What to Know About the New Childhood Vaccine Schedule

The U.S. federal government slashed the number of diseases that all children are advised to be vaccinated against to 11 from 17.

The Centers for Disease Control and Prevention upended the childhood vaccine schedule on Monday, reducing the number of vaccines recommended for all children, a change condemned by pediatricians and public health experts.

The agency slashed the number of diseases that all children are advised to be vaccinated against to 11, down from 17. It now recommends vaccines against six diseases, including hepatitis B, influenza and meningitis, only for “high risk” children or under a framework called shared clinical decision making.

“It makes it harder, it makes it more confusing, and in the end, it’s likely to decrease vaccine uptake,” said Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security.

What vaccines are recommended, and no longer recommended, for all children?

The C.D.C. still recommends that all children get vaccinated against:

• Diphtheria, tetanus and whooping cough, which are combined into one vaccine
• Measles, mumps and rubella, also combined into one vaccine
• Polio
• Haemophilus influenzae type b
• Pneumococcal conjugate
• Chickenpox
• Human papillomavirus, but only one dose instead of multiple shots

The agency no longer recommends that all children receive vaccines against six illnesses, which can be deadly:

• Hepatitis A
• Hepatitis B
• Influenza
• Meningitis
• Respiratory syncytial virus
• Rotavirus

Instead, for most of these diseases, it recommends that “high risk” children get vaccinated and that parents of other children consult a health care provider about whether the vaccines are appropriate.

It is not entirely clear what classifies a child as high risk, although a fact sheet from the Department of Health and Human Services states that risk factors can include “unusual” exposure to the disease, underlying comorbidities and the risk of passing the disease to others.

Dr. Andrew D. Racine, the president of the American Academy of Pediatrics, said his organization would continue to recommend that all children be immunized against the diseases for which the C.D.C. weakened its recommendations.

What do doctors and researchers say?

Robert F. Kennedy Jr., the health secretary, has repeatedly railed against the childhood vaccine schedule, claiming that children receive too many shots. The Trump administration says the changes are meant to bring the United States in line with the vaccine schedules of other wealthy countries, like Denmark.

But trying to transfer the health policy of a small country with universal health care, like Denmark, to the United States — which is large and offers uneven access to medical care — is a “mistake that will cost lives,” said Dr. Robert Hopkins, medical director at the National Foundation for Infectious Diseases.

Experts in pediatrics, epidemiology and public health denounced the changes and urged parents to continue to get their children vaccinated in accordance with the previous schedule.

“The schedule doesn’t just emerge out of thin air,” said Jason Schwartz, an associate professor of health policy at the Yale School of Public Health. “Each of the vaccines on the schedule, there’s an enormous body of evidence for their safety and effectiveness and value.”

Dr. Sean O’Leary, the chair of the American Academy of Pediatrics’ committee on infectious diseases, said the changes threatened children’s lives.

“There’s no evidence that skipping or delaying certain vaccines is beneficial for U.S. children,” he said. “There’s no scientific reason to believe that Denmark’s vaccine recommendations are safer.”

Like other experts, Dr. O’Leary also condemned the way the changes were made. The C.D.C. and its parent agency, the Department of Health and Human Services, adopted the changes based on a directive from President Trump, circumventing the normal process for vaccine recommendations.

What impact are these changes likely to have?

Public health researchers and doctors said the move would almost certainly lead fewer children to get vaccinated and increase the incidence of childhood diseases.

Pediatricians have always discussed the vaccine schedule in detail with parents who had questions or concerns, Dr. O’Leary said. But moving several vaccines to the “shared clinical decision making” category — which refers to a decision in consultation with a medical provider — might suggest that the shots are dangerous, some experts worry.

“When you talk about clinical decision making, that is a code word for, ‘Well, this may not be safe for your child or be necessary for your child,’” said Dr. Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota.

That is likely to fuel even more doubt and vaccine hesitancy among parents, Dr. Osterholm said. The push for parents to discuss some vaccinations with doctors instead of routinely getting the shots will also place more stress on family medicine doctors and the health care system writ large, he added.

The result is likely to be more outbreaks of preventable diseases, as has already happened in the United States with measles and whooping cough. And if those diseases become more widespread, risks increase even for vaccinated children.

The implications may be clearer immediately for the flu, which is currently surging. Last flu season was one of the deadliest on record for children.

What does this mean for insurance coverage?

All vaccines that were previously recommended should continue to be covered at no cost to patients — at least for now.

AHIP, a national trade organization for health insurers, confirmed on Monday that it was standing by its decision last year to maintain coverage for all vaccines that the C.D.C. had recommended as of Sept. 1, 2025, through at least the end of 2026. Blue Cross Blue Shield, one of the country’s largest insurers, said it would continue to cover all vaccines recommended as of Jan. 1, 2025. UnitedHealthcare previously made the same commitment.

“The biggest implication here isn’t for insurance coverage,” said Jennifer Kates, senior vice president at KFF, a health research group.

Andrew Nixon, a representative for the health department, confirmed that there would be no change to what is covered by the federal Vaccines for Children Program, which provides free vaccines to roughly half of American children.

However, Dorit Reiss, a professor at UC Law San Francisco who focuses on vaccine law, said the C.D.C. had created a potential opening for insurers to try to deny coverage in the future. Under the Affordable Care Act, almost all insurers are required to cover routine vaccinations recommended by the C.D.C. But there is no settled precedent on whether the “shared clinical decision making” category counts for that requirement, she said.

Will the effect vary by state?

Most likely, yes. C.D.C. recommendations are not mandates. But state governments require certain vaccines for schoolchildren, and they have historically relied heavily on the C.D.C.’s judgment in deciding which ones to require. The changes could accelerate a split between Republican- and Democratic-led states.

Some states would also be more shielded than others from hypothetical changes in insurance coverage because they require insurers to cover vaccines recommended by the state health department, Professor Reiss said.

Two sets of Democratic-led states — one group on the West Coast and one in the Northeast — formed alliances last year to make vaccine recommendations and promote vaccine uptake independent of the Trump administration. Their response to Monday’s changes remains to be seen.

Where can I go for information?

For general information about vaccine ingredients and safety, visit the Vaccine Education Center, a program created in 2000 by the Children’s Hospital of Philadelphia to dispel misinformation and help people understand the science behind immunization.

The website is also verified as a credible source of vaccine information by the World Health Organization, which endorses only sites that meet its credibility and transparency standards.

Other independent physician groups, like the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, also publish their own vaccine guidelines, which began breaking from C.D.C. recommendations last year.

Reed Abelson contributed reporting.

Related Content