5 Fast Facts: America’s Changing Childhood Vaccine Schedule

January 08, 2026

The Trump administration announced sweeping changes to the U.S. childhood vaccine schedule this week, reducing the number of vaccines all children are advised to receive from 17 to 11.

The overhaul comes after a review of how other nations structure their childhood vaccination schedules and represents a significant shift from the nation’s top public health agency, federal health officials said.

Here are five things to know:

1. What’s changing?

The new guidance changes the vaccines that fall into three categories: immunization recommended for all children; for certain high-risk groups; and those that are recommended based on shared clinical decision-making.

The agency still recommends vaccination for all children against measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella (chickenpox).

But the CDC no longer recommends six vaccines universally: Hepatitis A, Hepatitis B, the flu, Meningitis, respiratory syncytial virus, and rotavirus.

The agency now recommends these vaccines be given to children who fall in the “high risk” category or after “shared clinical decision-making” with a health care provider.

Vaccines recommended through December 31, 2025 would still be covered without cost-sharing, federal officials said.

2. What’s the rationale for the changes?

During December, the Trump administration issued a memorandum ordering a review of the childhood immunization schedule, calling the U.S. a “high outlier in the number of vaccinations recommended for all children.”

The changes would put the U.S. on par with other nations like Denmark, which recommends 10 vaccinations, and Japan and Germany, which recommend vaccinations for 14 and 15 diseases, respectively.

3. Critical response

The nation’s leading advocacy group for pediatricians issued a strong response to the new vaccine guidance, criticizing the new approach. In a statement, the American Academy of Pediatrics said the recommendations were “based on a brief review of other countries’ practices and upend a deliberate scientific process.

“Today’s announcement by federal health officials to arbitrarily stop recommending numerous routine childhood immunizations is dangerous and unnecessary. The longstanding, evidence-based approach that has guided the U.S. immunization review and recommendation process remains the best way to keep children healthy and protect against health complications and hospitalizations.”

4. Officials look to national medical groups beyond CDC, FDA

The changes at the national level create a larger divide between the nation’s public health agencies and other national medical organizations. For many years, these groups were generally unified in guidance and recommendations.

Last year, in response to new federal vaccine recommendations, state officials made changes allowing for consideration of other national medical associations beyond the federal health agencies for vaccine guidance.

The Pennsylvania Department of Health issued guidance last year expanding the list of organizations Pennsylvanians and their doctors should consult for vaccine recommendations (American College of Obstetricians and Gynecologists, American Academy of Pediatrics, American Academy of Family Physicians).

The Pennsylvania Insurance Department also indicated it was working with payors to ensure previously recommended vaccines are covered. Pennsylvania also joined the Northeast Public Health Collaborative, which also will be considering its role in vaccine recommendations.

5. The Rise of Shared Clinical Decision-Making

The new guidance emphasizes the role of shared clinical decision-making, a process that puts the onus on health care provider and the patient or parent/guardian to make decisions together on vaccination.

Survey results released this week from the Annenberg Public Policy Center note that there are significant gaps in Americans' understanding of this process, with “more than 2 in 5 people incorrectly say shared decision-making means it’s up to an individual whether to consult with their health care provider before taking a vaccine about whether it would be a good idea.”

HAP continues to monitor the latest public health guidance and provide updates to members. Additional information about the change is available in this announcement and fact sheet.