other places that raise questions about vaccines, that it may lead them to just say, you know, why do I need to bother I don't know anybody who's had meningitis, or I don't know anybody who's had hepatitis. There are people who get meningitis and get hepatitis, and these are serious infections that you don't want for your children or your family,” Goodman said.

In a previous life, Goodman worked as the Chief Scientist at FDA, and he notes the drastic differences in the way these federal health agencies operate today, especially the ACIP committee.

“Previously, decisions were made with a very deliberative process where those potential decisions were vetted with the public and with stakeholders through advisory committees and outside input was received, and feedback which often changed what we did, because the input was often helpful,” he said. “So there was a careful process that sought input from groups like the the American Academy of Pediatrics. Now the American Academy of Pediatrics and other professional groups have been banned from the working groups of the ACIP advisory committee that really used to help draft and derive the recommendations. We don't have the most experienced people, the advocates for patients, directly involved as we used to.”

Reference
1.Fact Sheet: CDC Childhood Immunization Recommendations. HHS. January 5, 2026. Accessed January 5, 2026.
https://www.hhs.gov/press-room/fact-sheet-cdc-childhood-immunization-recommendations.html